Workers’ Compensation · Primary-source case analysis

Bodam: Utilization Review Is Timely Only When the Decision Is Made and Communicated on Time

By Aneeta Mishra and Timothy Chan

Published August 25, 2026

Bodam v. San Bernardino County examined utilization review of a spinal-surgery request and the statutory deadlines for making and conveying the determination.

A timely internal decision alone was insufficient

The utilization-review process was not completed merely because the reviewer reached a conclusion before the deadline.

Communication was part of timeliness

The governing statute and regulations required the decision to be transmitted to the physician and parties within specified periods and by the required methods.

Untimeliness affected the dispute path

When utilization review was untimely, the WCAB could determine medical necessity rather than treating the dispute as committed exclusively to independent medical review.

The precedential weight and current law require care

Bodam is a significant panel decision, not binding en banc precedent. Amendments and later appellate or WCAB authority must be checked for the injury and treatment dates.

Key takeaways

• Calendar both the decision and communication deadlines.
• Preserve fax, mail, and electronic transmission proof.
• Identify the exact RFA receipt date and completeness.
• Check current statutes and later authority before selecting the remedy.