NY Work Comp L § 13-L (2021)
2021 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.