The number of independent medical reviews in California hit a record low in 2022, with 127,215 letters from injured workers challenging denials of treatment or medications in the workers’ compensation system, according to a report issued Friday by the California Workers’ Compensation Institute.
The report also found that independent medical reviews upheld 91.1% of previous decisions by 2022 – a figure that has remained stable, with between 88.2% and 92% of decisions upheld since 2014.
Reviews related to opioid prescriptions have continued to decline “rapidly,” with overall prescription-related review requests at 33% in 2022, a steady decline from a peak of 49.9% in 2014.
Changes to the Workers’ Compensation Act in 2012 required a process for appealing decisions with independent medical reviews and the industry saw a record 184,735 appeals in 2018.
The report also compared California’s volume to Texas, which has a similar process in place, and found that between 2014 and 2022, California had more than 92 times the IMR letter volume of Texas.