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Independent medical reviews fall in California under COVID-19 lockdown



Independent medical reviews of California workers 'compensation claims fell nearly 18% in the first half of 2020 compared to the same period in 2019, according to a bulletin published Friday by the California Workers' Compensation Institute.

Under California law, every liability administrator must have a usage review program to ensure that workers receive evidence-based medical care. Workers can dispute denied treatment requests by requesting an independent medical examination.

From January to July 2020, the CWCI found that 70,000 IMR decision letters had been issued, compared to 85,000 in the first half of 2019. The largest declines in IMR decisions occurred in May and June, when much of California was still protected. on site, according to CWCI.

However, the results of these letters remained largely the same, with 89% of IMR physicians upholding the 2020 use review decision, compared to 88% in 201

9. Approximately 40% of letters included multiple service decisions by 2020.

The bulletin also noted that prescription drug challenges accounted for almost 40% of all IMR decisions in the first half of 2020, with opioids accounting for 29%, which is slightly lower than opioids accounting for 31% of drug-related IMR decisions in 2019.

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