2006 New York Code - Medical Review In Member Disability Cases.

 
    §  13-552.1  Medical  review in member disability cases. a. As used in
  this section, the following terms shall mean and include:
    (1) "Panel of medical experts". Those physicians whose names  are  set
  forth   in   a   list  of  medical  experts  prepared  annually  by  the
  administrator of health services and filed in his office  and  with  the
  executive director of the retirement system on or before July first. The
  experts  so  designated  shall  be  physicians  having qualifications as
  specialists in such fields of medicine as such  administrator  deems  an
  essential  background  (i)  for  ascertaining,  in cases where a medical
  examination is required  in  relation  to  disability  retirement  under
  section 13-550, 13-551 or 13-553 of this chapter, whether such member is
  physically  or  mentally  incapacitated  for  the  performance  of  city
  service, and (ii) for rendering  of  reports  or  certifications  as  to
  diagnosis  and  issues  of  causal  relationship  with  respect  to such
  applications. Each of such physicians  shall  have  had,  prior  to  his
  designation, at least ten years of practice in the field with respect to
  which he is designated. The names of such physicians shall be separately
  grouped  in such list, according to the fields of medicine in which they
  are expert, and the names in each group shall be consecutively numbered.
    (2) "Party entitled to review". Either of the following:
    (i) the member; or
    (ii) the appropriate agency head.
    b. (1) In any case where an application for retirement of a member for
  disability has been filed pursuant to section 13-550 or 13-551  of  this
  chapter,  or  a  medical  examination  has  been  held  in  relation  to
  restoration to  service  under  section  13-553  of  this  chapter,  the
  executive  director of the retirement system, promptly after he receives
  the report or certification of the medical board with  respect  to  such
  application  or medical examination, shall give notice of such report or
  certification to such member and to the appropriate agency head.  Within
  fifteen  days  after such notification, any party entitled to review may
  file with the executive  director  a  written  request  that  a  special
  medical  committee,  as  provided  for in this section, shall review the
  conclusions and recommendations of the medical board set  forth  in  its
  report or certification.
    (2)  (i) Any request for review filed by a member with respect to such
  application for disability retirement or with respect to restoration  to
  service,  shall  be void and of no effect unless such request includes a
  waiver, as hereinafter provided, duly executed and acknowledged  by  the
  member or by a person acting in his behalf as hereinafter provided. Such
  waiver  may  be  executed by a person acting in behalf of such member in
  any case where, at the time of the execution  of  such  waiver  by  such
  person,  the  circumstances  are  such  that  if  such  application  for
  disability retirement had not been previously filed by or  with  respect
  to  such  member,  such  person  would  at  such  time  of  execution be
  authorized under the provisions of section  13-550  or  13-551  of  this
  chapter,  as  the  case may be, to file, as a person acting in behalf of
  such member, an application for disability retirement of such member.
    (ii) Such waiver shall provide that  the  execution  thereof  by  such
  member  or  by  a  person acting in behalf of such member as hereinabove
  authorized shall  constitute  an  agreement  by  such  member  that  his
  application  for disability retirement or for medical review in relation
  to restoration to service, as the case may be, shall be disposed of upon
  the recommendations of the special medical  committee  pursuant  to  the
  provisions  of  this  section,  that  such  action  shall  be  final and
  conclusive, and that he  waives  any  and  all  rights  which  he  might
  otherwise  have  to  seek  or  obtain  any  other  disposition  of  such
  application for disability retirement or review of medical  findings  in


  relation   to   restoration  to  service,  by  court  or  administrative
  proceedings or otherwise. A  waiver  so  executed  and  filed  shall  be
  effective and binding upon such member, in accordance with its terms.
    c.  Promptly  after the filing of a request for review to be made by a
  special medical committee, the executive director shall transmit a  copy
  of  such request and of the report or certification of the medical board
  to the administrator of health service.
    d. The administrator, upon receipt of such report or certification and
  request, shall promptly designate three of the physicians on  the  panel
  of  medical  experts  as  a special medical committee for the purpose of
  reviewing the recommendations and conclusions of the  medical  board  in
  such case. Such physicians shall be selected by him from the panel group
  possessing  the  specialist  qualifications  deemed essential by him for
  such review. All selections of physicians pursuant to this subdivision d
  shall be made in order of numerical standing in  the  group  from  which
  selection  is to be made, and on the basis of continuous rotation within
  the group.
    e. (1) Promptly after making the selection prescribed by subdivision d
  of this section, the administrator of health service  shall  notify  the
  selected physicians and the executive director thereof.
    (2)  Such  special  medical  committee shall, within thirty days after
  such notification to  the  physicians  constituting  such  committee  is
  completed,  perform,  with  respect to the application for retirement of
  such member for disability, or with respect to restoration  to  service,
  the same functions of medical examination or otherwise as are prescribed
  by  applicable  provisions  of  law for performance by the medical board
  with respect to retirement or restoration to service, and shall,  within
  such  period  adopt  by  majority  vote,  and  file  with  the executive
  director, a report or certification, as the case  may  be,  stating  the
  conclusions and recommendations of such committee concerning the matters
  required  to  be reported on or certified by the medical board, pursuant
  to applicable provisions of law.
    f.  The  conclusions  and  recommendations  of  the  special   medical
  committee shall supersede those of the medical board.
    g.  (1)  Each  physician  who  serves as a member of a special medical
  committee shall receive a fee for such service, to be determined by  the
  comptroller of the city.
    (2)  With  respect  to  each case in which a special medical committee
  acts upon the request by a member, one-half of the fees of  the  members
  of  such  committee  shall  be paid by the appropriate agency. The other
  half of such fees shall be paid by the member.
    (3) With respect  to  each  such  case  in  which  a  special  medical
  committee  acts upon the request by an appropriate agency head, the fees
  of the members of such committee shall be paid by such agency.
    h. In any case where  a  request  for  review  by  a  special  medical
  committee  is  filed  pursuant  to  the  provisions of this section, the
  provisions of sections 13-550, 13-551 and 13-553 of this  chapter  shall
  be  superseded  by the provisions of this section to the extent that the
  provisions of this section are inconsistent therewith.
    i. (1) In any case where the provisions of this  section  require  the
  executive  director  to  give notice to a member, the executive director
  may give such notice by delivery to such member personally or by mailing
  same to his  last  known  address,  as  shown  by  the  records  of  the
  retirement system.
    (2)  In  any  case  where  the  provisions of this section require the
  giving of notice or the transmission of papers to any other person, such
  notice may be given or transmission effected by delivery to such person,


  by delivery at his office to any of his employees, or by mailing to  the
  office address of such person.
    (3)  In  any  case  where  notice  is  given  by mail pursuant to this
  subdivision, such notice shall be deemed to be  given  on  the  date  of
  mailing.