What is Utilization Review (UR)?

Utilization Review is a process that uses independent medical experts to decide whether treatment is reasonable, necessary, and related to the work injury. UR is used when the insurer questions treatment, especially when care falls outside the guidelines or when documentation is incomplete. UR helps resolve medical disputes quickly without going to a hearing.

Source File: WorkersComp FAQ 5-16-2025
Law Reference: 19 Del. C. §2322F(h)–(j); 19 Del. Admin. Code 1342