The Navy ICPA's referred cases in which they noticed something unusual, or which required further clarification from a physician to help support or contest the claim. Given that bias, one might expect that the overwhelming majority of cases would have the Navy Physician opposing the claim. This was not the case." (p.19). Statistical Procedures

Using the k statistic, the authors assessed the level of agreement between the physicians opinions and the final claim decision of the governing body issuing the claim benefits. A two sided z test was also used to compare the proportion of males in the study population to the proportion of male...

Medical doctors are often over-specialized and may lack a general knowledge that is more applicable to a claims adjuster.
Problems

The problem with this study is that it has limited scope. The study only focused on federally employed workers. The governmental system itself does not apply to anywhere outside of its authority, making the conclusions of this article lacking reliability, despite its valid and systematic approach.