2020 New York Laws
WKC - Workers' Compensation
Article 2 - Compensation
13-L - Care and Treatment of Injured Employees by Duly Licensed Chiropractors.
§ 13-l. Care and treatment of injured employees by duly licensed chiropractors. 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. An employee injured under circumstances which make such injury compensable under this article, when care is required for an injury which consists solely of a condition which may lawfully be treated by a chiropractor as defined in section sixty-five hundred fifty-one of the education law may select to treat him or her, any duly registered and licensed chiropractor of the state of New York, authorized by the chair to render chiropractic care as hereinafter provided. If the injury or condition is one which is outside the limits prescribed by the education law for chiropractic care and treatment, the said chiropractor must so advise the said injured employee and instruct him or her to consult a physician of said employee's choice for appropriate care and treatment. Such physician shall thenceforth have supervision of the treatment of said condition including the future treatment to be administered to the patient by the chiropractor. The chair shall prepare and establish a schedule for the state, or schedules limited to defined localities of charges and fees for chiropractic treatment and care, to be determined in accordance with and to 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 chiropractic practice committee to submit to him or her a report on the amount of remuneration deemed by such committee to be fair and adequate for the types of chiropractic 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. 3. (a) No claim for chiropractic care or treatment shall be valid and enforceable as against the employer or employees unless within forty-eight hours following the first treatment the chiropractor 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 chiropractor 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 chiropractor, 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 chiropractor, the employer or carrier shall arrange for such examination to be performed by a qualified chiropractor in a medical facility convenient to the claimant.
(d) The independent chiropractic examiner shall provide such reports and shall submit to investigation as required by the chair.
(e) In order to qualify as admissible chiropractic evidence, for purposes of adjudicating any claim under this chapter, any report submitted to the board by an independent medical 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 chiropractic 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. 4. Fees for chiropractic services shall be payable only to a duly authorized chiropractor as defined in this section, or to the agent, executor or administrator of the estate of such chiropractor. No chiropractor 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. 5. Whenever his attendance at a hearing is required the chiropractor 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 and one of the civil practice law and rules. 6. (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 chiropractor for services rendered to an injured employee.
(b) If the parties fail to agree as to the chiropractic 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 chiropractor 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 chiropractors 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 chiropractic care rendered under this chapter to a claimant, and the amount of the disputed bill exceeds one thousand dollars and the chiropractor does not expressly request a single arbitrator process in accordance with paragraph (b) of this subdivision, such value shall be decided by the chiropractic 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. Where a chiropractor'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 (1 1/2%) per month payable to the chiropractor in accordance with the rules and regulations promulgated by the board. 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.
(e) A provider initiating an arbitration, including a single arbitrator process, pursuant to this section shall not pay a fee to cover the costs related to the conduct of such arbitration. 7. Within the limits prescribed by the education law for chiropractic care and treatment, the report or testimony of an authorized chiropractor concerning the condition of an injured employee and treatment thereof shall be deemed competent evidence and the professional opinion of the chiropractor 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 medical examination or presentation of medical testimony now conferred by law. 8. The chairman shall promulgate rules governing the procedure to be followed by those rendering chiropractic 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 workmen's compensation. In connection with the promulgation of said rules the chairman may consult the chiropractic practice committee hereinafter provided and may take into consideration the view of other interested parties. 9. The chair shall appoint for and with jurisdiction in the entire state of New York a single chiropractic practice committee composed of three duly registered and licensed chiropractors 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 chair within amounts appropriated therefor. One of said chiropractic members shall be designated by the chair as a chair of said chiropractic practice committee. No member of said committee shall render chiropractic treatment under this section nor be employed 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. 10. The chiropractic practice committee shall investigate, hear and make findings with respect to all charges as to professional or other misconduct of any authorized chiropractor as herein provided under rules and procedure 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 chiropractic 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 chiropractors authorized to render chiropractic care under this chapter or to conduct independent medical examinations in accordance with paragraph (b) of subdivision three of this section the name of any chiropractor who he or she shall find after reasonable investigation is disqualified because such chiropractor,
(a) has been guilty of professional or other misconduct or incompetency in connection with chiropractic services rendered under the law, or
(b) has exceeded the limits of his or her professional competence in rendering chiropractic services under the law, or has made false statements regarding his or her qualifications in his or her application for authorization, or
(c) has failed to submit timely, full and truthful chiropractic reports of all his or her 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 or 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, chiropractic practice committee or any duly authorized officer of the state, any legal question or produce any relevant book or paper concerning his or her conduct under an authorization granted to him or her under the 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, or independent medical examination, of a workers' compensation claimant. Nothing contained in this paragraph shall prohibit such chiropractors who practice as partners, in groups or as a professional corporation, or as a university faculty practice corporation from pooling fees and moneys received, either by the partnership, professional corporation, university faculty practice corporation or group 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 partnership, corporation, or group 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. 11. 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 ten of this section shall be guilty of a misdemeanor. 12. 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 chiropractic practice committee or to temporarily suspend the authorization of any chiropractor that he may believe 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 fully as if set forth herein.
