A. 10742--A 2
S 3. Section 3121 of the civil practice law and rules, subdivision (a)
as amended by chapter 294 of the laws of 1984, is amended to read as
follows:
S 3121. [Physical or mental] ADVERSARIAL MEDICAL examination. (a)
Notice of AN ADVERSARIAL MEDICAL examination. After commencement of an
action in which the mental or physical condition or the blood relation-
ship of a party, or of an agent, employee or person in the custody or
under the legal control of a party, is in controversy, any party may
serve notice on another party to submit to a physical, mental or blood
[examination] "ADVERSARIAL MEDICAL EXAMINATION" by a designated physi-
cian, or to produce for such ADVERSARIAL MEDICAL examination his OR HER
agent, employee or the person in his OR HER custody or under his OR HER
legal control. The notice may require duly executed and acknowledged
written authorizations permitting all parties to obtain, and make copies
of, the records of specified hospitals relating to such mental or phys-
ical condition or blood relationship; where a party obtains a copy of a
hospital record as a result of the authorization of another party, he OR
SHE shall deliver a duplicate of the copy to such party. A copy of the
notice shall be served on the person SUBJECT to [be examined] THE ADVER-
SARIAL MEDICAL EXAMINATION. It shall specify the time, which shall be
not less than twenty days after service of the notice, and the condi-
tions and scope of the ADVERSARIAL MEDICAL examination, AND IT SHALL
INFORM THE PERSON SUBJECT TO THE EXAMINATION THAT HE OR SHE HAS THE
RIGHT TO HAVE A REPRESENTATIVE PRESENT DURING SUCH EXAMINATION, AND
SHALL HAVE THE RIGHT TO RECORD OR TAPE SUCH EXAMINATION IN A MANNER SUCH
AS NOT TO UNREASONABLY IMPEDE SUCH EXAMINATION. THE PERSON SUBJECT TO
THE ADVERSARIAL MEDICAL EXAMINATION SHALL NOT BE REQUIRED TO PRODUCE ANY
DOCUMENTS OR SUPPLY ANY WRITTEN ANSWERS TO QUESTIONS PUT TO HIM OR HER
AT SUCH EXAMINATION EXCEPT AS IN RESPONSE TO PROPERLY SERVED DISCOVERY
DEMANDS MADE PURSUANT TO THE CIVIL PRACTICE LAW AND RULES.
(b) Copy of report. A copy of a detailed written report of the examin-
ing physician setting out [his] THE findings and conclusions OF THE
ADVERSARIAL MEDICAL EXAMINATION shall be delivered by the party seeking
the ADVERSARIAL MEDICAL examination to [any] EACH party [requesting to
exchange therefor a copy of each report in his control of an examination
made with respect to the mental or physical condition in controversy]
WITHIN THIRTY DAYS OF SUCH EXAMINATION.
(C) FAILURE TO EXCHANGE. NOTHING CONTAINED IN THIS SECTION SHALL LIMIT
THE RIGHTS OF ANY PARTY FROM MOVING TO PRECLUDE OR FOR SEEKING OTHER
SANCTIONS PURSUANT TO RULE 3124 OR SECTION 3126 FOR FAILURE TO EXCHANGE
A DETAILED WRITTEN REPORT OF AN "ADVERSARIAL MEDICAL EXAMINATION" UPON
OTHER PARTIES TO AN ACTION.
S 4. Section 5102 of the insurance law is amended by adding a new
subsection (n) to read as follows:
(N) "ADVERSARIAL MEDICAL EXAMINATION" MEANS ANY PHYSICAL EXAMINATION
REQUESTED BY AN INSURER MADE IN RESPONSE TO A CLAIM MADE PURSUANT TO
BENEFITS UNDER THIS ARTICLE. THE PERSON SUBJECT TO EXAMINATION SHALL
HAVE THE RIGHT TO HAVE A REPRESENTATIVE PRESENT DURING SUCH EXAMINATION
AND SHALL HAVE THE RIGHT TO RECORD OR TAPE SUCH EXAMINATION IN A MANNER
SUCH AS NOT TO UNREASONABLY IMPEDE SUCH EXAMINATION. THE PERSON TO BE
EXAMINED SHALL BE INFORMED OF SUCH RIGHTS AT LEAST TWENTY DAYS PRIOR TO
SUCH EXAMINATION. IF SUCH EXAMINATION SHALL BE USED TO DENY, IN WHOLE
OR IN PART, ANY BENEFITS UNDER THIS SECTION, A COPY OF THE DETAILED
WRITTEN REPORT OF SUCH EXAMINATION, WRITTEN BY THE EXAMINING PHYSICIAN
OR HEALTH CARE PROFESSIONAL, SHALL BE PROVIDED TO THE INJURED PARTY AND
ANY THIRD-PARTY MEDICAL PROVIDER TO WHOM THE INJURED PARTY MAY HAVE
A. 10742--A 3
ASSIGNED HIS OR HER CLAIM OR CLAIMS FOR BENEFITS ALONG WITH ANY DENIAL
OF BENEFITS. IN THE EVENT SUCH REPORT IS NOT SO PROVIDED BY THE INSURER
OR SELF-INSURER ALONG WITH THE DENIAL, THE INSURER SHALL BE PRECLUDED
FROM USING SUCH REPORT TO SUPPORT ANY DENIAL OF SUCH CLAIM.
S 5. Subdivision 4 of section 13-a of the workers' compensation law,
as amended by chapter 473 of the laws of 2000, is amended to read as
follows:
(4) (a) No claim for medical or surgical treatment shall be valid and
enforceable, as against such employer, or employee, unless within
forty-eight hours following the first treatment the physician giving
such treatment furnishes to the employer and directly to the chair a
preliminary notice of such injury and treatment, within fifteen days
thereafter a more complete report and subsequent thereto progress
reports if requested in writing by the chair, board, employer or insur-
ance 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 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 physician authorized by the
chair in accordance with sections thirteen-b and one hundred thirty-sev-
en of this chapter, at a medical facility convenient to the claimant and
in the presence of the claimant's physician, and refusal by the claimant
to submit to such [independent] ADVERSARIAL 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 peri-
od during which he or she has refused to submit to such examination. No
hospital shall be required to produce the records of any claimant with-
out receiving its customary fees or charges for reproduction of such
records.
(c) Where it would place an unreasonable burden upon the employer or
carrier to arrange for, or for the claimant to attend, an [independent]
ADVERSARIAL medical examination by an authorized physician, the employer
or carrier shall arrange for such examination to be performed by a qual-
ified physician in a medical facility convenient to the claimant.
(d) The [independent] ADVERSARIAL medical examiner 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] ADVERSARIAL 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 truth-
ful representation of the [independent] ADVERSARIAL medical 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.
Any report by an [independent] ADVERSARIAL medical examiner who is not
authorized, and who performs an [independent] ADVERSARIAL medical exam-
ination in accordance with paragraph (c) of this subdivision, which is
to be used as medical evidence under this chapter, shall include in the
report such information as the chair may require by regulation.
A. 10742--A 4
S 6. Subdivisions 1 and 2 of section 13-b of the workers' compensation
law, as amended by chapter 473 of the laws of 2000, are amended to read
as follows:
1. Upon the recommendation of the medical society of the county in
which the physician's office is located or of a board designated by such
county society or of a board representing duly licensed physicians of
any other school of medical practice in such county, the chair may
authorize physicians licensed to practice medicine in the state of New
York to render medical care under this chapter and to perform [independ-
ent] ADVERSARIAL medical examinations in accordance with subdivision
four of section thirteen-a of this article. If, within sixty days after
the chair requests such recommendations the medical society of such
county or board fails to act, or if there is no such society in such
county, the chair shall designate a board of three outstanding physi-
cians, who shall make the requisite recommendations.
No such authorization shall be made in the absence of a recommendation
of the appropriate society or board or of a review and recommendation by
the medical appeals unit. No person shall render medical care or conduct
[independent] ADVERSARIAL medical examinations under this chapter with-
out such authorization by the chair, provided, that:
(a) Any physician licensed to practice medicine in the state of New
York may render emergency medical care under this chapter without
authorization by the chair under this section; and
(b) A licensed physician who is a member of a constituted medical
staff of any hospital may render medical care under this chapter while
an injured employee remains a patient in such hospital; and
(c) Under the active and personal supervision of an authorized physi-
cian medical care may be rendered by a registered nurse or other person
trained in laboratory or diagnostic techniques within the scope of such
person's specialized training and qualifications. This supervision shall
be evidenced by signed records of instructions for treatment and signed
records of the patient's condition and progress. Reports of such treat-
ment and supervision shall be made by such physician to the chair on
such forms and at such times as the chair may require.
(d) Upon the referral which may be directive as to treatment of an
authorized physician physical therapy care may be rendered by a duly
licensed physical therapist. Where physical therapy care is rendered
records of the patient's condition and progress, together with records
of instruction for treatment, if any, shall be maintained by the phys-
ical therapist and physician. Said records shall be submitted to the
chair on such forms and at such times as the chair may require.
(e) Upon the prescription or referral of an authorized physician occu-
pational therapy care may be rendered by a duly licensed occupational
therapist. Where occupational therapy care is rendered records of the
patient's condition and progress, together with records of instruction
for treatment, if any shall be maintained by the occupational therapist
and physician. Said records shall be submitted to the chair on forms and
at such times as the chair may require.
(f) Where it would place an unreasonable burden upon the employer or
carrier to arrange for, or for the claimant to attend, an [independent]
ADVERSARIAL medical examination by an authorized physician, the employer
or carrier shall arrange for such examination to be performed by a qual-
ified physician in a medical facility convenient to the claimant.
2. A physician licensed to practice medicine in the state of New York
who is desirous of being authorized to render medical care under this
chapter and/or to conduct [independent] ADVERSARIAL medical examinations
A. 10742--A 5
in accordance with paragraph (b) of subdivision four of section thir-
teen-a and section one hundred thirty-seven of this chapter shall file
an application for authorization under this chapter with the medical
society in the county in which his or her office is located, or with a
board designated by such society, or with a board designated by the
chair as provided in this section. In such application the applicant
shall state his or her training and qualifications, and shall agree to
limit his or her professional activities under this chapter to such
medical care and [independent] ADVERSARIAL medical examinations, as his
or her experience and training qualify him or her to render. The appli-
cant shall further agree to refrain from subsequently treating for
remuneration, as a private patient, any person seeking medical treat-
ment, or submitting to an [independent] ADVERSARIAL 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 physicians
authorized to render medical care or to conduct [independent] ADVER-
SARIAL medical examinations under this chapter, or if the person seeking
such treatment, or submitting to an [independent] ADVERSARIAL medical
examination, has been transferred from his or her care in accordance
with the provisions of this chapter. 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 physician for
payment for treatment rendered by a physician after he or she has been
removed from the list of physicians authorized to render medical care or
to conduct [independent] ADVERSARIAL medical examinations under this
chapter, or after the injured person was transferred from his or her
care in accordance with the provisions of this chapter. The medical
society or the board designated by it, or the board as otherwise
provided under this section, if it deems such licensed physician duly
qualified, shall recommend to the chair that such physician be author-
ized to render medical care and/or conduct [independent] ADVERSARIAL
medical examinations under this chapter, and such recommendation and
authorization shall specify the character of the medical care or [inde-
pendent] ADVERSARIAL medical examination which such physician is quali-
fied and authorized to render under this chapter. Such recommendations
shall be advisory to the chair only and shall not be binding or conclu-
sive upon him or her. The licensed physician may present to the medical
society or board, evidences of additional qualifications at any time
subsequent to his or her original application. If the medical society or
board fails to recommend to the chair that a physician be authorized to
render medical care and/or to conduct [independent] ADVERSARIAL medical
examinations under this chapter, the physician may appeal to the medical
appeals unit. The medical society or the board designated by it, or the
board as otherwise provided under this section, may upon its own initi-
ative, or shall upon request of the chair, review at any time the quali-
fications of any physician as to the character of the medical care or
[independent] ADVERSARIAL medical examinations which such physician has
theretofore been authorized to render under this chapter and may recom-
mend to the chair that such physician be authorized to render medical
care or to conduct [independent] ADVERSARIAL medical examinations there-
after of the character which such physician is then qualified to render.
On such advisory recommendation the chair may review and after reason-
able investigation may revise the authorization of a physician in
respect to the character of medical care and/or to conduct [independent]
ADVERSARIAL medical examinations which he or she is authorized to
render. If the medical society or board recommends to the chair that a
A. 10742--A 6
physician be authorized to render medical care and/or to conduct [inde-
pendent] ADVERSARIAL medical examinations under this chapter of a char-
acter different from the character of medical care or [independent]
ADVERSARIAL medical examinations he or she has been theretofore author-
ized to render, such physician may appeal from such recommendation to
the medical appeals unit.
S 7. The section heading and the opening paragraph and paragraphs (b)
and (g) of subdivision 2 of section 13-d of the workers' compensation
law, the section heading, the opening paragraph and paragraph (g) of
subdivision 2, as amended by chapter 473 of the laws of 2000, paragraph
(b) of subdivision 2, as amended by chapter 6 of the laws of 2007, are
amended to read as follows:
Removal of physicians from lists of those authorized to render medical
care or to conduct [independent] ADVERSARIAL medical examinations.
The chair shall remove from the list of physicians authorized to
render medical care under this chapter, or to conduct [independent]
ADVERSARIAL medical examinations in accordance with paragraph (b) of
subdivision four of section thirteen-a of this article, the name of any
physician who he or she shall find after reasonable investigation is
disqualified because such physician:
(b) has exceeded the limits of his or her professional competence in
rendering medical care or in conducting [independent] ADVERSARIAL
medical examinations under the law, or has made materially false state-
ments regarding his or her qualifications in his or her application for
the recommendation of the medical society or board as provided in
section thirteen-b of this article; 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 prof-
ited by means of a credit or other valuable consideration as a commis-
sion, discount or gratuity in connection with the furnishing of medical
or surgical care, an [independent] ADVERSARIAL medical examination,
diagnosis or treatment or service, including X-ray examination and
treatment, or for or in connection with the sale, rental, supplying or
furnishing of clinical laboratory services or supplies, X-ray laboratory
services or supplies, inhalation therapy service or equipment, ambulance
service, hospital or medical supplies, physiotherapy or other therapeu-
tic service or equipment, artificial limbs, teeth or eyes, orthopedic or
surgical appliances or supplies, optical appliances, supplies or equip-
ment, devices for aid of hearing, drugs, medication or medical supplies,
or any other goods, services or supplies prescribed for medical diagno-
sis, care or treatment, under this chapter; except that reasonable
payment, not exceeding the technical component fee permitted in the
medical fee schedule, established under this chapter for X-ray examina-
tions, diagnosis or treatment, may be made by a physician duly author-
ized as a roentgenologist to any hospital furnishing facilities and
equipment for such examination, diagnosis or treatment, provided such
hospital does not also submit a charge for the same services. Nothing
contained in this paragraph shall prohibit such physicians who practice
as partners, in groups or as a professional corporation or as a univer-
sity 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 partnerships, corporations, or groups be
A. 10742--A 7
prohibited from sharing, dividing or apportioning the fees and moneys
received by them or by the partnership, corporation or group in accord-
ance with a partnership or other agreement.
S 8. Subdivisions 2 and 3, and the opening paragraph and paragraph (g)
of subdivision 10 of section 13-k of the workers' compensation law, as
amended by chapter 473 of the laws of 2000, are amended to read as
follows:
2. An employee injured under circumstances which make such injury
compensable under this article, when care is required for an injury to
the foot which injury or resultant condition therefrom may lawfully be
treated by a duly registered and licensed podiatrist of the state of New
York, may select to treat him or her any podiatrist authorized by the
chair to render podiatry care, as hereinafter provided. If the injury or
condition is one which is without the limits prescribed by the education
law for podiatry care and treatment, or the injuries involved affect
other parts of the body in addition to the foot, the said podiatrist
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 overall supervision of
the treatment of said patient including the future treatment to be
administered to the patient by the podiatrist. If for any reason during
the period when podiatry treatment and care is required, the employee
wishes to transfer his or her treatment and care to another authorized
podiatrist he or she may do so, in accordance with rules prescribed by
the chair, provided however that the employer shall be liable for the
proper fees of the original podiatrist for the care and treatment he or
she shall have rendered. A podiatrist licensed and registered to prac-
tice podiatry in the state of New York who is desirous of being author-
ized to render podiatry care under this section and/or to conduct [inde-
pendent] ADVERSARIAL medical examinations in accordance with paragraph
(b) of subdivision three of this section shall file an application for
authorization under this section with the podiatry practice committee.
In such application he or she shall agree to refrain from subsequently
treating for remuneration, as a private patient, any person seeking
podiatry treatment, or submitting to an [independent] ADVERSARIAL
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 podiatrists authorized to render podiatry care or to conduct
[independent] ADVERSARIAL 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
podiatrist for payment for treatment rendered by a podiatrist after he
or she has been removed from the list of podiatrists authorized to
render podiatry care or to conduct [independent] ADVERSARIAL medical
examinations under this section, or after the injured person was trans-
ferred from his or her care in accordance with the provisions of this
section. The podiatry practice committee if it deems such licensed
podiatrist duly qualified shall recommend to the chair that such podia-
trist be authorized to render podiatry care and/or to conduct [independ-
ent] ADVERSARIAL medical examinations under this section. Such recommen-
dation 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 podiatry treatment and care, to be determined in
A. 10742--A 8
accordance with and to be subject to change pursuant to rules promulgat-
ed by the chair. Before preparing such schedule for the state or sched-
ules for limited localities the chair shall request the podiatry prac-
tice 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 podiatry care to be rendered under this chapter, but consider-
ation 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 podiatry care or treatment shall be valid and
enforceable as against the employer or employee unless within forty-
eight hours following the first treatment the podiatrist giving such
care or treatment furnish to the employer and directly to the chair a
preliminary notice of such injury and treatment, within fifteen days
thereafter a more complete report and subsequent thereto progress
reports as requested in writing by the chair, board, employer or insur-
ance 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 podiatrist author-
ized 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 podia-
trist, and refusal by the claimant to submit to such [independent]
ADVERSARIAL 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]
ADVERSARIAL medical examination by an authorized podiatrist, the employ-
er or carrier shall arrange for such examination to be performed by a
qualified podiatrist in a medical facility convenient to the claimant.
(d) The [independent] ADVERSARIAL podiatric examiner 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] ADVERSARIAL podiatric examiner licensed by
the state of New York shall include the following:
(i) a signed statement certifying that the report is a full and truth-
ful representation of the [independent] ADVERSARIAL podiatric 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.
The podiatry practice committee shall investigate, hear and make find-
ings with respect to all charges as to professional or other misconduct
of any authorized podiatrist as herein provided under rules and proce-
dures to be prescribed by the chair and shall report evidence of such
misconduct, with their findings and recommendation with respect thereto,
to the chair. The findings, decision and recommendation of such podiatry
A. 10742--A 9
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 podiatrists authorized to render podiatry care under this chap-
ter or to conduct [independent] ADVERSARIAL medical examinations in
accordance with paragraph (b) of subdivision three of this section the
name of any podiatrist who he or she shall find after reasonable inves-
tigation is disqualified because such podiatrist
(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 prof-
ited by means of a credit or other valuable consideration as a commis-
sion, discount or gratuity in connection with the treatment, or [inde-
pendent] ADVERSARIAL medical examination, of a workers' compensation
claimant. Nothing contained in this paragraph shall prohibit such
podiatrists who practice as partners, in groups or as a professional
corporation from pooling fees and moneys received, either by the part-
nership, professional corporation or group by the individual members
thereof, for professional services furnished by any individual profes-
sional 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.
S 9. Subdivisions 2 and 3, and the opening paragraph and paragraph (g)
of subdivision 10 of section 13-l of the workers' compensation law, as
amended by chapter 473 of the laws of 2000, are amended to read as
follows:
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] ADVERSARIAL 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]
ADVERSARIAL 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] ADVERSARIAL 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 treat-
A. 10742--A 10
ed, 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 author-
ized to render chiropractic care or to conduct [independent] ADVERSARIAL
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 [inde-
pendent] ADVERSARIAL 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 insur-
ance 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] ADVERSARIAL 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]
ADVERSARIAL 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] ADVERSARIAL 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
A. 10742--A 11
submitted to the board by an [independent] ADVERSARIAL 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 truth-
ful representation of the [independent] ADVERSARIAL chiropractic examin-
er'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.
The chiropractic practice committee shall investigate, hear and make
findings with respect to all charges as to professional or other miscon-
duct 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] ADVERSARIAL 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,
(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 prof-
ited by means of a credit or otherwise valuable consideration as a
commission, discount or gratuity, in connection with the treatment, or
[independent] ADVERSARIAL medical examination, of a workers' compen-
sation claimant. Nothing contained in this paragraph shall prohibit
such chiropractors who practice as partners, in groups or as a profes-
sional corporation, or as a university faculty practice corporation from
pooling fees and moneys received, either by the partnership, profes-
sional 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 part-
nership, 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 agree-
ment.
S 10. Subdivisions 3 and 4 and the opening paragraph of subdivision 11
of section 13-m of the workers' compensation law, as amended by chapter
473 of the laws of 2000, are amended to read as follows:
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]
ADVERSARIAL medical examinations in accordance with paragraph (b) of
subdivision four of this section shall file an application for authori-
zation under this section with the psychology practice committee. The
applicant shall agree to refrain from subsequently treating for remuner-
ation, as a private patient, any person seeking psychological treatment,
or submitting to an [independent] ADVERSARIAL 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 agree-
A. 10742--A 12
ment 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] ADVERSARIAL 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] ADVERSARIAL 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 accord-
ance 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 insur-
ance 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] ADVERSARIAL 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]
ADVERSARIAL 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] ADVERSARIAL 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
A. 10742--A 13
the board by an [independent] ADVERSARIAL 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 truth-
ful representation of the [independent] ADVERSARIAL psychological exam-
iner'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.
The psychology practice committee shall investigate, hear and make
findings with respect to all charges as to professional or other miscon-
duct 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] ADVERSARIAL 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:
S 11. Section 13-n of the workers' compensation law, as added by chap-
ter 473 of the laws of 2000 and subdivision 3 as added by chapter 6 of
the laws of 2007, is amended to read as follows:
S 13-n. Mandatory registration of entities which derive income from
[independent] ADVERSARIAL medical examinations. 1. Any entity which
derives income from [independent] ADVERSARIAL medical examinations
performed in accordance with subdivision four of section thirteen-a,
subdivision three of section thirteen-k, subdivision three of section
thirteen-1 and subdivision four of section thirteen-m of this article,
whether by employing or contracting with [independent] ADVERSARIAL exam-
iners to conduct such [independent] ADVERSARIAL medical examinations or
by acting as a referral service or otherwise facilitating such examina-
tions, shall register with the chair by filing a statement of registra-
tion containing such information prescribed by the chair in regulation.
A fee may be imposed in accordance with regulations promulgated by the
chair. Any such fees collected shall be used for the purpose of adminis-
tering this section.
2. The chair shall assign a registration number to the entity upon
registration. If an entity operates under more than one name, or in more
than one location, the chair may assign a series of registration numbers
which would differentiate each such sub-entity. 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 [independ-
ent] ADVERSARIAL medical examiner who is employed by, or has contracted
with, an entity as described in subdivision one of this section for the
purpose of performing [independent] ADVERSARIAL medical examinations,
must include the registration number of such entity.
3. The chair, upon finding that an entity that derives income from
[independent] ADVERSARIAL medical examinations has materially altered an
[independent] ADVERSARIAL medical examination report, or caused such a
report to be materially altered, may revoke the registration of such
entity, impose a penalty not exceeding ten thousand dollars and refer
the matter to the attorney general for prosecution.
A. 10742--A 14
S 12. Section 137 of the workers' compensation law, as added by chap-
ter 473 of the laws of 2000, is amended to read as follows:
S 137. [Independent] ADVERSARIAL medical examinations. 1. (a) A copy
of each report of [independent] ADVERSARIAL medical examination shall be
submitted by the practitioner on the same day and in the same manner to
the board, the insurance carrier, the claimant's attending physician or
other attending practitioner, the claimant's representative and the
claimant.
(b) If a practitioner who has performed or will be performing an
[independent] ADVERSARIAL medical examination of a claimant receives a
request for information regarding the claimant, including faxed or elec-
tronically transmitted requests, the practitioner shall submit a copy of
the request for information to the board within ten days of receipt of
the request. Nothing in this subdivision shall be construed to abrogate
the attorney-client privilege.
(c) Copies of all responses to such requests for information as are
described in paragraph (b) of this subdivision, including all materials
which are provided in response to such a request, shall be submitted by
the responding practitioner to the board within ten days of submission
of the response to the requestor. Nothing in this subdivision shall be
construed to abrogate the attorney-client privilege.
2. In any open case where an award has been directed by the board for
temporary or permanent disability at an established rate of compensation
and there is a direction by the board for continuation of payments, or
any closed case where an award for compensation has been made for perma-
nent total or permanent partial disability, a report of an [independent]
ADVERSARIAL medical examination shall not be the basis for suspending or
reducing payments unless and until the rules and regulations of the
board regarding suspending or reducing payments have been met and there
is a determination by the board finding that such suspension or
reduction is justified.
3. (a) Only a New York state licensed and board certified physician,
surgeon, podiatrist or any other person authorized to examine or evalu-
ate injury or illness by the board shall perform such [independent]
ADVERSARIAL medical examination. Where a claimant resides out of state a
practitioner qualified to examine or evaluate injury or illness by the
board shall perform such [independent] ADVERSARIAL medical examination.
(b) Any practitioner performing the [independent] ADVERSARIAL medical
examinations shall be paid according to the fee schedule established
pursuant to section thirteen of this chapter.
4. All [independent] ADVERSARIAL medical examinations shall be
performed in medical facilities suitable for such exam, with due regard
and respect for the privacy and dignity of the injured worker as well as
the access and safety of the claimant. Such facilities must be provided
in a convenient and accessible location within a reasonable distance
from the claimant's residence.
5. All [independent] ADVERSARIAL medical examinations shall be
performed by a practitioner competent to evaluate or examine the injury
or disease from which the injured worker suffers. Such examination shall
be performed by a practitioner who is licensed and board certified in
the state of New York or any other person authorized to examine or eval-
uate injury or illness by the board.
6. No practitioner examining or evaluating a claimant under this chap-
ter nor any supervising authority or proprietor nor insurance carrier or
employer may cause, direct or encourage a report to be submitted as
evidence in workers' compensation claim adjudication which differs
A. 10742--A 15
substantially from the professional opinion of the examining practition-
er. Such an action shall be considered within the jurisdiction of the
workers' compensation fraud inspector general and may be referred as a
fraudulent practice.
7. The claimant shall receive notice by mail of the scheduled [inde-
pendent] ADVERSARIAL medical examination at least seven business days
prior to such examination. Such notice shall advise the claimant if the
practitioner intends to record or video tape the examination, and shall
advise the claimant of their right to video tape or otherwise record the
examination. Claimants shall be advised of their right to be accompanied
during the exam by an individual or individuals of their choosing.
8. [Independent] ADVERSARIAL medical examinations shall be performed
during regular business hours except with the consent and for the
convenience of the claimant. Claimants subject to such examination shall
be notified at the time of the exam in writing of the available travel
reimbursement under law.
9. A practitioner is not eligible to perform an [independent] ADVER-
SARIAL medical examination of a claimant if the practitioner has treated
or examined the claimant for the condition for which the [independent]
ADVERSARIAL medical examination is being requested or if another member
of a preferred provider organization or managed care provider to which
the practitioner belongs has treated or examined the claimant for the
condition for which the [independent] ADVERSARIAL medical examination is
being requested.
10. The ability of a claimant to appear for an exam or hearing shall
not be dispositive in the determination of disability, extent of disa-
bility or eligibility for benefits.
11. At the time of the [independent] ADVERSARIAL medical examination
the claimant shall receive a notice from the entity performing the
[independent] ADVERSARIAL medical examination, on a form which shall be
approved and promulgated by the chair, stating the rights and obli-
gations of the claimant and the practitioner with respect to such exam,
and such notice shall include but not be limited to a statement that the
claimant's receipt of benefits could be denied, terminated, or reduced
as a result of a determination which may be based upon the medical eval-
uation made after such [independent] ADVERSARIAL medical examination,
and the claimant's rights to challenge or appeal such a determination.
S 13. Subdivisions 1, 2 and 3 of section 50-h of the general municipal
law, subdivision 1 as amended by chapter 24 of the laws of 1988, subdi-
vision 2 as amended by chapter 254 of the laws of 1990 and subdivision 3
as added by chapter 393 of the laws of 1958, are amended to read as
follows:
1. Wherever a notice of claim is filed against a city, county, town,
village, fire district, ambulance district [or], school district OR
PUBLIC AUTHORITY the city, county, town, village, fire district, ambu-
lance district [or], school district OR PUBLIC AUTHORITY shall have the
right to demand an examination of the claimant relative to the occur-
rence and extent of the injuries or damages for which claim is made,
which examination shall be upon oral questions unless the parties other-
wise stipulate and may include [a physical] AN ADVERSARIAL MEDICAL exam-
ination of the claimant by a duly qualified physician. If the party to
be examined desires, he or she is entitled to have such examination in
the presence of his or her own personal physician and such relative or
other person as he or she may elect. THE PERSON SUBJECT TO THE ADVER-
SARIAL MEDICAL EXAMINATION SHALL NOT BE REQUIRED TO PRODUCE ANY DOCU-
MENTS OR SUPPLY ANY WRITTEN ANSWERS TO QUESTIONS PUT TO HIM OR HER AT
A. 10742--A 16
SUCH ADVERSARIAL MEDICAL EXAMINATION. Exercise of the right to demand a
physical examination of the claimant as provided in this section shall
in no way affect the right of a city, county, town, village, fire
district, ambulance district [or], school district OR PUBLIC AUTHORITY
in a subsequent action brought upon the claim to demand [a physical] AN
ADVERSARIAL MEDICAL examination of the plaintiff pursuant to statute or
court rule.
2. The demand for examination as provided in subdivision one of this
section shall be made by the chief executive officer or, where there is
no such officer, by the chairman of the governing body of the city,
county, town, village, fire district [or], school district OR PUBLIC
AUTHORITY or by such officer, agent or employee as may be designated by
him OR HER for that purpose. The demand shall be in writing and shall
be served personally or by registered or certified mail upon the claim-
ant unless the claimant is represented by an attorney, when it shall be
served personally or by mail upon his OR HER attorney. The demand shall
give reasonable notice of the examination. It shall state the person
before whom the examination is to be held, the time, place and subject
matter thereof and, if [a physical] AN ADVERSARIAL MEDICAL examination
is to be required, it shall so state. If the place of examination is
located outside the municipality against which the claim is made, the
claimant may demand, within ten days of such service, that the examina-
tion be held at a location within such municipality. Such location shall
be determined by the municipality. If [a physical] AN ADVERSARIAL
MEDICAL examination is to be required and there is no appropriate place
for such an examination within the municipality, such examination shall
be given at a location as close to such municipality as practicable. No
demand for examination shall be effective against the claimant for any
purpose unless it shall be served as provided in this subdivision within
ninety days from the date of filing of the notice of claim.
3. In any examination required pursuant to the provisions of this
section the claimant shall have the right to be represented by counsel.
The examination shall be conducted upon oath or affirmation. The officer
or person before whom the examination is had shall take down or cause to
be taken down every question and answer unless the parties consent that
only the substance of the testimony be inserted. The testimony so taken,
together with the report of the examining physician where [a physical]
AN ADVERSARIAL MEDICAL examination is required, shall constitute the
record of the examination. The transcript of the record of an examina-
tion shall not be subject to or available for public inspection, except
upon court order upon good cause shown, but shall be furnished to the
claimant or his OR HER attorney upon request.
S 14. Subdivisions 1, 2 and 3 of section 17-a of the court of claims
act, as added by chapter 189 of the laws of 1990, are amended to read as
follows:
1. Wherever a notice of intention to file a claim is served, the
defendant shall have the right to demand an examination of the claimant
relative to the occurrence and extent of the injuries or damages for
which claim is made, which examination shall be upon oral questions
unless the parties otherwise stipulate and may include [a physical] AN
ADVERSARIAL MEDICAL examination of the claimant by a duly qualified
physician. If the party to be examined desires, he or she is entitled to
have such [physical] AN ADVERSARIAL MEDICAL examination in the presence
of his or her own personal physician and such relative or other person
as he or she may elect. Exercise of the right to demand [a physical] AN
ADVERSARIAL MEDICAL examination of the claimant as provided in this
A. 10742--A 17
section shall in no way affect the right of a defendant in a subsequent
claim brought upon the notice of intention to file a claim to demand [a
physical] AN ADVERSARIAL MEDICAL examination of the claimant pursuant to
statute or court rule.
2. The demand for examination as provided in subdivision one of this
section shall be made by the attorney for the defendant or by such offi-
cer, agent or employee as may be designated by him for that purpose. The
demand shall be in writing and shall be served personally or by regis-
tered or certified mail upon the claimant unless the claimant is repres-
ented by an attorney, when it shall be served personally or by mail upon
his or her attorney. The demand shall give reasonable notice of the
examination. It shall state the person before whom the examination is to
be held, the time, place and subject matter thereof and, if [a physical]
AN ADVERSARIAL MEDICAL examination is to be required, it shall so state.
No demand for examination shall be effective against the claimant for
any purpose unless it shall be served as provided in this subdivision
within ninety days from the date of service of the notice of intention
to file a claim.
3. In any examination required pursuant to the provisions of this
section the claimant shall have the right to be represented by counsel.
The examination shall be conducted upon oath or affirmation. The officer
or person before whom the examination is held shall take down or cause
to be taken down every question and answer unless the parties consent
that only the substance of the testimony be inserted. The testimony so
taken, together with the report of the examining physician where [a
physical] AN ADVERSARIAL MEDICAL examination is required, shall consti-
tute the record of the examination. The transcript of the record of an
examination, including a copy of the report of the examining physician
shall not be subject to or available for public inspection, except upon
court order upon good cause shown, but shall be furnished to the claim-
ant or his or her attorney upon request.
S 15. This act shall take effect immediately and shall apply to all
currently pending actions and proceedings, and to proceedings commenced
subsequent to such date.