DWC issues notice of third 15-day public comment period for Utilization Review and related regulations

NEWSLINE

The Division of Workers' Compensation (DWC) has issued a third notice of public comment period beginning on October 2, 2025, for modifying the text of proposed amendments to the Utilization Review and related regulations. The affected regulations are Title 8, California Code of Regulations, sections 9785, 9792.6.1, 9792.7, 9792.9.4, 9792.9.5, 9792.9.7, 9792.9.10.2, 9792.10.8, and 9792.12.

Some of the changes proposed in the modified regulations include the following:

• Deletion of "secure" with respect to email communications as "encrypted" is sufficient.
• Amend to indicate that receipt of missing information, tests, or examination shall render an RFA complete.
• Addition of requirement that UR organizations retain files for 3 years following either the most recent UR decision for each injured employee or the date on which any appeal form the assessment of penalties is final, whichever is later. This is current law but was inadvertently removed from prior regulatory text versions in this rulemaking.
• Amendment clarifying that, for UR decisions that modify or deny a treatment request, the description regarding a claims administrators' internal UR appeals process, if any, must indicate inclusion of disputes over the necessity or availability of requested information. (This text was added to the original draft of the text but inadvertently not marked as such.)
• Amendment clarifying the definition of surgery as it pertains to being excluded from the 30-day exemption to prospective UR.
• Amendments to the IMR application instructions regarding IMR application deadlines.
• Amendments to reflect current costs for IMR.

DWC will consider all public comments. The 15-day notice of modification to the text of the proposed regulations, the text of the modified regulations, and the modified forms can be found on DWC's rulemaking page.

Written comments should be addressed to:
Maureen Gray, regulations coordinator
Department of Industrial Relations
Division of Workers' Compensation
1515 Clay Street, 18th floor
Oakland, CA 94612

The Division's contact person must receive all written comments concerning the proposed modification to the regulations no later than 11:59 p.m. on Friday, October 17, 2025. Written comments addressed to the contract person may be submitted by facsimile transmission (FAX) at (510) 286-0687. Written comments may also be sent electronically (via e-mail), using the following e-mail address: [email protected].