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Independent medical examinations will decrease by 2020



Requests for independent medical review of labor disputes in California declined by 2020, but nearly 94% of applications were considered eligible for review, the highest percentage since the IMR was launched, according to research released Wednesday by the California Department of Industrial Relations.

The state implemented the IMR system as part of the reforms for employee benefits in 2012.

In 2020, the state's independent medical review organizations processed 184,000 IMR applications, a decrease of 17% from the previous year, but the decrease was most significant in the previous part of 2020 due to the COVID-19 pandemic and application numbers recovered in the second half of the year, the report stated.

IMR's 2020 overturned approximately 9.5% of usage review decisions that denied treatment requests from physicians, which is slightly lower than 201

9's persuasion rate of 10.4%. and of these, 30% were related to opioid inquiries. IMR requests for diagnostic tests represented 18% of all problems, followed by rehabilitation services with 17%.

Denials that were most often transformed were for behavioral and mental health care (18%), followed by functional restoration and gym membership (16%) and specialist consultation and dental care (15%).

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