Subject Numbers Regarding Health Provider Authorizations

Authorization No. 218488-5W

March 16, 2018

Pursuant to Workers' Compensation Law Section 13-d(4), the Chair of the New York State Workers' Compensation Board has exercised her authority to temporarily suspend Dr. William Vincent Jacobson, III’s authorization to treat injured workers within the New York State workers’ compensation system effective March 15, 2018. Dr. Jacobson's last known business address is:

311 North Street, Suite 202
White Plains, New York 10605

The Chair’s designee’s investigation has revealed that the New York State Department of Health, State Board for Professional Medical Conduct (BPMC) has issued Order # 18-050, wherein Dr. Jacobson agreed not to contest the allegations in full satisfaction of the charges, including that on or about December 11, 2017, he was convicted of Aggravated Driving While Intoxicated, a misdemeanor, in violation of VTL §1192(2-a)(a), and that on or about February 28, 2017, he was operating a motor vehicle while intoxicated with a blood alcohol content of .18 or higher. This resulted in a Censure and Reprimand, and a $1,500.00 fine.

Therefore, the Chair believes that Dr. Jacobson may be guilty of misconduct, and that such misconduct would detrimentally affect the quality of care provided to injured workers.

Dr. Jacobson is prohibited from rendering treatment and care to injured workers while his authorization is temporarily suspended. Reports submitted by Dr. Jacobson for services rendered prior to March 15, 2018 are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Jacobson for services rendered prior to March 15, 2018 should not be denied due to the suspension of his authorization.

This suspension remains in effect until further notice. Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.