What is the test for a physician to request a request for Utilization Review?

Utilization review (UR) is the statutorily defined process by which an employer reviews and approves, modifies, delays or denies a physician's request for authorization (RFA). ( 4610, subds. (a), (b).) "Under the UR process, a request for treatment cannot be denied by a claims adjustor and must be approved unless a clinician determines that the treatment is medically unnecessary." ( Stevens v. Workers' Comp. Appeals Bd. (2015) 241 Cal.App.4th 1074, 1081, 194 Cal.Rptr.3d 469.) This ensures that a physician, rather than a claims adjuster with no medical training, makes the

[35 Cal.App.5th 1081]