Section 13-L. Care and treatment of injured employees by duly licensed chiropractors  


Latest version.
  • 1. Where the term  "chairman"  is  hereinafter  used,  it
      shall be deemed to mean the chairman of the workmen's 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. A chiropractor licensed and registered to
      practice chiropractic in the state of New York, who is desirous of being
      authorized to render chiropractic care  under  this  section  and/or  to
      conduct  independent  medical  examinations in accordance with paragraph
      (b) of subdivision three of this section shall file an  application  for
      authorization   under   this  section  with  the  chiropractic  practice
      committee. In such application he or she shall  agree  to  refrain  from
      subsequently treating for remuneration, as a private patient, any person
      seeking  chiropractic treatment, or submitting to an independent medical
      examination,  in  connection  with,  or  as  a  result  of,  any  injury
      compensable  under  this chapter, if he or she has been removed from the
      list of chiropractors authorized  to  render  chiropractic  care  or  to
      conduct  independent  medical examinations under this chapter, or if the
      person seeking such treatment has been transferred from his or her  care
      in  accordance with the provisions of this section. This agreement shall
      run to the benefit of the injured person so treated,  or  examined,  and
      shall  be  available  to  him  or her as a defense in any action by such
      chiropractor for payment rendered by a chiropractor after he or she  has
      been  removed  from  the  list  of  chiropractors  authorized  to render
      chiropractic care or to conduct independent medical  examinations  under
      this  section,  or  after the injured person was transferred from his or
      her care  in  accordance  with  the  provisions  of  this  section.  The
      chiropractic  practice  committee if it deems such licensed chiropractor
      duly qualified shall recommend to the chair that such be  authorized  to
      render   chiropractic   care   and/or  to  conduct  independent  medical
      examinations under this section. Such recommendations shall be  advisory
      to  the  chair  only  and shall not be binding or conclusive upon him or
      her. 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 subdivision two of this
      section 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. 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.  If  the
    
      parties  fail  to  agree as to the chiropractic care rendered under this
      chapter to a claimant 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.
      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.
        A  provider  initiating  an arbitration pursuant to this section shall
      pay a fee, as determined by regulations promulgated by the chair, to  be
      used to cover the costs related to the conduct of such arbitration. Upon
      resolution  in  favor of such party, the amount due, based upon the bill
      in dispute, shall be increased by the amount of the  fee  paid  by  such
      party.  Where  a  partial  award is made, the amount due, based upon the
      bill in dispute, shall be increased by a part of such fee.
        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 chairman shall appoint for and with jurisdiction in the  entire
      state  of  New York a single chiropractic practice committee composed of
      one duly  licensed  physician  and  two  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 chairman within amounts appropriated therefor.
      One of said chiropractic members shall be designated by the chairman  as
      a  chairman  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 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  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.