Legal Question in Workers Comp in California

That seems to be the prevailing opinion these days. For treatment recommendations, your PTP must submit a RFA, probably to be non-certified by UR, then off to IMR.

Good luck.

No treatment need be authorized until a treating physician (a treating doc from the Medical Provider Network only) issues both a report AND a new form the Request For Authorization RFA form.

The best way to make it happen is to take the AME Report to the MPN Doctor and insist the MPN Doctor write a RFA that matches what the AME recommended.

5 business days after the MPN doc delivers the RFA and supporting report to the adjuster, the procedure needs to be 'certified' (okayed) or non-certified (refused). If the non-certification is defective, you can to the WCAB Judge to show the defect and request the judge order the treatment because the non-certification was not timely and not per regulations, and skip the Independent Medical Review process.