Independent Medical Review Decisions: January 2014 Through December 2016 (Spotlight Report, published 03/17)


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An analysis of the California workers’ comp independent medical review (IMR) process used to resolve medical disputes. The analysis examines and compares IMR outcomes from 477,045 IMR decision letters issued in 2014, 2015 and 2016, including the types of requested medical services that were reviewed, the percentage of utilization review modifications or denials that were upheld, the distribution of IMRs across different regions of the state, and the proportion of IMRs associated with the medical providers with the highest volume of IMRs.