Abstract on New York State Worker's Compensation Bill S08176
Excerpt from Presentation Given at JurisSolution's Spring Seminar at The Learning Center in Queens, NY, April 13, 2001
By Elyssa Burack, Esq.
Effective 3/20/01 (Out for 45 day comment period ending 4/27/01)
(For the full text or more info. on this Legislation, or to download IME Forms, go to The NYS WCB website or call the Health Provider Administration Unit at 1-800-781-2362.)
This Legislation provides for direct regulation of Independent Medical Examinations (IMEs) and was adopted by the Worker’s Compensation Board. Below are some of the core changes; however, anyone involved in any aspect of worker’s compensation should do their own research. These highlights should not be construed as comprehensive, or as legal advice.
MR/IME-1 and IME-7 HEALTH PROVIDER’S APPLICATION FOR AUTHORIZATION UNDER THE WORKERS’ COMPENSTAION LAW and STATEMENT OF REGISTRATION Section 13-n, WCL
All practitioners who are currently authorized to treat workers’ compensation claimants in NY must now have a separate authorization to conduct IMEs. If you already have a WCB #, to prevent further confusion, the existing number is used followed by a suffix, a “W” (meaning the practitioner is authorized to act as a treating physician only), “I” (meaning the practitioner is authorized to do IMEs only) or “B” (meaning that the practitioner is authorized to do both treatment and IMEs). There is no charge to apply for the practitioner’s authorization on IME-1.
Entities (such as IME Company’s or “Vendors”) who derive income from IMEs in a support-like role whether by employing or contracting with independent examiners to conduct IMEs must similarly have an authorization number to do so. For these entities, there is a fee of $250 that must accompany the IME-7.
Any IME provider (physician or IME co.) who is not authorized by 3/20/01 will not be permitted to conduct IMEs on behalf of carriers, employers or claimants. Any unauthorized IME providers’ reports will be deemed ineffective.
IME-5 CLAIMANT’S NOTICE OF INDEPENDENT MEDICAL EXAMINATION under Section 137 WCL
The notification of IME appointments is a two-page letter, which gives a STATEMENT OF RIGHTS AND OBLIGATIONS of INDEPENDENT MEDICAL EXAMINATIONS on page two, Section 137 WCL. Pay close attention to the fact that the claimant has the right to videotape the IME and the practitioner’s right to videotape as long as it is checked off on the IME-5 appointment letter at the time when the letter is mailed. Also, the claimant has the right to have anyone accompany him/her to the IME, 7 days notice of the appointment, reasonable distance to the appointment, reimbursement for travel expenses to and from the examination site if requested by the carrier. The IME-5 must also be sent to the designated Worker’s Compensation Board.
IME-4 PRACTIONER’S REPORT OF INDEPENDENT MEDICAL EXAMINATION
IME reports are to be provided on the Practitioner’s Report of Independent Medical Examination, which contains space for the appropriate authorization numbers, the practitioner’s results and a certification statement above the practitioner’s signature. The Practitioner must submit a copy of the IME-4 on the same day and in the same manner to: 1. The Board, 2. The Insurance Carrier, 3. The claimant’s attorney or representative, 4. The Claimant and 5. The attending practitioner. The reports must be sent to all parties on the same day to protect all parties and to rebut allegations of changed reports.
IME-3 PRACTITIONER’S REPORT OF REQUEST FOR INFORMATION/RESPONSE TO REQUEST REGARDING INDEPENDENT MEDICAL EXAMINATION
Any requests for additional information or clarifications made upon the IME physician must be submitted by the practitioner within 10 days to the appropriate Workers’ Compensation Board. To report a request for information the practitioner must fill out item 10 on this form, and the answer to the request should be addressed on item 11. Copies of the request made as well as the answer to the request should be attached to the IME-3. Of importance is that the duty to report and answer the request falls on the practitioner. Examples of a request: This could involve a spelling or grammatical error, or a request for clarification of a part of the body that was examined. Anytime there is a need for an addendum of any sort or any change in an opinion based upon something not available to the IME physician at the time of the IME, the IME-3 should be used to report the request and the IME practitioner's response to the request. This regulation is intended to give all parties a level playing and to rebut allegations of the unauthorized changing of IME reports.
The attorneys at JurisSolutions, Inc. have provided the above to you. Of course, we have met all requirements to perform Worker's Compensation IMEs in New York. Our authorization number is 010009.
If you have any questions or comments on the above abstract, please feel free to call Elyssa Burack, Esq., one of the co-founding partners at 1-877-935-8750. Finally, on a lighter note, we understand the "I" for IME physicians, and the "B" for both, but if you have any insight as to why the Board used a “w” to signify treating physicians, feel free to drop us a line.