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.