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Medical Treatment Issues and Utilization Review

Medical treatment is one of the most regulated and scrutinized areas of workers’ compensation. This module explores how treatment decisions are made, approved, and challenged within California’s system. You’ll learn about the Medical Treatment Utilization Schedule (MTUS), utilization review (UR), and independent medical review (IMR), as well as how disputes are resolved.

Key Learning Outcomes

  • Understand the role of MTUS in defining appropriate care

  • Learn how utilization review and IMR function

  • Identify common treatment disputes and how to resolve them

  • Navigate timelines and documentation requirements

  • Improve outcomes through informed coordination with providers

Who Should Enroll

This course is designed for claims professionals, utilization review coordinators, medical management staff, and employer reps who oversee treatment plans or authorizations. It’s especially valuable for those responsible for ensuring medical compliance and defending treatment decisions.

Sullivan on Comp

The Claims Practitioner in Workers’ Compensation (CPWC) program is powered by Sullivan on Comp (SOC) and SOC Essentials—the most trusted resources in California workers’ compensation.

These expert materials deliver:

  • In-depth legal analysis

  • Practical, real-world claims guidance

  • Current updates on laws, regulations, and case law


With SOC integrated into this course, you’ll gain the legal insight and practical tools needed to handle California workers’ compensation claims with skill and confidence.

Topics Covered

This module outlines the structure and rules that guide WC medical treatment:

  • The Medical Treatment Utilization Schedule (MTUS)

  • Utilization review process and timelines

  • Independent medical review (IMR) overview

  • Disputing and defending treatment requests

  • Effective communication with providers and vendors

Why Professionals Trust This Course

This course is designed for professionals who are ready to build—or strengthen—a career in California workers’ compensation:

Updated for 2024 with real-world claims examples
Aligned with California DWC training requirements
Integrated with Sullivan on Comp for legal and practical clarity
Flexible, on-demand format for working professionals
Part of the full CPWC Certification path

CPWC09

On-Demand

Payment plans available.

Up-to-Date Content Developed with Industry Leaders

Upgrade to a Certification on Workers’ Comp

Students who chose certifications got:

Become a Workers' Compensation Expert

Ready to take the next step towards a rewarding career in the workers’ compensation industry? Look no further!

Connect with our experienced counselor to determine the best class or path for your goals.

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