S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6361
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              March 16, 2021
                                ___________
 
 Introduced  by  M.  of  A. REYES, FERNANDEZ, J. RIVERA, DICKENS, COLTON,
   JEAN-PIERRE, SAYEGH, DeSTEFANO, GOTTFRIED, DILAN -- Multi-Sponsored by
   -- M. of A.   COOK -- read once  and  referred  to  the  Committee  on
   Governmental Employees
 
 AN  ACT  to amend the retirement and social security law, in relation to
   criteria for medical examinations to determine disability status
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The retirement and social security law is amended by adding
 a new section 65 to read as follows:
   §  65.  CRITERIA  FOR  MEDICAL  EXAMINATIONS. A. IN INSTANCES WHERE AN
 APPLICANT FOR DISABILITY BENEFITS UNDER THIS TITLE IS  GIVEN  A  MEDICAL
 EXAMINATION,  THE HEALTH CARE PRACTITIONER WHO PERFORMS SUCH EXAMINATION
 OF THE APPLICANT SHALL:
   1. REVIEW AND CONSIDER ALL RECORDS  OR  INFORMATION  PROVIDED  BY  THE
 APPLICANT  OR  HIS  OR  HER  TREATING  HEALTH CARE PRACTITIONER THAT ARE
 PERTINENT TO THE CLAIMED MEDICAL CONDITION;
   2. MAKE A SPECIFIC DIAGNOSIS AS  EVIDENCED  BY  MEDICALLY  APPROPRIATE
 TESTS  OR EVALUATIONS IN DETERMINATION OF THE APPLICANT'S CLAIMED CONDI-
 TION;
   3. RENDER TO THE APPLICANT AND THE COMPTROLLER, AN  OPINION,  PARTICU-
 LARIZING THE PRESENCE OR ABSENCE OF THE ALLEGED CONDITION;
   4.  IN THE EVENT THAT HE OR SHE IDENTIFIES A CONDITION, OTHER THAN THE
 ALLEGED CONDITION, THAT MAY INTERFERE WITH THE INDIVIDUAL'S  ABILITY  TO
 FULLY  ENGAGE  IN  WORK  ACTIVITIES,  THE PRACTITIONER SHALL REPORT SUCH
 CONDITION; AND
   5. DETERMINE WHETHER THE INDIVIDUAL IS:
   (A) DISABLED AND ELIGIBLE FOR BENEFITS UNDER THIS TITLE; OR
   (B) NEITHER DISABLED NOR WORK LIMITED.
   B. IF THE PRACTITIONER TO WHOM THE APPLICANT  IS  REFERRED  ISSUES  AN
 OPINION  THAT  DIFFERS FROM THE APPLICANT'S TREATING HEALTH CARE PRACTI-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD00055-01-1

 A. 6361                             2
 
 TIONER, THE PRACTITIONER SHALL  PROVIDE  A  WRITTEN  DETERMINATION  THAT
 SPECIFIES  WHY  THE PRACTITIONER DISAGREES WITH THE APPLICANT'S TREATING
 HEALTH CARE PRACTITIONER'S DISABILITY DETERMINATION AND PRESENT EVIDENCE
 THAT SUPPORTS THE OPINION.
   C.  IN  THE  EVENT  THE PRACTITIONER TO WHOM THE APPLICANT IS REFERRED
 ISSUES AN OPINION THAT DIFFERS FROM THE APPLICANT'S TREATING HEALTH CARE
 PRACTITIONER'S OPINION, THE APPLICANT'S TREATING HEALTH CARE PRACTITION-
 ER'S OPINION SHALL BE GENERALLY CONTROLLING, SUBJECT TO, BUT NOT LIMITED
 TO, THE FOLLOWING FACTORS:
   1. THE LENGTH AND FREQUENCY OF THE TREATMENT PROVIDED;
   2. CONSISTENCY OF THE OPINION WITH THE RECORD AS A WHOLE;
   3. THE DEGREE TO WHICH THE OPINION IS SUPPORTED BY CONCRETE  EVIDENCE;
 AND
   4. SUCH PRACTITIONER'S SPECIALTY.
   §  2.  This  act shall take effect on the ninetieth day after it shall
 have become a law.