(1) authorize competent providers who meet eligibility requirements to conduct independent medical examinations of persons suffering injuries or illnesses which are the subject of claims under the Workers' Compensation Law, Volunteer Firefighters' Benefits Law and Volunteer Ambulance Workers' Benefit Law;

(2) modify or revoke such authorization where there is a failure of continued compliance with such laws and regulations or other provisions governing the professional conduct or obligations of such providers;

(3) require that such independent medical examinations are conducted in accordance with Workers' Compensation Law, sections 13-a, 13-b, 13-d, 13-k, 13-l, 13-m, 13-n and 137 and these regulations and that reports of such independent medical examinations are prepared and transmitted in accordance with Workers' Compensation Law, section 137 and these regulations; and

(4) require the registration with the chair of entities that derive income from independent medical examinations.

(1) Attending physician or other attending practitioner means those providers or practitioners who have primary responsibility for treating the claimant for the injury or illness for which such claimant is being examined.

(2) Authorized examiner means a physician, podiatrist, chiropractor, or psychologist who possesses a current, valid, and unrestricted professional license granted by the New York State Board of Regents, that is without any limitation imposed by the New York State Department of Health, Board of Professional Medical Conduct or the New York State Department of Education, Office of Professional Discipline, is not subject to any restriction on or suspension or revocation of a professional license granted by any other state, and meets the following requirements for authorization by the Chair of the Workers' Compensation Board to conduct independent medical examinations and review of records:

(3) Board certified means a physician or surgeon who is certified by a specialty board that is recognized by the American Board of Medical Specialties or the American Osteopathic Association.

(4) Independent medical examination means an examination performed by an authorized or qualified independent medical examiner, pursuant to section 13-a, 13-k, 13-l, 13-m or 137 of the Workers' Compensation Law, for purposes of evaluating or providing an opinion with respect to schedule loss, degree of disability, validation of treatment plan or diagnosis, causal relationship, diagnosis or treatment of disability, maximum medical improvement, ability to return to work, permanency, appropriateness of treatment, necessity of treatment, proper treatment, extent of disability, second opinion or any other purpose recognized or requested by the board. An examination that is conducted for any of the purposes described in this section, other than an examination conducted at a clinic that is a member of the occupational health clinics network established pursuant to subdivision (3) of section 151 of the Workers’ Compensation Law, shall be deemed an independent medical examination and shall be subject to the requirements governing the conduct and reports of such examinations as set forth under sections 13-a, 13-b, 13-d, 13-k, 13-l, 13-m, 13-n and 137 of the Workers' Compensation Law and this Part. An examination conducted at the request of the chair or the board in accordance with section 13(e) or 19 of the Workers' Compensation Law shall not constitute an independent medical examination for purposes of this Part, or for purposes of sections 13-b, 13-k, 13-l, 13-m and 137 of the Workers' Compensation Law.

(5) Independent medical examiner means a physician, surgeon, podiatrist, chiropractor or psychologist who is authorized to conduct independent medical examinations as defined in paragraph (4) of this subdivision, in accordance with sections 13-b, 13-k, 13-l, 13-m and 137 of the Workers' Compensation Law and this Part, or is found to be qualified to perform such examinations by a Workers' Compensation Law judge as set forth in paragraph (9) of this subdivision.

(6) IME entity means an individual or entity that derives income from independent medical examinations performed in accordance with Workers’ Compensation Law sections 13-a, 13-k, 13-l, or 13-m and this section or review of records, whether by employing or contracting with independent medical examiners to conduct such independent medical examinations or review of records, or by acting as a referral service or otherwise facilitating such examinations or review of records and is registered with the chair in accordance with Workers’ Compensation Law section 13-n and this section.

(7) Medical facility means a professional office suitable for a medical, podiatric, chiropractic or psychological examination, where the primary use of the examination location is not residential, commercial, educational, or retail in nature. A professional office that is adjacent to a residence may serve as a medical facility for independent medical examinations if the residence provides a separate entrance for the professional office that is clearly marked as a professional office, provides adequate privacy to the injured worker, and is listed with the Workers' Compensation Board and the State Education Department as an office address for the provider conducting the examination. A medical facility shall have adequate access, heat, light, space and equipment to provide for the safety and integrity of the examination, and shall meet reasonable sanitary requirements. Medical facilities shall meet other requirements consistent with section 137 of the Workers' Compensation Law as may be required by the chair or Workers' Compensation Law judge, and shall meet all applicable standards for accessibility as required under State or Federal law.

(8) Preferred provider organization or P.P.O. means a plan licensed by the Commissioner of Health pursuant to section 353 of the Workers' Compensation Law that is owned, operated, or administered by an entity that provides for the delivery of services required under article 10-A of the Workers' Compensation Law.

(9) Qualified means, with respect to independent medical examiners, a physician, podiatrist, chiropractor or psychologist who holds a current, valid and unrestricted professional license in the state in which he or she performs the subject independent medical examination or record review, and is found to meet additional professional standards as may be required in the discretion of a Workers' Compensation Law judge or the chair or board based upon the particular facts of a case. A qualified examiner does not include the insurance carrier or special fund’s medical professional as that term is defined in section 324.1(c) of this Title.

(10) Representative, for purposes of section 137(A)(1) of the Workers' Compensation Law, means a claimant's attorney or a representative who is licensed and authorized by the board to appear in matters or proceedings before the board in accordance with section 24-a of the Workers' Compensation Law, or a person who is licensed to represent the members of its bona fide charitable or welfare organization or labor or other organization pursuant to section 302-1.3(b) of this Title.

(11) Request for information, for purposes of Workers' Compensation Law section 137(1)(b), except as limited under Civil Practice Law and Rules section 4503, means any substantive communication with an independent medical examiner, or his or her office, regarding the claimant from any person or entity, including a claimant, an insurance carrier, or a third party administrator, that takes place or is initiated outside of the independent medical examination, including a request or referral for examination and any communication related thereto, questions or inquiries related to the claimant or the examination, and the provision of information to the examiner for review in connection with a request for the examiner's professional opinion with regard to the claimant or the examination. When any substantive communication consists of documents, records, reports, and items that are part of the official board file and available to all parties at the time they are provided to the independent medical examiner, or his or her office, the documents, records, reports, and items or copies thereof shall not be filed with the board.

(12) Review of records, records review or report made without physical examination means the evaluation of a claimant without physical examination, by a medical provider authorized by the chair to treat claimants or to conduct independent medical examinations or both, or a medical provider qualified within the meaning of paragraph (9) of this subdivision, based on the review of reports and records, including treatment notes, diagnostic test results, depositions or hearing testimony, exhibits, and other records or reports from medical providers or independent medical examiners or both in the electronic case file maintained by the Board. A review of records does not include reviews conducted by the insurance carrier or special fund’s medical professional as that term is defined in section 324.1(c) of this Title.

(1) Eligibility requirements. A physician, surgeon, podiatrist, chiropractor or psychologist who seeks to become authorized to conduct independent medical examinations of persons suffering injuries or illness which are the subject of claims under the Workers' Compensation Law, Volunteer Firefighters' Benefits Law and Volunteer Ambulance Workers' Benefits Law must meet the requirements set forth for an authorized provider under paragraph (b)(2) of this section and section 13-b, 13-k, 13-l, or 13-m of the Workers' Compensation Law.

(2) Application procedures. Application, review and authorization procedures for independent medical examiners shall be conducted in accordance with sections 13-b, 13-k, 13-l and 13-m of the Workers' Compensation Law. Each physician, surgeon, podiatrist, chiropractor or psychologist seeking authorization to conduct independent medical of persons suffering injuries or illness which are the subject of claims under the Workers' Compensation Law, Volunteer Firefighters's Benefits Law and Volunteer Ambulance Workers' Law shall complete Workers' Compensation Board form MR/IME-1, or such other form prescribed by the chair. A physician or surgeon shall submit the application for review to the county medical society in which his or her office is located, or to the New York State Osteopathic Medical Society, or to the panel or board designated by the chair for review as provided in section 13-b of the Workers' Compensation Law. A podiatrist, chiropractor or psychologist shall submit the application to the podiatry, chiropractic or psychology practice committee of the Workers' Compensation Board designated for review of such applications under section 13-k, 13-l or 13-m of the Workers' Compensation Law. The reviewing county medical society, State medical society, panel, board or practice committee shall make an advisory recommendation to the chair regarding each application as required under the Workers' Compensation Law. Upon such recommendation, the chair shall authorize a review of each application by the Workers' Compensation Board, and shall determine whether the applicant may become authorized to conduct independent medical examinations under the Workers' Compensation Law. Upon approval of an application by the chair, the applicant shall receive an authorization notice and a provider authorization number. An applicant who is denied authorization shall receive a notice of denial of authorization.

(3) Retaining authorization privileges.

(1) Notice. The claimant shall receive notice of the scheduled independent medical examination at least seven business days prior to the date of such examination. The notice shall be printed on the form prescribed by the chair for such purpose, which shall include all information required thereon, as set forth under Workers' Compensation Law, section 137. A copy of such notice shall be sent to the board on the same day it is sent to the claimant. Where the claimant asserts that notice of the examination was not received at least seven business days prior to the date of the examination and upon request by the board, the party scheduling such examination shall provide proof in the form of an affidavit, or a business record that meets requirements for admissibility under Civil Practice Law and Rules Rule 4518 that the notice was posted by United States mail at least 12 business days prior to the date of the examination or deposited into the custody of an overnight delivery service for overnight delivery, prior to the latest time designated by the overnight delivery service for overnight delivery at least eight business days prior to the date of the examination. In the event that an independent medical examination is required for the purpose of determining authorization for special services for specialist consultations, surgery, physical or occupational therapy, imaging studies or special diagnostic or laboratory tests in accordance with Workers' Compensation Law section 13-a(5), and a delay in authorization for such special services would result in a worsening of the claimant's condition or irreparable harm, and the examination can be scheduled less than 12 business days from the date of the request for the examination, the claimant may, by written consent waive the requirement of seven business days' notice of the examination. However, in case of such a waiver by the claimant of seven business days' notice of the examination, for purposes of scheduling an examination for authorization of such special services, a notice of the examination must be sent to the claimant as soon as possible after the scheduling of the examination in the same manner as otherwise required for notices of examinations under Workers' Compensation Law section 137 and this Part. In no event may the right to such notice be waived pursuant to an employment agreement or a collective bargaining agreement. If a claimant requests that an examination be rescheduled, and the examination is rescheduled less than seven business days after the request, the notice required under section 137 need not be received seven business days prior to the examination, but must be sent to the claimant as soon as possible in the same manner as required for the original notice under said section and this section. A copy of such notice shall be sent to the board on the same day it is sent to the claimant. Upon request by the Board, the party scheduling such examination shall provide proof in the form of an affidavit, or a business record that meets the requirements for admissibility under Civil Practice Law and Rules Rule 4518 that the notice was mailed as soon as possible.

(2) Examination requested by claimant. A party requesting an independent medical examination from a provider, other than the attending provider, in accordance with subdivision 4(B) of section 13-a, subdivision 3(B) of section 13-k, subdivision 3(B) of section 13-l, or subdivision 4(B) of section 13-m of the Workers' Compensation Law, for a purpose described under paragraph (b)(4) of this section, shall be liable for all reasonable fees and costs associated with such examination. However, where a claimant can demonstrate to the satisfaction of the board that he or she made a good faith effort to obtain an opinion from his or her attending provider prior to seeking an independent medical examination for any of the purposes described under paragraph (b)(4) of this section, and that the attending provider was unable by reason of death or absence from the State, or unreasonably failed or refused to provide such opinion, the carrier shall be liable for all reasonable fees and costs associated with such examination. Where a claimant seeks an independent medical examination in accordance with subdivision 4(B) of section 13-a, subdivision 3(B) of section 13-k, subdivision 3(B) of section 13-l, or subdivision 4(B) of section 13-m of the Workers' Compensation Law, for a purpose described under paragraph (b)(4) of this section, the independent medical examiner shall inform the claimant in writing on the form prescribed by the chair for notice of such examination that the claimant may be responsible for payment of the cost of such examination, and shall state the actual fee or fee range for such examination.

(3) Provision of information. An independent medical examiner may be provided with information, such as documents, reports, records, and/or test results, for review in connection with an independent medical examination or a review of records. Information provided to an independent medical examiner in connection with an independent medical examination or review of records shall be part of the official board file at the time it is provided to the independent medical examiner or his or her office so it is available to all parties. If the party requesting the examination wants to provide information to the independent medical examiner that is not part of the official board file, it shall submit the information to the board for inclusion in the official file on the same day the information is first sent to the independent medical examiner or IME entity. The party requesting the examination or review of records may provide the information to an IME entity and such entity may then provide the information to the independent medical examiner who conducts the independent medical examination or review of records.

(4) Reports.

(5) Request for information and response. Requests for information and responses to such requests shall be provided as required under Workers’ Compensation Law section 137(1)(b) and (c) and paragraph (b)(11) of this section. Such requests and responses to such requests should be provided on or attached to the form prescribed by the chair for such purpose. The failure to provide such requests or responses to such requests by the independent medical examiner in accordance with Workers’ Compensation Law section 137 and this section shall be considered in determining whether the report of any related independent medical examination substantially complies with Workers’ Compensation Law section 137 and this section.

(6) Reports filed by an IME entity. An independent medical examiner may retain the administrative services of an IME entity. Such IME entity may provide administrative support to the independent medical examiner, including but not limited to those responsibilities described in subdivisions (1) and (7) of Workers’ Compensation Law section 137, under the following circumstances:

(7) Conduct at examination. The claimant or the examiner may videotape or otherwise record the examination. An independent medical examiner may not refuse to conduct an independent medical examination because the claimant intends to videotape or otherwise record such examination when the claimant has appeared for such examination as scheduled. The claimant and the independent medical examiner and their agents shall not alter or misrepresent the content of the recording and shall not distribute publicly the recording beyond its use in a hearing of the board. The claimant may be accompanied to the examination by an individual or individuals of his or her own choosing. However, neither the examiner nor the claimant may disrupt or interfere with the examination by such recording or as a result of the presence to such companion or companions. the claimant may be accompanied to the examination by an individual or individuals of his or her own choosing. However, neither the examiner nor the claimant may disrupt or interfere with the examination by such recording or as a result of the presence of such companion or companions.

(8) Relationship between examiner and claimant. The independent medical examiner shall not provide treatment to the claimant, shall not be a partner, member, or employee of the claimant’s attending physician’s or practitioner’s practice, and only a limited patient-physician or patient-provider relationship is established by conducting an independent medical examination in accordance with Workers’ Compensation Law section 13-a, 13-k, 13-l, or 13-m or this section. The limited patient-physician or patient-provider relationship established requires the physician or provider to administer an objective medical evaluation but not to monitor claimants’ work related injury or illness over time, treat claimants, or fulfill the other duties traditionally held by attending physicians or providers. However, all laws and regulations governing the confidentiality of medical records and workers’ compensation records shall apply to records of an independent medical examination or review of records. Notwithstanding the limitations set forth under Workers’ Compensation Law section 137(9), an independent medical examiner who has evaluated a claimant at the request of the employer, carrier or claimant may conduct a subsequent independent medical examination of the claimant for the same injury or illness.

(9) Regular business hours. Independent medical examinations shall be conducted between the hours of 8:00 a.m. and 6:00 p.m., Monday through Friday except that they shall not be conducted on official and officially recognized religious holidays. An examination may be scheduled outside of regular business hours only with the consent and for the convenience of the claimant.

(10) Unreasonable burden. Where an insurance carrier, third party administrator or claimant finds that it would place an unreasonable burden to arrange for an independent medical examination or review of records, or to attend an independent medical examination by an authorized examiner, the employer, carrier or claimant shall arrange for such examination or review of records to be performed by a qualified provider. Upon request by the board, the person or entity requesting such examination or review of records by a qualified provider must demonstrate the existence of the unreasonable burden to the satisfaction of the board. Where a person or entity is unable to demonstrate to the satisfaction of the board that an unreasonable burden existed which required the examination or review of records to be conducted by a qualified provider rather than an authorized examiner, the report based upon such examination or review of records by a qualified provider shall not be admissible as evidence in a workers' compensation proceeding.

(11) Ability of claimant to appear. The physical capability of a claimant to present himself or herself for examination, and the observations of the examiner in relation to the claimant's ability to present for such examination shall not constitute dispositive evidence in determining a claimant's disability, degree of disability or eligibility for compensation or benefits under the Workers' Compensation Law. However, refusal by the claimant to submit to an independent medical examination requested by an employer or carrier in accordance with subdivision 4(B) of section 13-a, subdivision 3(B) of section 13-k, subdivision 3(B) of section 13-l, or subdivision 4(B) of section 13-m of the Workers' Compensation Law, for a purpose described under paragraph (b)(4) of this section, shall bar the claimant from recovering compensation for any period during which he or she has refused to submit to such examination.

(12) No waiver of claimant's rights. Except as otherwise provided, a claimant may not waive any of the rights provided under Workers' Compensation Law section 137 in relation to independent medical examinations. A report of an examination that does not substantially comply with the requirements of Workers' Compensation Law section 137 and this section, shall not be admissible as evidence for any of the purposes described in paragraph (b)(4) of this section in a workers' compensation proceeding, unless the party raising an objection to the admissibility of the report does not raise such objection in a timely manner. Except for a waiver that is expressly authorized by the Workers' Compensation Law or this section or by a Workers' Compensation Law judge, and is knowingly executed by the claimant, no agreement between an employee and employer, or employee and carrier shall be binding upon the board; nor shall any such agreement in any way excuse compliance with said section 137 or this section. In no event shall a collective bargaining agreement be binding upon the board or excuse compliance with respect to said section 137 or this section; nor shall a claimant be required or permitted to waive any of the requirements of section 137 or this section pursuant to such agreement.

(13) Selection of examiners in a P.P.O. Notwithstanding any provision to the contrary:

(14) A written report of an independent medical examination, duly sworn to, shall be filed with the board, and copies thereof furnished to all parties as may be required under the Workers' Compensation Law, within 10 business days after the independent medical examination, or sooner if directed, except that in cases of persons examined outside the State, such reports shall be filed and furnished within 20 business days after the independent medical examination. A written report is filed with the board when it has been received by the board pursuant to the requirements of the Workers' Compensation Law.

(15) Copies of written reports of medical experts, made on behalf of any party without physician examination of the claimant, to be used for reference at a hearing, must be furnished to the referee and to all other parties or their representatives, if any, prior to that hearing.

(1) Mandatory registration.

(2) Compliance with laws. An officer of each such entity registering with the chair shall affirm under penalty of perjury upon registration that the entity is organized under the laws of New York State or in the state in which it was incorporated in a corporate form that is recognized by the laws of the State of New York, is duly registered with the Department of State, and is in full compliance with the laws of the State of New York, its state of incorporation if outside New York, and the United States, including but not limited to any laws or regulations under the Public Health Law, the Education Law and the Workers' Compensation Law governing the practice of medicine, podiatry, chiropractic and psychology, treatment of injured or ill workers, solicitation and fee-splitting, and any laws or regulations under the jurisdiction of the State Insurance Department, the Federal Centers for Medicare and Medicaid Services, the State Department of Taxation and Finance or the Federal Internal Revenue Service. The officer shall further affirm that he or she has read or is familiar with the fee-splitting and anti-solicitation provisions of the Workers' Compensation Law under sections 13-d, 13-i, 13-k, 13-l and 13-m, and that the entity is not in violation of any such section.

(3) Additional information. The chair or his or her designee reserves the right to request any and all information or documentation necessary from any IME entity for the purpose of administering and ensuring compliance with Workers’ Compensation Law sections 13-a, 13-b, 13-d, 13-i, 13-k, 13-l, 13-m, 13-n, 137 and other related provisions of such law and this section. All IME entities must cooperate in any investigation and produce for review by the chair or his or her designee any relevant documents, reports or notes.

(4) Acceptance of registration not a defense. The acceptance of a registration statement by the chair in accordance with Workers' Compensation Law section 13-n and these regulations shall not be construed as authorization, approval or endorsement of the registering entity, or its services, corporate organization or business practices by the chair or board, and the acceptance of a registration statement by the chair shall not be a defense to any investigation, action or proceeding by any government agency or official enforcing the laws of this State or the United States.

(5) Registration fee. The registering entity shall pay a registration fee of $250 to the chair for the purpose of administering the registration and ensuring compliance of such entities in accordance with Workers' Compensation Law section 13-n.

(6) Removal from list of registered IME entities. The chair or his or her designee may remove an IME entity from its list of such registered IME entities for failure to comply with Workers’ Compensation Law section 13-n or 137 or this section. The following procedure shall apply to such removal:

(7) Penalties for materially altering or causing a report to be materially altered. If the chair or his or her designee finds that an IME entity that derives income from independent medical examinations has materially altered an independent medical examination report, or caused such a report to be materially altered, then in addition to revoking or rescinding the registration of such IME entity through the process set forth in paragraph (6) of this subdivision, the chair or his or her designee shall: