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New York Workers' Compensation Law Section 13-l - Care And Treatment Of Injured Employees By Duly Licensed Chiropractors.Legal Research Home > New York Lawyer > Workers' Compensation > New York Workers' Compensation Law Section 13-l - Care And Treatment Of Injured Employees By Duly Licensed Chiropractors.
§ 13-l. Care and treatment of injured employees by duly licensed
chiropractors. 1. Where the term "chairman" is hereinafter used, it
shall be deemed to mean the chairman of the workmen's compensation board
of the state of New York.
2. An employee injured under circumstances which make such injury
compensable under this article, when care is required for an injury
which consists solely of a condition which may lawfully be treated by a
chiropractor as defined in section sixty-five hundred fifty-one of the
education law may select to treat him or her, any duly registered and
licensed chiropractor of the state of New York, authorized by the chair
to render chiropractic care as hereinafter provided. If the injury or
condition is one which is outside the limits prescribed by the education
law for chiropractic care and treatment, the said chiropractor must so
advise the said injured employee and instruct him or her to consult a
physician of said employee's choice for appropriate care and treatment.
Such physician shall thenceforth have supervision of the treatment of
said condition including the future treatment to be administered to the
patient by the chiropractor. A chiropractor licensed and registered to
practice chiropractic in the state of New York, who is desirous of being
authorized to render chiropractic care under this section and/or to
conduct independent medical examinations in accordance with paragraph
(b) of subdivision three of this section shall file an application for
authorization under this section with the chiropractic practice
committee. In such application he or she shall agree to refrain from
subsequently treating for remuneration, as a private patient, any person
seeking chiropractic treatment, or submitting to an independent medical
examination, in connection with, or as a result of, any injury
compensable under this chapter, if he or she has been removed from the
list of chiropractors authorized to render chiropractic care or to
conduct independent medical examinations under this chapter, or if the
person seeking such treatment has been transferred from his or her care
in accordance with the provisions of this section. This agreement shall
run to the benefit of the injured person so treated, or examined, and
shall be available to him or her as a defense in any action by such
chiropractor for payment rendered by a chiropractor after he or she has
been removed from the list of chiropractors authorized to render
chiropractic care or to conduct independent medical examinations under
this section, or after the injured person was transferred from his or
her care in accordance with the provisions of this section. The
chiropractic practice committee if it deems such licensed chiropractor
duly qualified shall recommend to the chair that such be authorized to
render chiropractic care and/or to conduct independent medical
examinations under this section. Such recommendations shall be advisory
to the chair only and shall not be binding or conclusive upon him or
her. The chair shall prepare and establish a schedule for the state, or
schedules limited to defined localities of charges and fees for
chiropractic treatment and care, to be determined in accordance with and
to be subject to change pursuant to rules promulgated by the chair.
Before preparing such schedule for the state or schedules for limited
localities the chair shall request the chiropractic practice committee
to submit to him or her a report on the amount of remuneration deemed by
such committee to be fair and adequate for the types of chiropractic
care to be rendered under this chapter, but consideration shall be given
to the view of other interested parties, the amounts payable by the
employer for such treatment and services shall be the fees and charges
established by such schedule.
3. (a) No claim for chiropractic care or treatment shall be valid and
enforceable as against the employer or employees unless within
forty-eight hours following the first treatment the chiropractor giving
such care or treatment furnishes to the employer and directly to the
chair a preliminary notice of such injury and treatment, and within
fifteen days thereafter a more complete report and subsequent thereto
progress reports as requested in writing by the chair, board, employer
or insurance carrier, at intervals of not less than three weeks apart or
at less frequent intervals if requested on forms prescribed by the
chair. The board may excuse the failure to give such notices within the
designated periods when it finds it to be in the interest of justice to
do so.
(b) Upon receipt of the notice provided for by paragraph (a) of this
subdivision, the employer, the carrier, and the claimant each shall be
entitled to have the claimant examined by a qualified chiropractor
authorized by the chair in accordance with subdivision two of this
section and section one hundred thirty-seven of this chapter at a
medical facility convenient to the claimant and in the presence of the
claimant's chiropractor, and refusal by the claimant to submit to such
independent medical examination at such time or times as may reasonably
be necessary in the opinion of the board shall bar the claimant from
recovering compensation, for any period during which he or she has
refused to submit to such examination.
(c) Where it would place an unreasonable burden upon the employer or
carrier to arrange for, or for the claimant to attend, an independent
medical examination by an authorized chiropractor, the employer or
carrier shall arrange for such examination to be performed by a
qualified chiropractor in a medical facility convenient to the claimant.
(d) The independent chiropractic examiner shall provide such reports
and shall submit to investigation as required by the chair.
(e) In order to qualify as admissible chiropractic evidence, for
purposes of adjudicating any claim under this chapter, any report
submitted to the board by an independent medical examiner licensed by
the state of New York shall include the following:
(i) a signed statement certifying that the report is a full and
truthful representation of the independent chiropractic examiner's
professional opinion with respect to the claimant's condition,
(ii) such examiner's board issued authorization number,
(iii) the name of the individual or entity requesting the examination,
(iv) if applicable, the registration number as required by section
thirteen-n of this article, and
(v) such other information as the chair may require by regulation.
4. Fees for chiropractic services shall be payable only to a duly
authorized chiropractor as defined in this section, or to the agent,
executor or administrator of the estate of such chiropractor. No
chiropractor rendering treatment to a compensation claimant shall
collect or receive a fee from such claimant within this state, but shall
have recourse for payment of services rendered only to the employer
under the provisions of this section.
5. Whenever his attendance at a hearing is required the chiropractor
of the injured employee shall be entitled to receive a fee from the
employer in an amount to be fixed by the board, in addition to any fee
payable under section eight thousand and one of the civil practice law
and rules.
6. The provisions of subdivisions one and three of section thirteen-g
of this article with respect to the conditions under which a hospital,
physician or self-employed physical or occupational therapist may
request payment or arbitration of a bill, or under which an award may be
made for payment of such bill, shall be applicable to bills rendered by
a chiropractor for services rendered to an injured employee. If the
parties fail to agree as to the chiropractic care rendered under this
chapter to a claimant such value shall be decided by the chiropractic
practice committee and the majority decision of such committee shall be
conclusive upon the parties as to the value of the services rendered.
The board or the chair may make an award not in excess of the
established fee schedules for any such bill or part thereof which
remains unpaid in the same manner as an award for bills rendered under
subdivisions one and three of section thirteen-g of this article, and
such award may be collected in like manner as an award of compensation.
Where a chiropractor's bill has been determined to be due and owing in
accordance with the provisions of this section the board shall include
in the amount of the award interest of not more than one and one-half
percent (1 1/2%) per month payable to the chiropractor in accordance
with the rules and regulations promulgated by the board. The chair shall
assess the sum of fifty dollars against the employer for each such award
made by the board, which sum shall be paid into the state treasury.
A provider initiating an arbitration pursuant to this section shall
pay a fee, as determined by regulations promulgated by the chair, to be
used to cover the costs related to the conduct of such arbitration. Upon
resolution in favor of such party, the amount due, based upon the bill
in dispute, shall be increased by the amount of the fee paid by such
party. Where a partial award is made, the amount due, based upon the
bill in dispute, shall be increased by a part of such fee.
7. Within the limits prescribed by the education law for chiropractic
care and treatment, the report or testimony of an authorized
chiropractor concerning the condition of an injured employee and
treatment thereof shall be deemed competent evidence and the
professional opinion of the chiropractor as to causal relation and as to
required treatment shall be deemed competent but shall not be
controlling. Nothing in this section shall be deemed to deprive any
employer or insurance carrier of any right to medical examination or
presentation of medical testimony now conferred by law.
8. The chairman shall promulgate rules governing the procedure to be
followed by those rendering chiropractic care under this section, which
rules so far as practicable shall conform to the rules presently in
effect with reference to medical care furnished to claimants in
workmen's compensation. In connection with the promulgation of said
rules the chairman may consult the chiropractic practice committee
hereinafter provided and may take into consideration the view of other
interested parties.
9. The chairman shall appoint for and with jurisdiction in the entire
state of New York a single chiropractic practice committee composed of
one duly licensed physician and two duly registered and licensed
chiropractors of the state of New York. Each member of said committee
shall receive compensation either on an annual basis or on a per diem
basis to be fixed by the chairman within amounts appropriated therefor.
One of said chiropractic members shall be designated by the chairman as
a chairman of said chiropractic practice committee. No member of said
committee shall render chiropractic treatment under this section nor be
employed or accept or participate in any fee from any insurance company
authorized to write workmen's compensation insurance in this state or
from any self-insurer, whether such employment or fee relates to a
workmen's compensation claim or otherwise. The attorney-general, upon
request, shall advise and assist such committee.
10. The chiropractic practice committee shall investigate, hear and
make findings with respect to all charges as to professional or other
misconduct of any authorized chiropractor as herein provided under rules
and procedure to be prescribed by the chair and shall report evidence of
such misconduct, with their findings and recommendations with respect
thereto, to the chair. The findings, decision and recommendation of such
chiropractic practice committee shall be advisory to the chair only, and
shall not be binding or conclusive upon him or her. The chair shall
remove from the list of chiropractors authorized to render chiropractic
care under this chapter or to conduct independent medical examinations
in accordance with paragraph (b) of subdivision three of this section
the name of any chiropractor who he or she shall find after reasonable
investigation is disqualified because such chiropractor,
(a) has been guilty of professional or other misconduct or
incompetency in connection with chiropractic services rendered under the
law, or
(b) has exceeded the limits of his or her professional competence in
rendering chiropractic services under the law, or has made false
statements regarding his or her qualifications in his or her application
for authorization, or
(c) has failed to submit timely, full and truthful chiropractic
reports of all his or her findings to the employer and directly to the
chair of the board within the time limits provided in this section, or
(d) has knowingly made a false statement or representation as to a
material fact in any medical report made pursuant to this chapter or in
testifying or otherwise providing information for the purposes of this
chapter, or
(e) has solicited or has employed another to solicit for himself or
herself or for another professional treatment, examination or care of an
injured employee with any claim under this chapter, or
(f) has refused to appear before, to testify, to submit to a
deposition, or answer upon request of the chair, board, chiropractic
practice committee or any duly authorized officer of the state, any
legal question or produce any relevant book or paper concerning his or
her conduct under an authorization granted to him or her under the law,
or
(g) has directly or indirectly requested, received or participated in
the division, transference, assignment, rebating, splitting or refunding
of a fee for, or has directly or indirectly requested, received or
profited by means of a credit or otherwise valuable consideration as a
commission, discount or gratuity, in connection with the treatment, or
independent medical examination, of a workers' compensation claimant.
Nothing contained in this paragraph shall prohibit such chiropractors
who practice as partners, in groups or as a professional corporation, or
as a university faculty practice corporation from pooling fees and
moneys received, either by the partnership, professional corporation,
university faculty practice corporation or group by the individual
members thereof, for professional services furnished by any individual
professional member, or employee of such partnership, corporation or
group, nor shall the professionals constituting the partnership,
corporation, or group be prohibited from sharing, dividing or
apportioning the fees and moneys received by them or by the partnership,
corporation or group in accordance with a partnership or other
agreement.
11. Any person who violates or attempts to violate, and any person who
aids another to violate or attempts to induce him to violate the
provisions of paragraph (g) of subdivision ten of this section shall be
guilty of a misdemeanor.
12. Nothing in this section shall be construed as limiting in any
respect the power or duty of the chairman to investigate instances of
misconduct, either before or after investigation by the chiropractic
practice committee or to temporarily suspend the authorization of any
chiropractor that he may believe to be guilty of such misconduct. The
provisions of subdivision one of section thirteen-d of this article
which are not inconsistent with the provisions of this section shall be
applicable as fully as if set forth herein.
Last modified: July 31, 2006 |