IMR Decisions: January 2014 Through June 2017 (Spotlight Report, published 09/17) [PDF]

A CWCI study that tracks changes in the volume of Independent Medical Review letters and in the number of individual treatment decisions covered in those letters. The report compares results from the last 3 years to data derived from 86,066 IMR decision letters issued from January through June of 2017. Results show the number of IMR letters issued during the study period and processing time by quarter; the average number of medical service decisions per letter in 2017; the volume of IMR decisions and uphold rates by type of service, drug type (for pharmaceutical IMRs), provider concentration, accident year, region, and high-volume providers; and the percent of IMR requests initiated by injured workers rather than by a representative.

Spotlight Report