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Medical treatment review requests continue to decline in Calif.

Medical treatment review

The number of independent medical reviews in California hit an all-time low in 2022, with 127,215 letters from doctors regarding injured workers challenging the denial 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 earlier decisions in 2022 — a figure that has remained steady, with between 88.2% and 92% of decisions upheld since 2014.

Reviews related to opioid prescriptions have continued to decline “sharply,” with overall prescription-related review requests at 33% in 2022, a steady decline from a high of 49.9% in 2014.

Changes to workers compensation law in 2012 called for a process to appeal decisions with independent medical reviews and the industry saw an all-time high of 184,735 appeals in 2018.

The report also compared California’s volume with that of Texas, which has a similar process in place, finding that between 2014 and 2022 California had more than 92 times the IMR letter volume of Texas.