Establishes factors and requirements to be considered when a health care practitioner's opinion differs from that of an applicant's treating health care practitioner's opinion as to an applicant's disability.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8994
SPONSOR: Hevesi (MS)
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 examina-
tion 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 PROVISIONS:
Section 1 amends section 332-b of the social services law by adding a
new subdivision 4-b.Section 2 is the effective date.
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 limita-
tions. 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 exam-
iner makes any findings contrary to the treating health care practition-
er's diagnosis, the reasons for the differing diagnosis should have to
be defended and explicitly stated in writing.
PRIOR LEGISLATIVE HISTORY:
2019: A4236 (Hevesi, Veto 179);
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
This act shall take effect on the ninetieth day after it shall have
become a law.
STATE OF NEW YORK
January 8, 2020
Introduced by M. of A. HEVESI, GLICK, JAFFEE, BARRON, COLTON, MOSLEY,
EPSTEIN, BUTTENSCHON, OTIS, SANTABARBARA, SEAWRIGHT -- Multi-Sponsored
by -- M. of A. COOK -- read once and referred to the Committee on
AN ACT to amend the social services law, in relation to establishing
factors to be considered when a health care practitioner upon exam-
ination has a different opinion from an applicant's treating health
care practitioner's opinion as to an applicant's disability
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 332-b of the social services law is amended by
2 adding a new subdivision 4-b to read as follows:
3 4-b. In the event the practitioner to whom the individual is referred
4 pursuant to subdivision four or paragraph (b) of subdivision two of this
5 section issues an opinion that differs from the applicant's treating
6 health care practitioner's opinion, the applicant's treating health care
7 practitioner's opinion is generally controlling, subject to, but not
8 limited to, the following factors:
9 (a) the length and frequency of the treatment provided,
10 (b) consistency of the opinion with the record as a whole,
11 (c) the degree to which the opinion is supported by concrete evidence,
13 (d) the practitioner's specialty.
14 § 2. This act shall take effect on the ninetieth day after it shall
15 have become a law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 is old law to be omitted.