The New York Physician's Application for Designation as an Impartial Specialist is a form used to apply to become a designated Impartial Specialist for the state of New York. This form must be completed and submitted to the Commissioner of the Department of Health in order to be eligible to serve as an Impartial Specialist in the state. The form must include information on the applicant's qualifications, such as educational background, professional licenses, work experience, and relevant certifications. It should also provide details on the scope of the proposed Impartial Specialist's services, including the type of cases they will review, the types of records they will review, the services they will provide, and the proposed fees for their services. The types of New York Physician's Applications for Designation as an Impartial Specialist include applications for general practitioners, specialists, and pediatricians.
New York Physician's Application for Designation as an Impartial Specialist
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How to fill out New York Physician's Application For Designation As An Impartial Specialist?
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Compensation Rates An injured employee is entitled to a compensation rate equal to two-thirds of the average weekly wage (AWW) in New York State for the 52-week period immediately prior to the date of accident. The rate is subject to prescribed maximums and degree of disability.
Workers' compensation coverage IS NOT required for partnerships, LLCs, and LLPs that do not have employees. Members and partners are not considered employees for the purposes of obtaining workers' compensation insurance, but may voluntarily cover themselves under a workers' compensation policy.
To apply for authorization, you must: Sign up to use the NYS Workers' Compensation Board Medical Portal and/or login with the credentials that have been assigned to you; Complete the required training specific to your profession; Complete the New Provider Authorization Request online application.
File a Workers' Compensation Claim in New York State Visit our claims page. Call 877-632-4996 to speak with a New York State Board representative. Complete and file the C-3 Employee Claim form.
SI-12 (7/09) Affidavit Certifying That Compensation Has Been Secured. Employers with Board-approved self-insurance for workers' compensation. Filed with the government agency issuing a permit, license or contract. The SI-12 must be completed by the Board's Self-Insurance Office and approved by the Board's Secretary.
WCB means the Workers Compensation Board.