Workers Compensation Board Update-
- In order to support the newly adopted Permanent Impairment
Guidelines for Schedule Loss of Use (effective January 1, 2018), the New York
Workers Compensation Board is requiring two new Independent Medical Examination
Report Forms to be completed. The new forms include Form IME-4.3 A when
Schedule Loss of Use is appropriate or Form IME-4.3 B when Non-Scheduled
Permanent Partial Disability is appropriate. The Board has also modified
the IME-4 form to capture the start and end time of the exam as well
as the time spent reviewing medical records.
These new forms/information are required for all Independent
Medical Exams that take place on or after May 16, 2018. The IME
evaluator must fill out the IME-4 cover sheet, along with the appropriate
listed attachments for either Schedule Loss of Use and/or Non-Schedule
Permanent Partial Disability. All three elements, IME-4 including the duration
of the exam and medical records review, IME-4.3A or IME-4.3B and
a narrative report are required for a complete IME report.