N.Y. Workers' Compensation Law § 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.

* NB Repealed January 1, 2028