§ 13-L — Care and treatment of injured employees by duly licensed chiropractors

New York § 13-L

• Jurisdiction: New York
• Law WKC: Workers' Compensation
• Art. 2: Compensation

Text

§ 13-l. Care and treatment of injured employees by duly licensed\nchiropractors. 1. Where the term "chairman" is hereinafter used, it\nshall be deemed to mean the chair of the workers' compensation board of\nthe state of New York.\n 2. An employee injured under circumstances which make such injury\ncompensable under this article, when care is required for an injury\nwhich consists solely of a condition which may lawfully be treated by a\nchiropractor as defined in section sixty-five hundred fifty-one of the\neducation law may select to treat him or her, any duly registered and\nlicensed chiropractor of the state of New York, authorized by the chair\nto render chiropractic care as hereinafter provided. If the injury or\ncondition is one which is outside the limits prescribed by the education\nlaw for chiropractic care and treatment, the said chiropractor must so\nadvise the said injured employee and instruct him or her to consult a\nphysician of said employee's choice for appropriate care and treatment.\nSuch physician shall thenceforth have supervision of the treatment of\nsaid condition including the future treatment to be administered to the\npatient by the chiropractor. The chair shall prepare and establish a\nschedule for the state, or schedules limited to defined localities of\ncharges and fees for chiropractic treatment and care, to be determined\nin accordance with and to be subject to change pursuant to rules\npromulgated by the chair. Before preparing such schedule for the state\nor schedules for limited localities the chair shall request the\nchiropractic practice committee to submit to him or her a report on the\namount of remuneration deemed by such committee to be fair and adequate\nfor the types of chiropractic care to be rendered under this chapter,\nbut consideration shall be given to the view of other interested\nparties, the amounts payable by the employer for such treatment and\nservices shall be the fees and charges established by such schedule.\n 3. (a) No claim for chiropractic care or treatment shall be valid and\nenforceable as against the employer or employees unless within\nforty-eight hours following the first treatment the chiropractor giving\nsuch care or treatment furnishes to the employer and directly to the\nchair a preliminary notice of such injury and treatment, and within\nfifteen days thereafter a more complete report and subsequent thereto\nprogress reports as requested in writing by the chair, board, employer\nor insurance carrier, at intervals of not less than three weeks apart or\nat less frequent intervals if requested on forms prescribed by the\nchair. The board may excuse the failure to give such notices within the\ndesignated periods when it finds it to be in the interest of justice to\ndo so.\n (b) Upon receipt of the notice provided for by paragraph (a) of this\nsubdivision, the employer, the carrier, and the claimant each shall be\nentitled to have the claimant examined by a qualified chiropractor\nauthorized by the chair in accordance with section thirteen-b and\nsection one hundred thirty-seven of this chapter at a medical facility\nconvenient to the claimant and in the presence of the claimant's\nchiropractor, and refusal by the claimant to submit to such independent\nmedical examination at such time or times as may reasonably be necessary\nin the opinion of the board shall bar the claimant from recovering\ncompensation, for any period during which he or she has refused to\nsubmit to such examination.\n (c) Where it would place an unreasonable burden upon the employer or\ncarrier to arrange for, or for the claimant to attend, an independent\nmedical examination by an authorized chiropractor, the employer or\ncarrier shall arrange for such examination to be performed by a\nqualified chiropractor in a medical facility convenient to the claimant.\n (d) The independent chiropractic examiner shall provide such reports\nand shall submit to investigation as required by the chair.\n (e) In order to qualify as admissible chiropractic evidence, for\npurposes of adjudicating any claim under this chapter, any report\nsubmitted to the board by an independent medical examiner licensed by\nthe state of New York shall include the following:\n (i) a signed statement certifying that the report is a full and\ntruthful representation of the independent chiropractic examiner's\nprofessional opinion with respect to the claimant's condition,\n (ii) such examiner's board issued authorization number,\n (iii) the name of the individual or entity requesting the examination,\n (iv) if applicable, the registration number as required by section\nthirteen-n of this article, and\n (v) such other information as the chair may require by regulation.\n 4. Fees for chiropractic services shall be payable only to a duly\nauthorized chiropractor as defined in this section, or to the agent,\nexecutor or administrator of the estate of such chiropractor. No\nchiropractor rendering treatment to a compensation claimant shall\ncollect or receive a fee from such claimant within this state, but shall\nhave recourse for payment of services rendered only to the employer\nunder the provisions of this section.\n 5. Whenever his attendance at a hearing is required the chiropractor\nof the injured employee shall be entitled to receive a fee from the\nemployer in an amount to be fixed by the board, in addition to any fee\npayable under section eight thousand and one of the civil practice law\nand rules.\n 6. (a) The provisions of subdivisions one and three of section\nthirteen-g of this article with respect to the conditions under which a\nhospital, physician or self-employed physical or occupational therapist\nmay request payment or arbitration of a bill, or under which an award\nmay be made for payment of such bill, shall be applicable to bills\nrendered by a chiropractor for services rendered to an injured employee.\n (b) If the parties fail to agree as to the chiropractic care rendered\nunder this chapter to a claimant, and the amount of the disputed bill is\none thousand dollars or less, or where the amount of the disputed bill\nexceeds one thousand dollars and the chiropractor expressly so requests,\nsuch value shall be decided by a single arbitrator process, pursuant to\nrules promulgated by the chair. The chair shall appoint a member in good\nstanding of a recognized professional association representing\nchiropractors in the state of New York to determine the value of such\ndisputed bill. Decisions rendered under the single arbitrator process\nshall be conclusive upon the parties as to the value of the services in\ndispute.\n (c) If the parties fail to agree as to the chiropractic care rendered\nunder this chapter to a claimant, and the amount of the disputed bill\nexceeds one thousand dollars and the chiropractor does not expressly\nrequest a single arbitrator process in accordance with paragraph (b) of\nthis subdivision, such value shall be decided by the chiropractic\npractice committee and the majority decision of such committee shall be\nconclusive upon the parties as to the value of the services rendered.\n (d) The board or the chair may make an award not in excess of the\nestablished fee schedules for any such bill or part thereof which\nremains unpaid in the same manner as an award for bills rendered under\nsubdivisions one and three of section thirteen-g of this article, and\nsuch award may be collected in like manner as an award of compensation.\nWhere a chiropractor's bill has been determined to be due and owing in\naccordance with the provisions of this section the board shall include\nin the amount of the award interest of not more than one and one-half\npercent (1 1/2%) per month payable to the chiropractor in accordance\nwith the rules and regulations promulgated by the board. The chair shall\nassess the sum of fifty dollars against the employer for each such award\nmade by the board, which sum shall be paid into the state treasury.\n (e) A provider initiating an arbitration, including a single\narbitrator process, pursuant to this section shall not pay a fee to\ncover the costs related to the conduct of such arbitration.\n 7. Within the limits prescribed by the education law for chiropractic\ncare and treatment, the report or testimony of an authorized\nchiropractor concerning the condition of an injured employee and\ntreatment thereof shall be deemed competent evidence and the\nprofessional opinion of the chiropractor as to causal relation and as to\nrequired treatment shall be deemed competent but shall not be\ncontrolling. Nothing in this section shall be deemed to deprive any\nemployer or insurance carrier of any right to medical examination or\npresentation of medical testimony now conferred by law.\n 8. The chairman shall promulgate rules governing the procedure to be\nfollowed by those rendering chiropractic care under this section, which\nrules so far as practicable shall conform to the rules presently in\neffect with reference to medical care furnished to claimants in\nworkmen's compensation. In connection with the promulgation of said\nrules the chairman may consult the chiropractic practice committee\nhereinafter provided and may take into consideration the view of other\ninterested parties.\n 9. The chair shall appoint for and with jurisdiction in the entire\nstate of New York a single chiropractic practice committee composed of\nthree duly registered and licensed chiropractors of the state of New\nYork. Each member of said committee shall receive compensation either\non an annual basis or on a per diem basis to be fixed by the chair\nwithin amounts appropriated therefor. One of said chiropractic members\nshall be designated by the chair as a chair of said chiropractic\npractice committee. No member of said committee shall render\nchiropractic treatment under this section nor be employed or accept or\nparticipate in any fee from any insurance company authorized to write\nworkers' compensation insurance in this state or from any self-insurer,\nwhether such employment or fee relates to a workers' compensation claim\nor otherwise. The attorney general, upon request, shall advise and\nassist such committee.\n 10. The chiropractic practice committee shall investigate, hear and\nmake findings with respect to all charges as to professional or other\nmisconduct of any authorized chiropractor as herein provided under rules\nand procedure to be prescribed by the chair and shall report evidence of\nsuch misconduct, with their findings and recommendations with respect\nthereto, to the chair. The findings, decision and recommendation of such\nchiropractic practice committee shall be advisory to the chair only, and\nshall not be binding or conclusive upon him or her. The chair shall\nremove from the list of chiropractors authorized to render chiropractic\ncare under this chapter or to conduct independent medical examinations\nin accordance with paragraph (b) of subdivision three of this section\nthe name of any chiropractor who he or she shall find after reasonable\ninvestigation is disqualified because such chiropractor,\n (a) has been guilty of professional or other misconduct or\nincompetency in connection with chiropractic services rendered under the\nlaw, or\n (b) has exceeded the limits of his or her professional competence in\nrendering chiropractic services under the law, or has made false\nstatements regarding his or her qualifications in his or her application\nfor authorization, or\n (c) has failed to submit timely, full and truthful chiropractic\nreports of all his or her findings to the employer and directly to the\nchair of the board within the time limits provided in this section, or\n (d) has knowingly made a false statement or representation as to a\nmaterial fact in any medical report made pursuant to this chapter or in\ntestifying or otherwise providing information for the purposes of this\nchapter, or\n (e) has solicited or has employed another to solicit for himself or\nherself or for another professional treatment, examination or care of an\ninjured employee with any claim under this chapter, or\n (f) has refused to appear before, to testify, to submit to a\ndeposition, or answer upon request of the chair, board, chiropractic\npractice committee or any duly authorized officer of the state, any\nlegal question or produce any relevant book or paper concerning his or\nher conduct under an authorization granted to him or her under the law,\nor\n (g) has directly or indirectly requested, received or participated in\nthe division, transference, assignment, rebating, splitting or refunding\nof a fee for, or has directly or indirectly requested, received or\nprofited by means of a credit or otherwise valuable consideration as a\ncommission, discount or gratuity, in connection with the treatment, or\nindependent medical examination, of a workers' compensation claimant.\nNothing contained in this paragraph shall prohibit such chiropractors\nwho practice as partners, in groups or as a professional corporation, or\nas a university faculty practice corporation from pooling fees and\nmoneys received, either by the partnership, professional corporation,\nuniversity faculty practice corporation or group by the individual\nmembers thereof, for professional services furnished by any individual\nprofessional member, or employee of such partnership, corporation or\ngroup, nor shall the professionals constituting the partnership,\ncorporation, or group be prohibited from sharing, dividing or\napportioning the fees and moneys received by them or by the partnership,\ncorporation or group in accordance with a partnership or other\nagreement.\n 11. Any person who violates or attempts to violate, and any person who\naids another to violate or attempts to induce him to violate the\nprovisions of paragraph (g) of subdivision ten of this section shall be\nguilty of a misdemeanor.\n 12. Nothing in this section shall be construed as limiting in any\nrespect the power or duty of the chairman to investigate instances of\nmisconduct, either before or after investigation by the chiropractic\npractice committee or to temporarily suspend the authorization of any\nchiropractor that he may believe to be guilty of such misconduct. The\nprovisions of subdivision one of section thirteen-d of this article\nwhich are not inconsistent with the provisions of this section shall be\napplicable as fully as if set forth herein.\n