N.Y. Workers' Compensation Law § 13-k: Care and treatment of injured employees by duly licensed podiatrists

* § 13-k. Care and treatment of injured employees by duly licensed

podiatrists. 1. When 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 to

the foot which injury or resultant condition therefrom may lawfully be

treated by a duly registered and licensed podiatrist of the state of New

York, may select to treat him or her any podiatrist authorized by the

chair to render podiatric medical care, as hereinafter provided. If the

injury or condition is one which is without the limits prescribed by the

education law for podiatric medical care and treatment, or the injuries

involved affect other parts of the body in addition to the foot, the

said podiatrist 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

overall supervision of the treatment of said patient including the

future treatment to be administered to the patient by the podiatrist. If

for any reason during the period when podiatric medical treatment and

care is required, the employee wishes to transfer his or her treatment

and care to another authorized podiatrist he or she may do so, in

accordance with rules prescribed by the chair, provided however that the

employer shall be liable for the proper fees of the original podiatrist

for the care and treatment he or she shall have rendered. The chair

shall prepare and establish a schedule for the state, or schedules

limited to defined localities, of charges and fees for podiatric medical

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 podiatric medicine 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

podiatric medical 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 podiatry care or treatment shall be valid and

enforceable as against the employer or employee unless within

forty-eight hours following the first treatment the podiatrist giving

such care or treatment furnish to the employer and directly to the chair

a preliminary notice of such injury and treatment, 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 podiatrist

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

podiatrist, 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 podiatrist, the employer or carrier

shall arrange for such examination to be performed by a qualified

podiatrist in a medical facility convenient to the claimant.

(d) The independent podiatric examiner 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 podiatric 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 podiatric 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 podiatry services shall be payable only to a duly

authorized podiatrist as defined in this section or to the agent,

executor or administrator of the estate of such podiatrist. No

podiatrist 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 podiatrist 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.

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 podiatrist for services rendered to an injured employee.

(b) If the parties fail to agree as to the value of podiatry 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 podiatrist

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 podiatrists 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 value of podiatry care

rendered under this chapter to a claimant and the amount of the disputed

bill exceeds one thousand dollars and the podiatrist does not expressly

request a single arbitrator process in accordance with paragraph (b) of

this subdivision, such value shall be decided by an arbitration

committee consisting of three duly registered and licensed podiatrists

who are members of a recognized professional association representing

podiatrists in the state of New York, one to be appointed by the

president of such an association, one to be appointed by the employer or

carrier and one to be appointed by the chair of the workers'

compensation board 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 podiatrist'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 podiatrist 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

arbitration process, pursuant to this section shall not be required to

pay a fee related to the conduct of such arbitration. Each member of the

arbitration committee shall be entitled to receive and shall be paid a

fee for each day's attendance at an arbitration session in an amount

fixed by the chair of the workers' compensation board.

7. Within the limits prescribed by the education law for podiatry care

and treatment, the report or testimony of an authorized podiatrist

concerning the condition of the foot of an injured employee and the

treatment thereof shall be deemed competent evidence and the

professional opinion of the podiatrist 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 podiatry 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 podiatry practice committee

hereinafter provided and may take into consideration the view of other

interested parties.

9. The chairman shall appoint for and with jurisdiction in the entire

state of New York a single podiatry practice committee composed of one

duly licensed physician and two duly registered and licensed podiatrists

of the state of New York. Each podiatry member of said committee shall

have been engaged in the practice of podiatry as a duly registered and

licensed podiatrist of the state of New York at least ten years prior to

the time of his appointment and 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 members shall be designated

by the chairman as chairman of said podiatry practice committee. No

member of said committee shall render podiatry treatment under this

section nor be employed by or accept or participate in any fee from any

insurance company authorized to write workmen's compensation insurance

in this state or from any self-insurer, whether such employment or fee

relates to a workmen's compensation claim or otherwise. The attorney

general, upon request, shall advise and assist such committee.

10. The podiatry practice committee shall investigate, hear and make

findings with respect to all charges as to professional or other

misconduct of any authorized podiatrist as herein provided under rules

and procedures to be prescribed by the chair and shall report evidence

of such misconduct, with their findings and recommendation with respect

thereto, to the chair. The findings, decision and recommendation of such

podiatry 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 podiatrists authorized to render podiatry 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 podiatrist who he or she shall find after reasonable

investigation is disqualified because such podiatrist

(a) has been guilty of professional or other misconduct or

incompetency in connection with podiatry services rendered under the

law; or

(b) has exceeded the limits of his or her professional competence in

rendering podiatry care under the law, or has made materially false

statements regarding his or her qualifications in his or her application

for authorization; or

(c) has failed to submit timely, full and truthful podiatry reports of

all his or her findings to the employer and directly to the chair or the

board within the time limits provided in this section; or

(d) has knowingly made a false statement or presentation 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 to answer upon request of, the chair, board, podiatry

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 other 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 podiatrists 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 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 podiatry

practice committee or to temporarily suspend the authorization of any

podiatrist 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.

13. Upon the referral which may be directive as to treatment of an

authorized podiatrist physical therapy care may be rendered by a duly

licensed physical therapist.

* NB Repealed January 1, 2028