N.Y.
Workers' Compensation Law Section 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 chair 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 by a psychologist, duly registered and licensed by the state of New York, authorized by the chair to render psychological care pursuant to § 13-B (Authorization of providers, medical bureaus and laboratories by the chair)section thirteen-b of this article. 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 § 13-C (Licensing of compensation medical bureaus and laboratories)section thirteen-c of this article, may provide psychological services when required.(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 chair on such forms and at such times as the chair may require.3.
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 section thirteen-b 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 § 13-N (Mandatory registration of entities which derive income from independent medical examinations)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 Civil Practice Law & Rules Law § 8001 (Persons subpoenaed)section eight thousand one of the civil practice law and rules.7.
(a) The provisions of subdivisions one and three of § 13-G (Payment of bills for medical care)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.(b)
If the parties fail to agree as to the psychological care rendered under this chapter to a claimant, and the amount of the disputed bill is one thousand dollars or less, or where the amount of the disputed bill exceeds one thousand dollars and the psychologist expressly so requests, such value shall be decided by a single arbitrator process, pursuant to rules promulgated by the chair. The chair shall appoint a member in good standing of a recognized professional association representing psychologists in the state of New York to determine the value of such disputed bill. Decisions rendered under the single arbitrator process shall be conclusive upon the parties as to the value of the services in dispute.(c)
If the parties fail to agree as to the psychological care rendered under this chapter to a claimant, and the amount of the disputed bill exceeds one thousand dollars and the psychologist does not expressly request a single arbitrator process in accordance with paragraph (b) of this subdivision, 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.(d)
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 § 13-G (Payment of bills for medical care)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. 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.(e)
A provider initiating an arbitration, including a single arbitrator process, pursuant to this section shall not be required to pay a fee to cover the costs related to the conduct of such arbitration.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 chair shall appoint for and with jurisdiction in the entire state of New York a single psychology practice committee composed of three 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. Each member of said committee shall receive compensation either on an annual basis or on a per diem basis to be fixed by the chair within amounts appropriated therefor. One of said psychologists shall be designated by the chair as a chair 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 § 13-D (Removal of providers from lists of those authorized to render medical care or to conduct independent medical examinations)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.
Source:
Section 13-M — Care and treatment of injured employees by duly licensed psychologists, https://www.nysenate.gov/legislation/laws/WKC/13-M (updated Jan. 10, 2020; accessed Oct. 26, 2024).
