1. DWC

DWC - IMR Search

Case Search

(e.g. CM18-0000038)
(MM/DD/YYYY)
 
 
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Case and Treatment Request Search

 
 
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Search selections for specific services will appear here after searching for a category. 


CASE SEARCH

IMRO Case Number
The IMRO assigns a unique case number for each application. This is different than the “claim number” assigned to the workers’ compensation claim. The IMRO case number can be found on correspondence from Maximus Federal Services and on the Final Determination Letter. Do not use the injured worker’s claim number.

Date of Injury
This date refers to the date of injury of the claim for which the IMR is filed. Each IMR is directly related to one Workers’ Compensation claim.

Date of Utilization Review Denial
The issuance date of the Utilization Review report that denied or modified the request from the treating physician.

  • The IMR application must be filed within 30 days of the date of the UR determination.
  • A copy of the UR report must accompany the signed IMR application at time of filing.

Date IMR Application Received
This is the date that the IMRO received the IMR application. The database only includes applications for which a final decision was made.

Decision date
The date of issuance for the Final Determination. This correspondence is sent to the injured worker, their representative(s), and their treating physician.

IMRO Reviewer Board Specialty
This is the Board Certification of the IMRO medical reviewer who reviewed and made the final decision on the IMR case. The IMRO medical reviewer does not necessarily have the same Board Certification as the requesting physician, but is knowledgeable and qualified to review the requested treatment.

IMR Case Outcome
This describes the overall outcome of the IMR review at the IMR case level. A case may contain one or more treatment requests.

  • Uphold – None of the disputed items/services are medically necessary and appropriate.
  • Overturn – All of the disputes items/services are medically necessary and appropriate.
  • Partial Overturn – Some (but not all) of the disputes items/services are medically necessary and appropriate.

Search Results:
Click the Case Number to view the Final Determination Letter. Click the + sign next to the Case Number to see more details about the case. An IMR case may contain multiple treatment requests.

CASE AND TREATMENT REQUEST SEARCH

Use this section to search treatment requests by category. As these categories are still in development, accurate detail on treatment requests can be found in the Final Determination Letter.

Treatment Request Outcome

  • Uphold – The IMRO decided that the disputed service was not medically necessary and appropriate.
  • Overturn – The IMRO decided that the disputed service is medically necessary and appropriate.

Treatment Request Category
“Treatment request” refers to the medical treatment that was denied in UR and challenged through the IMR process. IMR cases have at least one treatment, or may have more than one. Treatment requests are classified into broad categories and subcategories; specific detail is found in the Final Determination Letter.



May 2021