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Information Every Worker Should Know About Independent Medical Examinations: Part Three

The claimant’s receipt of benefits could be denied, terminated, or reduced as a result of a determination, made by the Workers’ Compensation Board, which may be based upon a medical evaluation made after an independent medical examination. However, the ability of the claimant to appear for an examination or hearing shall not in itself determine questions of disability, extent of disability or eligibility for benefits.
In any open case where an award has been directed by the Board for temporary or permanent disability at an established rate of compensation, and there is a direction by the Board for continuation of payments, or any closed case where an award for compensation has been made for permanent total or permanent partial disability, a report of an independent medical examination shall not be the basis for suspending or reducing payments unless and until the rules and regulations of the Board regarding suspending or reducing payments have been met and there is a determination by the Board finding that such suspension or reduction is justified.
The claimant has the right to appeal any Workers’ Compensation Board determination, including determinations based on an independent medical examination. The Board’s notice of decision contains full instructions and time limitations for filing an appeal.

HIPAA Notice: In order to adjudicate a workers’ compensation claim, WCL Sections 13-a and 137 permit an employer or carrier to have a claimant examined by a health care provider. Pursuant to 45 CFR 512 a health care provider who has been retained by an employer or carrier to evaluate a workplace injury is exempt from HIPAA’s restrictions on disclosure of health information.

IF YOU HAVE ANY QUESTIONS ABOUT AN INDEPENDENT MEDICAL EXAMINATION, OR ANY OTHER QUESTIONS OR PROBLEMS ABOUT A JOB-RELATED INJURY OR DISEASE, CONTACT ANY OFFICE OF THE WORKERS’ COMPENSATION BOARD. Toll Free Line (877-632-4996)

SI TIENE ALGUNA DUDA SOBRE LAS EVALUACIONES MÉDICAS INDEPENDIENTES, O CUALQUIER OTRA PREGUNTA O PROBLEMA SOBRE ENFERMEDADES O LESIONES RELACIONADAS CON SU TRABAJO, COMUNÍQUESE CON CUALQUIER OFICINA DE LA INSTITUCIÓN WORKERS’ COMPENSATION BOARD (JUNTA DE COMPENSACIÓN LABORAL).

Source: NYS Workers’ Compensation Board