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ADHD: when insurers say no, reviewers often say yes

In 130 published external-review decisions involving adhd, independent physician reviewers overturned the insurer’s denial 55.4% of the time.

Published decisions
130
2001–2026
Overturned
55.4%
72 denials reversed

Most-fought treatments for adhd

What insurers denied — and how those fights ended.
TreatmentDecisionsOverturned
Vyvanse22
72.7%
How to use this in your appeal

These outcomes come from California’s external review program — an independent physician panel whose decision binds the insurer. Every state has an equivalent, and internal appeals succeed even more often. If your care for adhd was denied, the published record says the denial is worth fighting.

SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY

Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.

Fighting a denial for adhd? 55.4% won.

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