Section 13-552.1. Medical review in member disability cases  


Latest version.
  • a. As used in
      this section, the following terms shall mean and include:
        (1) "Panel of medical experts". Those physicians whose names  are  set
      forth   in   a   list  of  medical  experts  prepared  annually  by  the
      administrator of health services and filed in his office  and  with  the
      executive director of the retirement system on or before July first. The
      experts  so  designated  shall  be  physicians  having qualifications as
      specialists in such fields of medicine as such  administrator  deems  an
      essential  background  (i)  for  ascertaining,  in cases where a medical
      examination is required  in  relation  to  disability  retirement  under
      section 13-550, 13-551 or 13-553 of this chapter, whether such member is
      physically  or  mentally  incapacitated  for  the  performance  of  city
      service, and (ii) for rendering  of  reports  or  certifications  as  to
      diagnosis  and  issues  of  causal  relationship  with  respect  to such
      applications. Each of such physicians  shall  have  had,  prior  to  his
      designation, at least ten years of practice in the field with respect to
      which he is designated. The names of such physicians shall be separately
      grouped  in such list, according to the fields of medicine in which they
      are expert, and the names in each group shall be consecutively numbered.
        (2) "Party entitled to review". Either of the following:
        (i) the member; or
        (ii) the appropriate agency head.
        b. (1) In any case where an application for retirement of a member for
      disability has been filed pursuant to section 13-550 or 13-551  of  this
      chapter,  or  a  medical  examination  has  been  held  in  relation  to
      restoration to  service  under  section  13-553  of  this  chapter,  the
      executive  director of the retirement system, promptly after he receives
      the report or certification of the medical board with  respect  to  such
      application  or medical examination, shall give notice of such report or
      certification to such member and to the appropriate agency head.  Within
      fifteen  days  after such notification, any party entitled to review may
      file with the executive  director  a  written  request  that  a  special
      medical  committee,  as  provided  for in this section, shall review the
      conclusions and recommendations of the medical board set  forth  in  its
      report or certification.
        (2)  (i) Any request for review filed by a member with respect to such
      application for disability retirement or with respect to restoration  to
      service,  shall  be void and of no effect unless such request includes a
      waiver, as hereinafter provided, duly executed and acknowledged  by  the
      member or by a person acting in his behalf as hereinafter provided. Such
      waiver  may  be  executed by a person acting in behalf of such member in
      any case where, at the time of the execution  of  such  waiver  by  such
      person,  the  circumstances  are  such  that  if  such  application  for
      disability retirement had not been previously filed by or  with  respect
      to  such  member,  such  person  would  at  such  time  of  execution be
      authorized under the provisions of section  13-550  or  13-551  of  this
      chapter,  as  the  case may be, to file, as a person acting in behalf of
      such member, an application for disability retirement of such member.
        (ii) Such waiver shall provide that  the  execution  thereof  by  such
      member  or  by  a  person acting in behalf of such member as hereinabove
      authorized shall  constitute  an  agreement  by  such  member  that  his
      application  for disability retirement or for medical review in relation
      to restoration to service, as the case may be, shall be disposed of upon
      the recommendations of the special medical  committee  pursuant  to  the
      provisions  of  this  section,  that  such  action  shall  be  final and
      conclusive, and that he  waives  any  and  all  rights  which  he  might
      otherwise  have  to  seek  or  obtain  any  other  disposition  of  such
      application for disability retirement or review of medical  findings  in
    
      relation   to   restoration  to  service,  by  court  or  administrative
      proceedings or otherwise. A  waiver  so  executed  and  filed  shall  be
      effective and binding upon such member, in accordance with its terms.
        c.  Promptly  after the filing of a request for review to be made by a
      special medical committee, the executive director shall transmit a  copy
      of  such request and of the report or certification of the medical board
      to the administrator of health service.
        d. The administrator, upon receipt of such report or certification and
      request, shall promptly designate three of the physicians on  the  panel
      of  medical  experts  as  a special medical committee for the purpose of
      reviewing the recommendations and conclusions of the  medical  board  in
      such case. Such physicians shall be selected by him from the panel group
      possessing  the  specialist  qualifications  deemed essential by him for
      such review. All selections of physicians pursuant to this subdivision d
      shall be made in order of numerical standing in  the  group  from  which
      selection  is to be made, and on the basis of continuous rotation within
      the group.
        e. (1) Promptly after making the selection prescribed by subdivision d
      of this section, the administrator of health service  shall  notify  the
      selected physicians and the executive director thereof.
        (2)  Such  special  medical  committee shall, within thirty days after
      such notification to  the  physicians  constituting  such  committee  is
      completed,  perform,  with  respect to the application for retirement of
      such member for disability, or with respect to restoration  to  service,
      the same functions of medical examination or otherwise as are prescribed
      by  applicable  provisions  of  law for performance by the medical board
      with respect to retirement or restoration to service, and shall,  within
      such  period  adopt  by  majority  vote,  and  file  with  the executive
      director, a report or certification, as the case  may  be,  stating  the
      conclusions and recommendations of such committee concerning the matters
      required  to  be reported on or certified by the medical board, pursuant
      to applicable provisions of law.
        f.  The  conclusions  and  recommendations  of  the  special   medical
      committee shall supersede those of the medical board.
        g.  (1)  Each  physician  who  serves as a member of a special medical
      committee shall receive a fee for such service, to be determined by  the
      comptroller of the city.
        (2)  With  respect  to  each case in which a special medical committee
      acts upon the request by a member, one-half of the fees of  the  members
      of  such  committee  shall  be paid by the appropriate agency. The other
      half of such fees shall be paid by the member.
        (3) With respect  to  each  such  case  in  which  a  special  medical
      committee  acts upon the request by an appropriate agency head, the fees
      of the members of such committee shall be paid by such agency.
        h. In any case where  a  request  for  review  by  a  special  medical
      committee  is  filed  pursuant  to  the  provisions of this section, the
      provisions of sections 13-550, 13-551 and 13-553 of this  chapter  shall
      be  superseded  by the provisions of this section to the extent that the
      provisions of this section are inconsistent therewith.
        i. (1) In any case where the provisions of this  section  require  the
      executive  director  to  give notice to a member, the executive director
      may give such notice by delivery to such member personally or by mailing
      same to his  last  known  address,  as  shown  by  the  records  of  the
      retirement system.
        (2)  In  any  case  where  the  provisions of this section require the
      giving of notice or the transmission of papers to any other person, such
      notice may be given or transmission effected by delivery to such person,
    
      by delivery at his office to any of his employees, or by mailing to  the
      office address of such person.
        (3)  In  any  case  where  notice  is  given  by mail pursuant to this
      subdivision, such notice shall be deemed to be  given  on  the  date  of
      mailing.