2023 New York Laws › WKC - Workers' Compensation › Article 2 - Compensation › 13-M - 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 chair 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 by a
psychologist,  duly  registered  and  licensed by the state of New York,
authorized by the chair to render psychological care pursuant to section
thirteen-b of this article. 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  article,  may  provide psychological services when
required.
(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 chair on such
forms and at such times as the chair may require.
3. 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  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
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.
(b) If the parties fail to agree as to the psychological 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 psychologist 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
psychologists  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 psychological care rendered
under this chapter to a claimant, and the amount of  the  disputed  bill
exceeds  one  thousand  dollars  and the psychologist does not expressly
request a single arbitrator process in accordance with paragraph (b)  of
this subdivision, 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.
(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.

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. 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.
(e)   A   provider  initiating  an  arbitration,  including  a  single
arbitrator process, pursuant to this section shall not  be  required  to
pay a fee to cover the costs related to the conduct of such arbitration.
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 chair shall appoint for and with jurisdiction  in  the  entire
state  of  New  York  a single psychology practice committee composed of
three 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.  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 psychologists shall be designated by
the chair as a chair 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.