What happens after a UR decision is issued?

The UR reviewer issues a written decision confirming whether the treatment was reasonable and necessary. If the reviewer approves the treatment, the insurer must pay the bill. If the reviewer does not approve it, the carrier may deny payment. UR decisions can later be challenged before the Industrial Accident Board.

Source File: Part E Shoulder for Publication
Law Reference: 19 Del. C. §2322F(j)