N.Y. Workers' Compensation Law § 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.

* NB Repealed January 1, 2028