BILL NUMBER: S4584

SPONSOR: SANDERS
 
TITLE OF BILL:  An act to amend the social services law, in relation
to establishing factors to be considered when a health care practitioner
upon examination has a different opinion from an applicant's treating
health care practitioner's opinion as to an applicant's disability

 
PURPOSE OR GENERAL IDEA OF BILL:

To ensure that the opinions and determinations of a public assistance
applicant's treating health care practitioner are given sufficient
weight when making disability determinations.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends subdivision 4 of section 332-b of the social services
law, by adding a new subdivision 4-b.

Section 2 is the effective date.

              

 
EXISTING LAW:  Currently it is within the evaluating practitioner's
discretion what, if any, weight is given to the treating health care
practitioner's opinion.

 
JUSTIFICATION:

If an individual applying for public assistance has work limitations,
disabilities, or health issues which have been identified by their
treating health care practitioner, their diagnosis and recommendations
should be considered to be accurate, in the absence of any contradictory
findings. As the current law is written, there is little weight given to
the treating health care practitioner's opinion, and if not supplied in
a very timely fashion, is not even considered in making a determination
on work limitations.

The social services appointed examining practitioner only sees the
applicant for one short assessment, which is not always sufficient in
exploring many complicated issues related to work limitations. If the
applicant's treating health care practitioner has been following him or
her for a long period of time, they most likely have established enough
of a relationship with their patient which would allow for the discovery
of hidden disabilities that the examiner may never find.  It is for this
reason that, under current law, if the examiner makes any findings
contrary to the treating health care practitioner's diagnosis, the
reasons for the differing diagnosis should have to be defended and
explicitly stated in writing.

The federal government recognizes the importance of giving sufficient
consideration to a physician's medical opinion, and they follow this
practice explicitly in their Supplemental Security Income determination
procedure, detailed in 20 CFR 416.927. (evaluating opinion evidence).
This bill is modeled after this federal regulation.  This section of
federal regulation outlines Evaluating Opinion Evidence, and it is after
this federal regulation that this bill has been modeled after.

 
PRIOR LEGISLATIVE HISTORY:

2015-2016: A3450 (Wright M-S);
2013-2014: A2960;
2011-2012: A2957;
2010: A1417;
2009: A1417;
2008: A7946;
2007: A7946

 
FISCAL IMPLICATIONS:  None.

 
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become a law.