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Everything here is free to read, and nothing here is a claim about your case. Built from California’s published records and modified by us — not official government data. How these numbers were made.

18 authorities · 2021-2025 · California

What reviewers cite

California reviewers are directed by statute to decide on peer-reviewed evidence, nationally recognised professional standards, expert opinion and generally accepted practice. When they name the standard they applied, it is in the published decision. This is the index of who they named.

Why this is the most reliable thing on the site. Extracting “the reviewer named the NCCN guidelines” is closer to reading a label than to judging a case. It needed no interpretive gate, and it validated where thirteen judgement-shaped codes did not — see the results.

The index

named in ≥ 30 decisions
  • FDA74.2%2,151
  • LOCUS family82.1%820
  • American Society of Addiction Medicine79.3%584
  • NCCN52.1%451
  • American Academy of Child and Adolescent Psychiatry77.1%315
  • American College of Rheumatology57.9%261
  • American College of Cardiology47.7%111
  • American Diabetes Association65.2%89
  • American Heart Association47.7%86
  • American Gastroenterological Association81.2%85
  • American Headache Society78.9%76
  • American Urological Association42.7%75
  • American College of Obstetricians and Gynecologists32.2%59
  • American Society of Plastic Surgeons40.0%55
  • American Academy of Neurology84.6%52
  • WPATH82.0%50
  • American Academy of Dermatology66.0%47
  • American Academy of Pediatrics58.1%43

A rate here is the outcome of decisions that named the authority, not the effect of naming it. Reviewers cite the standard they applied; the citation and the outcome share a cause. Read it as “disputes where this standard was the yardstick came out this way”, never as “citing this standard produces this result”.

Where each one turns up

most common setting
AuthorityMost often inDecisionsOverturned
FDAPharmacy2,15174.2%
LOCUS familyMental Health82082.1%
American Society of Addiction MedicineMental Health58479.3%
NCCNCancer Care45152.1%
American Academy of Child and Adolescent PsychiatryMental Health31577.1%
American College of RheumatologyDiagnostic imaging & screening26157.9%
American College of CardiologyDiagnostic imaging & screening11147.7%
American Diabetes AssociationPharmacy8965.2%
American Heart AssociationDiagnostic imaging & screening8647.7%
American Gastroenterological AssociationPharmacy8581.2%
American Headache SocietyPharmacy7678.9%
American Urological AssociationCancer Care7542.7%
American College of Obstetricians and GynecologistsDiagnostic imaging & screening5932.2%
American Society of Plastic SurgeonsReconstructive & plastic procedures5540.0%
American Academy of NeurologyPharmacy5284.6%
WPATHReconstructive & plastic procedures5082.0%
American Academy of DermatologyPharmacy4766.0%
American Academy of PediatricsAutism-related treatment4358.1%

Every rate here counts only denials appealed all the way to independent review. Fewer than 1% of denials are appealed internally at all, so a share on this page is not the share of denials that are wrong — it is the share of contested ones that reviewers did not sustain. California only, and only plans the state regulates: not self-funded employer plans, Medicare or Medicaid.

Free help. The California DMHC Help Center files an Independent Medical Review at no cost — 1-888-466-2219, dmhc.ca.gov. You do not need us or a lawyer to reach it.