The workers' compensation reforms of late 2003 did two things that have seriously impacted the benefits of injured workers, the reforms eliminated vocational rehabiliation and instituted utilization review. Utilization review is being used by carriers to deny treatment. One claims adjuster recently posted in a workcompcentral forum (archived):

"As an adjuster, unless there are no objective findings for the procedure and or it seems unreasonable to me, the majority of times I refer something to a UR doctor, is when I want to deny something. Even if major surgery is indicated, I always generally refer but more to cover my rearend."

Fighting for medical treatment is one of the least satisfying and most difficult aspects of representing injured workers.