S T A T E O F N E W Y O R K
________________________________________________________________________
6361
2021-2022 Regular Sessions
I N A S S E M B L Y
March 16, 2021
___________
Introduced by M. of A. REYES, FERNANDEZ, J. RIVERA, DICKENS, COLTON,
JEAN-PIERRE, SAYEGH, DeSTEFANO, GOTTFRIED, DILAN -- Multi-Sponsored by
-- M. of A. COOK -- 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-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00055-01-1
A. 6361 2
TIONER, THE PRACTITIONER SHALL PROVIDE A WRITTEN DETERMINATION THAT
SPECIFIES WHY THE PRACTITIONER DISAGREES WITH THE APPLICANT'S TREATING
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.