Appeals by a Medical Provider for Medical Claims Denied by Workers Compensation
If a claim medical treatment to treat an injured worker is denied by the industrial carrier or self-insured employer, a medical provider may file an appeal to the Adjudication Division of the order issued by the Industrial Accidents Division following its informal dispute resolution process.
A completed Medical Provider Application for Hearing with required supporting documentation can be filed in person, by mail or by fax with the Division of Adjudication. Once a completed Application has been filed, it will be forwarded to the employer and the designated agent for the employer’s insurance carrier with an Order requiring a written Answer be filed within 30 days. Once an Answer has been filed, a hearing will be scheduled no sooner than 120 days from the date the Answer is filed. The Division conducts its hearings as formal hearings under the Utah Administrative Procedures Act.
Application for Hearing Forms
Adjudication Rules
Workers Compensation Act
Utah Administrative Procedures Act (Utah Code § 63b-46b-1 et seq.)
Industrial Accidents Informal Dispute Resolution Process (R612-2-4)