Assembly Bill A6356

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6356
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 6, 2019
                                ___________
 
 Introduced  by M. of A. REYES -- read once and referred to the Committee
   on Governmental Employees
 
 AN ACT to amend the retirement and social security law, in  relation  to
   criteria for medical examinations to determine disability status
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The retirement and social security law is amended by adding
 a new section 65 to read as follows:
   § 65. CRITERIA FOR MEDICAL EXAMINATIONS.  A.  IN  INSTANCES  WHERE  AN
 APPLICANT  FOR  DISABILITY  BENEFITS UNDER THIS TITLE IS GIVEN A MEDICAL
 EXAMINATION, THE HEALTH CARE PRACTITIONER WHO PERFORMS SUCH  EXAMINATION
 OF THE APPLICANT SHALL:
   1.  REVIEW  AND  CONSIDER  ALL  RECORDS OR INFORMATION PROVIDED BY THE
 APPLICANT OR HIS OR HER  TREATING  HEALTH  CARE  PRACTITIONER  THAT  ARE
 PERTINENT TO THE CLAIMED MEDICAL CONDITION;
   2.  MAKE  A  SPECIFIC  DIAGNOSIS AS EVIDENCED BY MEDICALLY APPROPRIATE
 TESTS OR EVALUATIONS IN DETERMINATION OF THE APPLICANT'S CLAIMED  CONDI-
 TION;
   3.  RENDER  TO THE APPLICANT AND THE COMPTROLLER, AN OPINION, PARTICU-
 LARIZING THE PRESENCE OR ABSENCE OF THE ALLEGED CONDITION;
   4. IN THE EVENT THAT HE OR SHE IDENTIFIES A CONDITION, OTHER THAN  THE
 ALLEGED  CONDITION,  THAT MAY INTERFERE WITH THE INDIVIDUAL'S ABILITY TO
 FULLY ENGAGE IN WORK ACTIVITIES,  THE  PRACTITIONER  SHALL  REPORT  SUCH
 CONDITION; AND
   5. DETERMINE WHETHER THE INDIVIDUAL IS:
   (A) DISABLED AND ELIGIBLE FOR BENEFITS UNDER THIS TITLE; OR
   (B) NEITHER DISABLED NOR WORK LIMITED.
   B.  IF  THE  PRACTITIONER  TO WHOM THE APPLICANT IS REFERRED ISSUES AN
 OPINION THAT DIFFERS FROM THE APPLICANT'S TREATING HEALTH  CARE  PRACTI-
 TIONER,  THE  PRACTITIONER  SHALL  PROVIDE  A WRITTEN DETERMINATION THAT
 SPECIFIES WHY THE PRACTITIONER DISAGREES WITH THE  APPLICANT'S  TREATING
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD08883-01-9

 A. 6356                             2
 
 HEALTH CARE PRACTITIONER'S DISABILITY DETERMINATION AND PRESENT EVIDENCE
 THAT SUPPORTS THE OPINION.
   C.  IN  THE  EVENT  THE PRACTITIONER TO WHOM THE APPLICANT IS REFERRED
 ISSUES AN OPINION THAT DIFFERS FROM THE APPLICANT'S TREATING HEALTH CARE
 PRACTITIONER'S OPINION, THE APPLICANT'S TREATING HEALTH CARE PRACTITION-
 ER'S OPINION SHALL BE GENERALLY CONTROLLING, SUBJECT TO, BUT NOT LIMITED
 TO, THE FOLLOWING FACTORS:
   1. THE LENGTH AND FREQUENCY OF THE TREATMENT PROVIDED;
   2. CONSISTENCY OF THE OPINION WITH THE RECORD AS A WHOLE;
   3. THE DEGREE TO WHICH THE OPINION IS SUPPORTED BY CONCRETE  EVIDENCE;
 AND
   4. SUCH PRACTITIONER'S SPECIALTY.
   §  2.  This  act shall take effect on the ninetieth day after it shall
 have become a law.