Subject Numbers Regarding Health Provider Authorizations

Authorization No. 150592-4W

August 29, 2022

Pursuant to Workers' Compensation Law Section 13-d(4), the Chair of the New York State Workers' Compensation Board ("Chair") had exercised her authority to temporarily suspend Dr. Raphael P. Davis' authorization to treat injured workers in the New York State workers' compensation system effective August 18, 2022 (Subject Number 046-1539).

The temporary suspension was based on the Chair's designee's investigation, which revealed that, despite multiple written requests, Dr. Davis had failed and refused to provide the Board with proof of reimbursement of the sum of $4,965.59 to a claimant's private health insurer, which sum having also been paid to Dr. Davis by the claimant's workers' compensation carrier for the same treatment.

Upon receipt of proof reimbursement, the Chair has rescinded the temporary suspension of Dr. Davis and has reinstated his authority to treat injured workers effective August 26, 2022. The Medical Director's Office will restore Dr. Davis to the list of providers authorized to treat injured workers as of August 26, 2022.

Any questions regarding the authorized lists should be referred to the Medical Director's Office at 1 (800) 781-2362.