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Subject Number 046-216 Revocation of Independent Medical Examination Authorization for Failure to Renew Board Certification

Subject Numbers Regarding Health Provider Authorizations

January 8, 2008

The following medical doctors, surgeons, and osteopaths who were authorized by the New York State Workers' Compensation Board to conduct independent medical examinations of injured or ill workers have failed to renew their board certification with the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA), as the case may be.

Those providers as listed below are no longer compliant with WCL §137 or 12 NYCRR §300.2(b)(3), which require such board certification in order to continue to be IME authorized. Accordingly, each individual's respective authorization to conduct independent medical examinations has been revoked until such time that said provider renews his or her board certification and submits an application for authorization with adequate and appropriate proof to that effect. The providers' authorization to treat workers' compensation claimants, if so authorized, is not affected by this revocation.

NAME AUTHORIZATION NUMBER EFFECTIVE DATE OF REVOCATION
Autz, Arthur Louis 186518-7W 01/01/05
Battaglia, Michael Joseph 182014-1W 01/01/05
Bauer, Steven Robert 207738-6W 01/01/07
Blum, Dwight C 137492-5W 01/01/07
Brandel, Zev 207019-1W 01/01/05
Ciuffo, Joseph J 155718-0W 01/01/05
Engel, Peter Bruce 183422-5W 01/01/05
Futterman, Bennett Alan 143677-3W 01/01/07
Gelin, Emmanuel 192203-8W 01/01/05
Guidarelli, Anthony Fred 105592-0W 01/01/07
Gustin, Gabriel 213265-2W 01/01/05
Karmazin, Yevgeniya 198112-5W 01/01/07
Kay, Bruce Saul 136630 01/01/05
Khokhar, Imtiaz A 197453 08/02/07
Kjoller, Jane Laura 194237-4W 01/01/05
Larosa, Joseph Michael 181747-7W 01/01/05
Luna Vega, Alberto Rodolfo 171809-7W 07/02/07
Makram, Cherif 159208-8W 07/02/05
Mehta, Mrugendra Indravadan 224413 07/02/07
Moore, Donald E 157236-1W 01/01/05
O'Brien, Thomas Gerard 210513-8W 01/01/07
Oh, Chung Hyun 111469-3W 07/02/07
Padial, Michael S 191639 01/01/05
Peer, Richard Milton 106941-8W 07/02/06
Reddy, Nirmala M 167789-7W 01/01/05
Santiago, Ricardo Nakadomari 202437-0W 07/01/07
Shanon, Roy Mark 175599-0W 01/01/05
Verdini, John Patrick 179399-1W 01/01/05
Wieder, Harvey 206669-4W 01/01/05
Zuo, Hailiu 192825-8W 01/01/05

Any reports of independent medical examination conducted prior to the provider's respective revocation date of his or her authorization are permitted and the examiner is entitled to payment. Further, said provider may provide testimony and/or deposition concerning independent medical exams he or she concluded prior to revocation date.

Any questions regarding this matter should be referred to the Office of General Counsel at (518) 486-9564.

Zachary S. Weiss
Chair