Labor Code Section 4610.6 addresses the process of Independent Medical Review (IMR) oversight of Utilization Review (UR) decisions and outlines several basis to overturn an IMR decision. Any injury worker is painfully aware of Utilization Review, a process wherein insurance carriers deny medical treatment with impunity. Litigation to hold UR physician reviewers liable for malpractice has unfortunately stalled in an unfavorable position. Further, IMR seems to be immune to further litigation regarding its merits as the Appeals Court has found the IMR process constitutional. However, one favorable case has issued of late. In Jocelyn Bowen vs. County of San Berdardino (ADJ156419 ) the WCAB, over the objection from the Administrative Director, found that an IMR Final Determination was defective because it was based upon a plainly erroneous fact that was not a matter of expert opinion. The attorney for the injured worker submitted several medical reports that were ignored by the IMR reviewer in upholding a UR denial of medication. The WCAB reasoned that the IMR reviewer is obligated to review the entire medical record and cannot pick and choose which documents to include. However, the IMR appeal was filed in 2016 based upon medical reports from 2015 and the WCAB decision finally issued in 2019, which means it took four years of litigation to get the insurance carrier to approve a prescription for Norco. That is the current state of California workers compensation.