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Chronic Low Back Pain: when insurers say no, reviewers often say yes
In 212 published external-review decisions involving chronic low back pain, independent physician reviewers overturned the insurer’s denial 42% of the time.
Published decisions
212
2001–2026
Overturned
42%
89 denials reversed
Most-fought treatments for chronic low back pain
What insurers denied — and how those fights ended.
| Treatment | Decisions | Overturned |
|---|---|---|
| Intracept Procedure | 21 | 47.6% |
| Intracpt Procedure | 13 | 30.8% |
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 chronic low back pain 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.