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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo


Subject No. 046-506

Chair Announces Impartial Specialist Program Improvements and
Seeks Applications from Physicians

Date: May 3, 2013

The Workers' Compensation Board (Board) is implementing a set of improvements to the Impartial Specialist program. Impartial Specialists are physicians who provide the Board with unbiased expert medical opinions in select complex disputes. Impartial Specialists provide a critical service to the Board and the entire workers’ compensation system.

The Board is currently accepting applications from qualified physicians. More information about the Impartial Specialist program is contained in the Impartial Specialist Program Details on the Board's website, and summarized below.

Impartial Specialist Qualifications and Applications

For the first time, the Chair of the Workers’ Compensation Board will formally designate a panel of outstanding physicians to serve as Impartial Specialists. To qualify to serve as an Impartial Specialist, a physician must be board certified, have at least five years of experience in his or her specialty, maintain an active clinical practice, and not be subject to any restrictions on his or her professional license. The Chair is particularly interested in physicians who are affiliated with academic medical institutions.

Qualified physicians interested in serving as an Impartial Specialist must submit an application to the Board. To ensure impartiality, each applicant’s practice of independent medical examinations (IME) will be reviewed. Those who perform a significant number of IMEs on behalf of either carriers or claimants (more than 20 annually) will be excluded. Once selected, the Impartial Specialist will serve a renewable term of five years. Designated Impartial Specialists must complete medical education courses on the Board’s medical treatment guidelines and permanent impairment guidelines. The Board will maintain a List of the Designated Impartial Specialists on its website.

Improved Processes

The Board has developed standardized procedures for obtaining Impartial Specialists opinions. A referral to an Impartial Specialist may be ordered by a judge, a Board panel, or the full Board during an administrative appeal, or may be agreed to by the parties in a claim. The referral may be for a full examination or a review of records. Once an Impartial Specialist Report is ordered, the parties will be given ten days to submit any medical evidence that is not currently in the Board’s electronic file. During that time, the parties have the opportunity to agree on a particular Impartial Specialist; if they do not, the Board will assign one from the panel based on the relevant specialty, geographic area, and the physician’s availability. Under exceptional circumstances, such as when there is no designated Impartial Specialist with the relevant specialty training within a reasonable geographic area who is available to evaluate the claimant, the Chair may designate a physician to conduct a particular Impartial Specialist examination or review of records.

If the Impartial Specialist is required to perform a physical examination, the Board will arrange the appointment with the Impartial Specialist and notify the claimant of the location, date and time. The Board will provide the Impartial Specialist with an electronic (or paper) copy of the medical records contained in the Board’s e-case file in advance. The parties may object in writing to the selection of the particular Impartial Specialist if the claimant has been treated or previously examined by the Impartial Specialist or anyone in the same practice. The claimant must contact the Board immediately if he or she is unable to attend the scheduled examination. Failure to attend without notifying the Board may result in suspension of benefits or other adverse consequences to the injured worker.

The Impartial Specialist must submit his or her report to the Board using the Form IS-4, Report of Impartial Specialist Examination or Record Review, within 20 days of the examination or 25 days of receiving the records, if no exam is performed. The parties will have the option of cross-examining the Impartial Specialist, either by deposition if the claimant is represented or at a hearing if not. If testimony is taken by deposition, the carrier must arrange for the transcript to be submitted to the Board within 45 days.

Fee Schedule

Impartial Specialists will receive a standard fee of either $750 or $1,250 per case, depending on the complexity of the issues. If cross examination is requested, they will also be paid $450 for testimony, which can often be performed by telephone. Carriers are required to make prompt payment of the fees on receipt of the report and following testimony. Any delays in payment by carriers will be dealt with appropriately by the Board.

Questions may be referred to the Board’s Medical Director’s Office at 800-781-2362 or provider@wcb.ny.gov.

 

Robert E. Beloten
Chair