Physicians Application For Renewal Of Designation As Impartial Specialist {IS-1R} | Pdf Fpdf Docx | New York

 New York   Workers Compensation 
Physicians Application For Renewal Of Designation As Impartial Specialist {IS-1R} | Pdf Fpdf Docx | New York

Last updated: 6/20/2023

Physicians Application For Renewal Of Designation As Impartial Specialist {IS-1R}

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Description

IS-1R - PHYSICIAN'S APPLICATION FOR RENEWAL OF DESIGNATION AS AN IMPARTIAL SPECIALIST. This form is used in the context of workers' compensation cases in New York State. A physician seeking to renew his/her designation as an Impartial Specialist must be licensed in New York State and not have any license restrictions and/or disciplinary actions in place or pending. The physician must be Board-Certified in a medical specialty/subspecialty recognized by the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) and must be actively treating patients with a minimum of 5 years of practice in that medical specialty. Please attach a copy of your NYS license, Board certifications and curriculum vitae. www.FormsWorkflow.com

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