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The IMR Appeals Process

The Law Office of Robert E. Wood Nov. 17, 2023

At The Law Office of Robert E. Wood, we're committed to helping injured employees seek security through workers' compensation benefits. One component that often comes into play is the Independent Medical Review (IMR) appeals process. This critical process provides an avenue for challenging a denied claim and pursuing the medical and financial assistance you deserve. In this blog post, we'll dive deep into the IMR Appeals Process, outlining each step, and explaining how our dedicated team can assist you along the way. 

If you’re ready to speak with a workers’ comp lawyer about your case, get in touch with us today. Call our firm in Oakdale, California, to arrange a free initial consultation. We’ll be happy to clarify any questions or concerns.  

The IMR Appeals Process

The IMR Appeals Process is a multi-stage journey designed to scrutinize and potentially overturn a denied workers' compensation claim. It's not a straightforward path, but with our guidance, we can navigate it together. 

Internal Appeals 

The first step in challenging a denied workers' compensation claim is initiating an internal appeal. This process involves formally requesting that the decision be reevaluated by the claims administrator or insurance company that initially denied your claim. It's a critical first step, as it provides an opportunity for the decision makers to correct any errors or oversights in the initial review. 

While the thought of launching an appeal might seem daunting, rest assured that we're here to guide you every step of the way. Our attorney can help you compile the necessary documentation, including medical records and supporting evidence, and submit a comprehensive, well-prepared appeal request.  

External Review Request 

If the internal appeal doesn't yield the desired result, don't lose heart. That's where the external review request comes into play. This stage involves submitting a request for an independent review of the denied claim. Unlike the internal appeal, this review is conducted by an independent third party, separate from the insurance company or claims administrator. 

Requesting an external review can provide a fresh perspective on your case, free from any potential bias or preconceived notions. We'll assist you in initiating this request, submitting all the necessary documents, and presenting your case in the best possible light. 

Ultimately, both the internal appeal and external review request are opportunities to challenge, and potentially overturn a denied workers' compensation claim. They're essential steps in the IMR appeals process and provide valuable avenues for securing the medical and financial assistance you rightfully deserve.  

Request for IMR 

To kick-start the actual IMR appeals process, you must submit a formal request for an Independent Medical Review (IMR). This request will include all relevant medical records and supporting documentation. Our workers’ compensation attorney understands how crucial it is to present a comprehensive and persuasive case at this stage, and we're committed to helping you do just that. 

Selection of an Independent Review Organization (IRO) 

Once the request for IMR is received, an Independent Review Organization (IRO) is chosen to thoroughly review your case. The IRO is composed of independent medical professionals who have extensive experience with workers' compensation claims. We'll work closely with the IRO, providing all the information they need to conduct a fair and thorough review. 

Submission of Medical Records 

As part of this process, we'll submit all pertinent medical records and supporting documents to the chosen IRO. These records form the foundation for the independent medical experts' review. We understand the importance of presenting a comprehensive and coherent set of records, and we'll make sure no stone is left unturned. 

Review by Independent Medical Experts 

The selected independent medical experts will then carefully review the submitted medical records and evaluate your denied claim. They'll consider all relevant medical evidence and determine whether the denial was justified or if the claim should be approved. We'll stay in close contact with these experts throughout their review, addressing any queries they might have and providing additional information as necessary. 


Based on the review conducted by the independent medical experts, a final decision is made about your workers' compensation claim. This decision is binding and determines whether your claim will be approved or remain denied. Regardless of the decision, we'll be there to support you and discuss the next steps. 

What Happens With Newly Discovered Information 

Sometimes, new information may come to light during the IMR Appeals Process. This information could be pivotal in supporting your claim. If such information becomes available, it's crucial to notify the IRO promptly and provide them with the relevant documentation. The IRO will then determine if the new information warrants a reassessment of your case. We'll work closely with you to ensure that all relevant information is submitted and that your case receives a fair review. 

Time Frame for Final Review

The IMR Appeals Process adheres to a specific time frame for the final review and decision. According to California's workers' compensation laws, the IRO must issue a decision within 30 days of receiving the IMR request. This helps ensure that the process remains efficient and timely, allowing you to receive a resolution to your workers' compensation claim as quickly as possible.  

Legal Guidance You Can Trust

Navigating the IMR appeals process can be challenging, but you don't have to do it alone. At The Law Office of Robert E. Wood, we're here to guide you every step of the way, providing friendly, knowledgeable, and dedicated legal support. If you're facing a denied workers' compensation claim, don't hesitate to reach out to us. We're here to help. 

Contact our office in Oakland, California, to schedule a free consultation. We're proud to serve workers across the San Francisco Bay Area.