2006 New York Code - Care And Treatment Of Injured Employees By Duly Licensed Psychologists.

 
    §  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 chairman 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,
  upon the referral of an authorized physician, by  a  psychologist,  duly
  registered  and  licensed  by  the  state of New York, authorized by the
  chairman to render psychological care pursuant  to  this  section.  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 chapter,  may  provide  psychological  services  when
  required,  upon  the  referral of an authorized physician, provided such
  care  is  rendered  by  a  duly  registered,  licensed  and   authorized
  psychologist, as required by this section.
    (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 chairman  on  such
  forms and at such times as the chairman may require.
    3.  A  psychologist, licensed and registered to practice psychology in
  the state of New York, who is desirous of  being  authorized  to  render
  psychological  care  under  this  section  and/or to conduct independent
  medical examinations in accordance with  paragraph  (b)  of  subdivision
  four  of  this section shall file an application for authorization under
  this section with the psychology practice committee. The applicant shall
  agree to refrain from  subsequently  treating  for  remuneration,  as  a
  private   patient,   any  person  seeking  psychological  treatment,  or
  submitting to an independent medical examination, in connection with, or
  as a result of, any injury compensable under this chapter, if he or  she
  has  been  removed  from  the list of psychologists authorized to render
  psychological care under this chapter. This agreement shall run  to  the
  benefit  of  the  injured person so treated, and shall be available as a
  defense in any action by such psychologist  for  payment  for  treatment
  rendered  by  such  psychologist  after  being  removed from the list of
  psychologists authorized to render  psychological  care  or  to  conduct
  independent  medical  examinations  under  this  section. The psychology
  practice committee if it deems such licensed psychologist duly qualified
  shall recommend to the chair that such person be  authorized  to  render
  psychological  care  and/or  to conduct independent medical examinations
  under this section. Such recommendations shall be only advisory  to  the
  chair  and  shall  not be binding or conclusive. 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 subdivision three of this
  section 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.
  If the parties fail to agree as to the psychological care rendered under
  this  chapter  to  a  claimant,  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.  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.
    (b) 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.
    (c) A provider initiating an  arbitration  pursuant  to  this  section
  shall  pay a fee, as determined by regulations promulgated by the chair,
  to  be  used  to  cover  the  costs  related  to  the  conduct  of  such
  arbitration.  Upon  resolution  in  favor of such party, the amount due,
  based upon the bill in dispute, shall be increased by the amount of  the
  fee  paid  by such party. Where a partial award is made, the amount due,
  based upon the bill in dispute, shall be increased by  a  part  of  such
  fee.
    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 chairman shall appoint for and with jurisdiction in the entire
  state of New York a single psychology practice committee composed of two
  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,  and  one
  duly  licensed  physician  of the state of New York. Each member of said
  committee shall receive compensation either on an annual basis or  on  a
  per  diem  basis to be fixed by the chairman within amounts appropriated
  therefor. One of said psychologists shall be designated by the  chairman
  as  a  chairman 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.