In New York, injured workers have the right to choose their own treating physician, provided the physician is authorized by the Workers’ Compensation Board (WCB) to treat injured workers.
This article explains New York workers' compensation physician choice requirements, including an employee’s right to select or change an authorized physician, employer posting requirements, and the limited circumstances under which an employer may transfer care.
Employee’s Right to Choose a Physician
An injured employee may select any WCB-authorized physician to provide necessary medical care.
If the employee later wishes to change physicians, they may transfer care to another authorized provider.
The first physician’s payment is limited to the value of treatment already rendered, as determined by the state fee schedule, unless a higher amount is approved under § 13(a).
If an injury prevents the employee from selecting a physician immediately, or if the employee declines to choose a provider in writing, the employer must arrange medical care. Once able, the employee may select their own authorized physician for continued treatment.
Employer Notification Requirement
Employers must post a WCB-approved notice informing employees of their right to choose an authorized physician. This notice must appear in a conspicuous place at every work location.
Employer’s Right to Transfer Care
An employer may transfer an injured worker’s care from one authorized physician to another if one of the following conditions applies:
- The transfer is necessary for the employee’s best interest.
- The original physician is not authorized by the WCB to treat injured workers.
-
The physician is not authorized to treat the specific injury or condition under § 13-b(2).
If a physician believes a transfer was not properly authorized, they may appeal to an arbitration committee.
If the committee determines the transfer was improper, the employer must pay the original physician a portion or all of the fee earned by the new physician, as determined by the committee.
New York |
Statute/Rule |
Statute |
|
Section |
|
Subsection Text |
(1) An injured employee may, when care is required, select to treat him or her any physician authorized by the chair to render medical care, as hereafter provided. If for any reason during the period when medical treatment and care is required, the employee wishes to transfer his or her treatment and care to another authorized physician, he or she may do so, in accordance with rules prescribed by the chair. In such instance the remuneration of the physician whose services are being dispensed with shall be limited to the value of treatment rendered at fees as established in the schedule for his or her location, unless payment in higher amounts has been approved as authorized in section thirteen, paragraph a. If a claimant shall receive treatment in any hospital or other institution operated in whole or in part by the state of New York, the employer shall be liable for food, clothing and maintenance furnished by the hospital or other institution to such employee. If the employee is unable due to the nature of the injury to select such authorized physician and the emergency nature of the injury requires immediate medical treatment and care, or if he or she does not desire to select a physician, and in writing so advises the employer, the employer shall promptly provide him or her with the necessary medical care, provided however, that nothing herein contained shall operate to prevent such employee, when subsequently able to do so, from selecting for continuance of any medical treatment or care required, any physician authorized by the chair to render medical care as hereinafter provided.
(2) The chairman shall prescribe the form of a notice informing employees of their privilege under this chapter, and such notice shall be posted and maintained by the employer in a conspicuous place or places in and about his place or places of business.
(3) The employer shall have the right to transfer the care of an injured employee from the attending physician, whether chosen originally by the employee or by the employer, to another authorized physician (1) if the interest of the injured employee necessitates the transfer or (2) if the physician has not been authorized to treat injured employees under this act or (3) if he has not been authorized under this act to treat the particular injury or condition as provided by section thirteen-b (2). An authorized physician from whom the case has been transferred shall have the right of appeal to an arbitration committee as provided in subdivision two of section thirteen-g and if said arbitration committee finds that the transfer was not authorized by this section, said employer shall pay to the physician a sum equal to the total fee earned by the physician to whom the care of the injured employee has been transferred, or such proportion of said fee as the arbitration committee shall deem adequate.
(4) (a) No claim for medical or surgical treatment shall be valid and enforceable, as against such employer, or employee, unless within forty-eight hours following the first treatment the physician giving such treatment furnishes to the employer and directly to the chair a preliminary notice of such injury and treatment, within fifteen days thereafter a more complete report and subsequent thereto progress reports if 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 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 physician authorized by the chair in accordance with sections thirteen-b and one hundred thirty-seven of this chapter, at a medical facility convenient to the claimant and in the presence of the claimant's physician, 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. No hospital shall be required to produce the records of any claimant without receiving its customary fees or charges for reproduction of such records.
(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 physician, the employer or carrier shall arrange for such examination to be performed by a qualified physician in a medical facility convenient to the claimant. |
daisyBill Solution
Stay up-to-date on the latest developments in workers’ comp medical billing by subscribing to daisyNews.
SIGN UP FOR DAISYNEWS