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This entry was published on 2020-01-10
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SECTION 13-M
Care and treatment of injured employees by duly licensed psychologists
Workers' Compensation (WKC) CHAPTER 67, ARTICLE 2
§ 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 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 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 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.

(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 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 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.