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Independent medical reviews fall by 2020 in California



The number of compensation claims for workers requiring an independent medical examination has dropped to a minimum, according to a study released Thursday by the California Workers' Compensation Institute.

The Oakland-based institute reviewed more than 1.1. million IMR decision letters issued from 2014 to 2020 and found that the use of IMR to resolve medical disputes increased to a record 184,000 in 2018, but decreased in 2019 to 163,000 and dropped to a full-time level of 136,000 in 2020. CWCI said it low total injury volume from pandemic-related suspensions and the adoption of an evidence-based drug form also affected IMR use.

The form, adopted in 2018 and established categories of medicines exempt from review of use, led to the use of IMR in disputes over prescription medicines decreasing from 46.4% of all IMR disputes in 201

8 to 39.1% of all disputes in 2020 The mix of services submitted to IMR has also changed, with review requests increasing by 1.5% to 2% over the last two years for physiotherapy, injections, durable medical equipment, prostheses, orthoses and supplies, according to the report.

The results from IMR remained stable, with IMR physicians maintaining a physician's modification or denial of service 90% of the time 2020, compared to 88% of the time 2019.

CWCI also noted that, as in previous studies, continued a small number of doctors carry out much of the IMR activity, with the top 1% of the requesting doctors – only 89 doctors – accounting for 39.8% of the disputed job requests that underwent IMR 2020. The 10 best individual doctors alone account for 10, 2% of the disputed inquiries, and the study showed that seven of the 10 best doctors in 2020 were also in the top 10 list for 2019.

More news about insurance and work compensation on the coronavirus crisis here .

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