CWCI: IMR Volume Down, UR Uphold Rate Better than 90%

Independent medical reviewers affirmed the denial or modification of more than nine out of every 10 disputed medical treatment requests in 2022, just as they have, on average, each year since 2014 when the administrative process created by Senate Bill 863 was fully implemented. The California Workers’ Compensation Institute reported 91.1% of utilization review decisions that were appealed through IMR were affirmed last year. The IMR uphold rate has ranged from 88.2% to 92%, and averaged just over 90% since 2014 when the program was opened up to disputes over treatment requests for all d...