Find the Right California Workers' Comp Form
Throughout the course of any Workers’ Compensation case, an injured worker will receive a wide variety of forms, regarding everything from medical treatment to financial benefits. It is extremely important to read the forms carefully, and contact an attorney to confirm what action, if any, needs to be taken. Keep in mind that many of these forms include strict timelines that must be met.
Independent Medical Review (IMR) ApplicationDownload Form
It is required that this form be filled out, and sent to the injured worker with a Utilization Review denial letter. If an injured wishes to appeal a denial of medical treatment, then this form must be submitted within 30 days of the date of the utilization review denial letter.
The injured worker, their doctor, or their attorney can submit this Application. The administrative director (AD) designated a company entitled Maximus to conduct all of the Independent Medical Review (IMR).