Subject Numbers Regarding Health Provider Authorizations

Authorization No. 254778-4B

July 29, 2013

Pursuant to Workers' Compensation Law Section 13-d(5), the Chair of the New York State Workers' Compensation Board has exercised his authority to revoke Dr. John Butsch's authorization to perform independent medical examinations in the New York State workers' compensation system effective close of business July 1, 2013. Dr. Butsch's last known business address is Buffalo General Medical Center, 100 High Street, Buffalo, New York 14203.

The Workers' Compensation Board has determined that Dr. Butsch's board certification from the American Board of Surgery expired on July 1, 2013.

Dr. Butsch is prohibited from performing independent medical examinations of injured workers. Reports submitted by Dr. Butsch for independent medical examinations performed prior to July 2, 2013, are valid, but are invalid for any independent medical examinations performed on or after that date. Requests to cross-examine Dr. Butsch for independent medical examinations performed prior to July 2, 2013, should not be denied due to the revocation of his authorization.

Any questions regarding the authorized lists should be referred to the Medical Director's Office at 1 (800) 781-2362.