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- Referred to social services
- Referred to social services
Full text
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Sponsor's memo
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 examination has a different opinion from an applicant's treating health care practitioner's opinion as to an applicant's disability; and requires an explicit written determination by the health care practitioner when the diagnoses differ
Purpose
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 subdivision 4 of section 332-b of the social services law, by adding a new paragraph (f), which provides that if a public assistance applicant is sent to a practitioner to determine if the applicant has any work limitations, the practitioner must take into account the applicant's treating health care practitioner's opinion, and give it sufficient weight based on a number of factors.
Existing law
Currently it is within the evaluating practitioner's discretion what, if any, weight is given to the treating health care practitioner's opinion.
Justification
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 limitations. 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.
The federal government recognizes the importance of giving sufficient consideration to a physician's medical opinion, and they follow this practice explicitly in their Supplemental Security Income determination procedure, detailed in 20 CFR 416.927. This section of federal regulation outlines Evaluating Opinion Evidence, and it is after this federal regulation that this bill has been modeled after.
It is for this reason that if the examiner makes any findings contrary to the treating health care practitioner's diagnosis, the reasons for the differing diagnosis should have to be defended and explicitly stated in writing.
Legislative history
2008: S.1509: Advanced to Third Reading 2006: A.5402: Referred to Rules. 2004: S.6424/A.9983 - Died in Committee
Fiscal implications
None. EFFECTIVE DATE : Immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.