An Independent Review Is Not Available in All the Following

An independent review is not available in all the following circumstances EXCEPT:

A) The employer's WC healthcare plan refuses to pay for a service the plan does not cover.
B) The employer's healthcare plan is not subject to the law related to the independent review organization (IRO) process.
C) The plan determines that the treatment was not medically necessary after treatment was received.
D) The employer's plan or its utilization review agent (URA) determines that an ongoing treatment is medically unnecessary.