News Leaflets
A leading news portal.

Few California Workers’ Comp Treatment Request Denials Overturned

0 35

Few medical treatment denials in California workers’ compensation were overturned last year, a review released on Wednesday shows.

The California Division of Workers’ Compensation posted an annual report on the department’s Independent Medical Review program, which describes IMR program activity in 2021, the eighth year since the program was implemented.

The IMR program, the medical dispute resolution process for the state’s workers’ comp system that resolves disputes about the medical treatment of injured workers, received 178,927 IMR applications and issued 133,400 final determination letters addressing one or more medical necessity disputes.

Some highlights of the report include:

  • Nearly 94% of all unique IMR filings were deemed eligible for review, the same annual percentage as for those filed in 2020.
  • Pharmaceutical requests accounted for 31% of all treatment requests sent for IMR, a smaller proportion of total service requests than in previous years.
  • Opioids comprised 27% of all pharmaceutical requests.
  • Treatment request denials were overturned at a rate of 7.2%. Specialist consultants, office visits and mental health services were overturned most often.
  • Guidelines contained in the Medical Treatment Utilization Schedule continue to serve as the primary resource for the determination of medical necessity.

The Division of Workers’ Compensation is part of the state’s Department of Industrial Relations. The report is posted on the DIR website.

Related:

Topics
California
Workers’ Compensation

Was this article valuable?


Here are more articles you may enjoy.

Interested in Workers Comp?

Get automatic alerts for this topic.

FOLLOW US ON GOOGLE NEWS

Read original article here

Denial of responsibility! News Leaflets is an automatic aggregator of the all world’s media. In each content, the hyperlink to the primary source is specified. All trademarks belong to their rightful owners, all materials to their authors. If you are the owner of the content and do not want us to publish your materials, please contact us by email – [email protected]. The content will be deleted within 24 hours.

Leave a comment
Immediate Unity Profit Immediate Gains ProI