Subject Numbers Regarding Health Provider Authorizations

July 9, 2009

Authorization No. 195621-8W

Please be advised that, effective October 1, 2004, Consent Order No. 04-215 was adopted by the New York State Department of Health, State Board for Professional Medical Conduct (BPMC), limiting the practice of Susan M. Chlebowski, M.D., to a residency program in psychiatry. Dr. Chlebowski had been authorized to provide services to workers' compensation claimants as an anesthesiologist. By Modification Order of Consent Order No. 04-215, effective May 20, 2009, Dr. Chlebowski completed her residency in psychiatry and completed the terms previously imposed in BPMC Consent Order 04-215. The Modification Order does not constitute a new action. Dr. Chlebowski voluntarily resigned her authorization to treat workers' compensation claimants effective June 26, 2009. No current business address is available for Dr. Chlebowski.

Dr. Chlebowski is prohibited from rendering medical or other treatment and care to individuals who have suffered work-related injuries or illnesses. Medical reports submitted by Dr. Chlebowski for treatment rendered prior to October 1, 2004, are valid, but are invalid for any treatment rendered on or after that date. Requests to cross-examine Dr. Chlebowski regarding treatment she rendered prior to October 1, 2004, should not be denied due to the resignation of her authorization.

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