GQ Corner
Q. Is the Carrier required to provide utilization review (UR) contact information to an injured worker?
A. There is nothing in the Act or rules that specifically requires a Carrier to provide UR contact information to the Claimant, although Rule 102.4(f) does require Carrier to respond to questions from the Claimant within five (5) days of the request. There is no reason not to provide that information, especially since a copy of the URA determination letter is required to be sent to the Claimant.
The Claimant should be discouraged from reaching out to the URA physician if they receive an adverse determination. Rather, in that event Claimant or their doctor have the opportunity to file a request for reconsideration, which will result in the appointment of a second URA physician.
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