Utilization review and pre certification services Forms for Sacramento
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FAQ
I request the Department to review my Independent Medical Review (IMR) Application/Complaint Form to determine if my complaint qualifies for an IMR or the Department's Complaint process.These records may also include non-medical records and any other information related to my case.
In California, all employers or insurance companies handling workers' compensation claims are required to have a utilization review (UR) program. A UR program allows an employer or insurance company to review a treatment request made by an injured worker's physician to determine if the treatment is medically necessary.
You can file an IMR by filling out an IMR Application/Complaint Form. It is available online at: in 13 languages, including English and Spanish. You can ask for the form by calling DMHC's Help Center at 1-888-466- 2219 or TDD at 1-877-688-9891.
How long is the IMR decision binding? The IMR decision is binding for one year. If IMR finds that you are not entitled to the treatment your doctor cannot ask for the same treatment again for one year, unless there is a new injury/issue.
What is IMR. California's workers' compensation system uses a process called independent medical review (IMR) to resolve disputes about the medical treatment of injured employees.