In a recent noteworthy panel decision, the WCAB, denying the defendant's petition for removal, upheld the WCJ's order referring the applicant's request for pain management treatment to the independent medical review (IMR) process. In doing, so the WCAB upheld the WCJ's findings that the report of the secondary treating physician/pain management specialist constituted substantial evidence, that the secondary treating physician's report did not need to be incorporated into the primary treating physician's report, and that the defendant's utilization review was timely, when the secondary treating physician submitted the request for pain management treatment and detox program authorization on DWC Form PR-2, but did not include the Request for Authorization for Medical Treatment (RFA), DWC Form RFA.

While the WCAB did not find that the secondary treating physician's treatment request in this case was invalid based on his failure to submit the DWC Form RFA, the WCAB determined that the applicant could not challenge the defendant's utilization review based on timeliness when the secondary treating physician did not submit the proper form. The WCAB provided guidance to the parties, reminding them that under new 8 Cal. Code Reg. § 9792.6(b), all requests for treatment authorization submitted after 7/1/2013 must be accompanied by the DWC Form RFA...read more.