IMR Notches Highest Uphold Rate in 2021

Independent medical review upheld 92.8% of appealed utilization review determinations in calendar year 2021, the highest upholding rate in any year since the administrative process for challenging treatment denials was created, according to a new report by the California Division of Workers’ Compensation. The division said its initial analysis of the data didn’t identify the cause of the increase and that it will continue to study the trend to find possible reasons. Independent medical review was created with the SB 863 reforms. Proponents said the new process would expedite the ...