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New York Workers' Compensation Law Section 13-m - Care And Treatment Of Injured Employees By Duly Licensed Psychologists.Legal Research Home > New York Lawyer > Workers' Compensation > New York Workers' Compensation Law Section 13-m - Care And Treatment Of Injured Employees By Duly Licensed Psychologists.
§ 13-m. Care and treatment of injured employees by duly licensed
psychologists. 1. Where the term "chairman" is hereinafter used, it
shall be deemed to mean the chairman of the workers' compensation board
of the state of New York.
2. (a) An injured employee, injured under circumstances which make
such injury compensable under this article, may lawfully be treated,
upon the referral of an authorized physician, by a psychologist, duly
registered and licensed by the state of New York, authorized by the
chairman to render psychological care pursuant to this section. Such
services shall be within the scope of such psychologist's specialized
training and qualifications as defined in article one hundred
fifty-three of the education law.
(b) Medical bureaus, medical centers jointly operated by labor and
management representatives, hospitals and health maintenance
organizations, authorized to provide medical care pursuant to section
thirteen-c of this chapter, may provide psychological services when
required, upon the referral of an authorized physician, provided such
care is rendered by a duly registered, licensed and authorized
psychologist, as required by this section.
(c) A psychologist rendering service pursuant to this section shall
maintain records of the patient's psychological condition and treatment,
and such records or reports shall be submitted to the chairman on such
forms and at such times as the chairman may require.
3. A psychologist, licensed and registered to practice psychology in
the state of New York, who is desirous of being authorized to render
psychological care under this section and/or to conduct independent
medical examinations in accordance with paragraph (b) of subdivision
four of this section shall file an application for authorization under
this section with the psychology practice committee. The applicant shall
agree to refrain from subsequently treating for remuneration, as a
private patient, any person seeking psychological 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 psychologists authorized to render
psychological care under this chapter. This agreement shall run to the
benefit of the injured person so treated, and shall be available as a
defense in any action by such psychologist for payment for treatment
rendered by such psychologist after being removed from the list of
psychologists authorized to render psychological care or to conduct
independent medical examinations under this section. The psychology
practice committee if it deems such licensed psychologist duly qualified
shall recommend to the chair that such person be authorized to render
psychological care and/or to conduct independent medical examinations
under this section. Such recommendations shall be only advisory to the
chair and shall not be binding or conclusive. The chair shall prepare
and establish a schedule for the state or schedules limited to defined
localities of charges and fees for psychological treatment and care, to
be determined in accordance with and 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
psychology practice committee to submit to such chair a report on the
amount of remuneration deemed by such committee to be fair and adequate
for the types of psychological 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.
4. (a) No claim for psychological care or treatment shall be valid and
enforceable as against the employer or employees unless within
forty-eight hours following the first treatment the psychologist 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 psychologist,
authorized by the chair in accordance with subdivision three 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 psychologist, 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 psychologist, the employer or
carrier shall arrange for such examination to be performed by a
qualified psychologist in a medical facility convenient to the claimant.
(d) The independent psychological examiner licensed by the state of
New York shall provide such reports and shall submit to investigation as
required by the chair.
(e) In order to qualify as admissible medical evidence, for purposes
of adjudicating any claim under this chapter, any report submitted to
the board by an independent psychological 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 psychological 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.
5. Fees for psychological services shall be payable only to a duly
authorized psychologist as licensed in article one hundred fifty-three
of the education law, or to the agent, executor or administrator of the
estate of such psychologist. No psychologist 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.
6. Whenever his attendance at a hearing is required the psychologist
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 one of the civil practice law and
rules.
7. (a) 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 psychologist for services rendered to an injured employee.
If the parties fail to agree as to the psychological care rendered under
this chapter to a claimant, such value shall be decided by the
psychology 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. 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.
(b) Where a psychologist'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 per month payable to the psychologist in accordance
with the rules and regulations promulgated by the board.
(c) 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.
8. Within the limits prescribed by the education law for psychological
care and treatment, the report or testimony of an authorized
psychologist concerning the condition of an injured employee and
treatment thereof shall be deemed competent evidence and the
professional opinion of the psychologist 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 a medical examination or
presentation of medical testimony now conferred by law.
9. The chairman shall promulgate rules governing the procedure to be
followed by those rendering psychological 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 workers'
compensation. In connection with the promulgation of said rules the
chairman may consult the psychology practice committee hereinafter
provided and may take into consideration the view of other interested
parties.
10. The chairman shall appoint for and with jurisdiction in the entire
state of New York a single psychology practice committee composed of two
duly registered and licensed psychologists, at least one of whom shall
be a member in good standing of the New York state psychological
association recommended by the president of such organization, and one
duly licensed physician 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 psychologists shall be designated by the chairman
as a chairman of said psychology practice committee. No member of said
committee shall render psychological treatment under this section nor be
an employer or accept or participate in any fee from any insurance
company authorized to write workers' compensation insurance in this
state or from any self-insurer, whether such employment or fee relates
to a workers' compensation claim or otherwise. The attorney general,
upon request, shall advise and assist such committee.
11. The psychology practice committee shall investigate, hear and make
findings with respect to all charges as to professional or other
misconduct of any authorized psychologist as herein provided under rules
and procedures 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
psychology 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 psychologists authorized to render psychological
care under this chapter or to conduct independent medical examinations
in accordance with paragraph (b) of subdivision four of this section the
name of any psychologist who he or she shall find after reasonable
investigation is disqualified because such psychologist:
(a) has been guilty of professional or other misconduct or
incompetency in connection with the rendering of psychological services,
or
(b) has exceeded the limits of his or her professional competence in
rendering psychological services under the law, or has made false
statements regarding qualifications in the application for
authorization, or
(c) has failed to submit timely, full and truthful psychological
reports of all 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/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, psychology
practice committee or any duly authorized officer of the state, any
legal question or produce any relevant book or paper concerning conduct
under an authorization granted under 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 of a
workers' compensation claimant.
12. 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 eleven of this section shall
be guilty of a misdemeanor.
13. 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 psychology
practice committee, or to temporarily suspend the authorization of any
psychologist believed 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
if fully set forth herein.
14. Nothing contained in this section shall prohibit psychologists who
practice as partners, in groups or as a professional corporation from
pooling fees and moneys received, either by the partnership,
professional corporation or group or 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 partnerships, corporations, or groups
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.
Last modified: July 31, 2006 |