If an IW unreasonably fails or refuses to obtain medical treatment, what is one potential remedy?

• A. File a petition to suspend benefits
• B. Do nothing
• C. Consider imposing a monetary sanction
• D. Transfer the case to another reviewer

Answer: (D)

When an injured worker unreasonably refuses to obtain medical treatment, the plan can move the case to another reviewer. This gives the claim a fresh, independent medical perspective and helps ensure the treatment decision is evaluated anew without being blocked by the prior reviewer’s stance. Reassigning for review can quickly determine whether the proposed care remains medically necessary and appropriate, allowing the process to move forward and the employee’s benefits and care to stay aligned with medical reality. While other actions like suspending benefits or imposing sanctions can come into play in specific circumstances, transferring the case to a different reviewer directly addresses the blockage by obtaining a new professional assessment.