Subject Numbers Regarding Health Provider Authorizations

Authorization No. 264785-7W

October 10, 2017

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. Dayna McCarthy’s authorization to treat injured workers within the New York State workers’ compensation system effective October 5, 2017.

The Chair’s designee’s investigation has revealed that on or about August 4, 2017, the Medical Director’s Office (MDO) sent Dr. McCarthy a letter regarding a complaint that she had not submitted a report and the required Doctor's Report of MMI/Permanent Impairment (Form C-4.3) for a workers’ compensation claimant. In its letter, the MDO requested that Dr. McCarthy submit the required Form C-4.3 and acknowledge her future compliance with workers’ compensation law, rules, regulations and policies. To date, the MDO has not received the requested response; the requested Form C-4.3 has not been submitted to the claimant’s file, nor has Dr. McCarthy responded to the Chair’s designee’s inquiries.

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

Dr. McCarthy is prohibited from rendering treatment and care to injured workers while her authorization is temporarily suspended. Reports submitted by Dr. McCarthy for services rendered prior to October 5, 2017 are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. McCarthy for services rendered prior to October 5, 2017 should not be denied due to the suspension of her 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.