Today’s issue of WorkCompRecap features the release of a new update from CWCI that found that after hitting an all-time low in 2022, the number of independent medical review (IMR) letters used to resolve California workers’ compensation medical disputes rose 4.1% in the first six months of 2023 compared to 1H 2022.
Key findings included that total IMR volume trended down for four consecutive years (2019-2022), as the number of work injury claims fell during the pandemic and pharmaceutical disputes declined after the state adopted guidelines and implemented a formulary. From 2018 through June 2023, opioids’ share of pharmaceutical IMRs has dropped from nearly a third to less than a quarter of all prescription drug IMRs. Since peaking at 184,735 letters in 2018, IMR letter volume has declined to 127,215 in 2022 (down 31%). CWCI also noted that IMR outcomes remained fairly stable, with IMR physicians upholding UR doctors’ modifications or denials 89.2% of the time in the 1H 2023 versus 91.1% of the time in 2022.