Form MR / IME-1 Health Provider's Application for Authorization Under the Workers' Compensation Law - New York

Form MR / IME-1 Health Provider's Application for Authorization Under the Workers' Compensation Law - New York

What Is Form MR/IME-1?

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the MR/IME-1 form?
A: The MR/IME-1 form is the Health Provider's Application for Authorization Under the Workers' Compensation Law in New York.

Q: Who uses the MR/IME-1 form?
A: Health providers use the MR/IME-1 form when applying for authorization under the Workers' Compensation Law in New York.

Q: What is Workers' Compensation?
A: Workers' Compensation is a system that provides benefits to workers who are injured or become ill due to their job.

Q: What is the purpose of the MR/IME-1 form?
A: The purpose of the MR/IME-1 form is to allow health providers to request authorization to perform medical review or independent medical examinations for Workers' Compensation cases.

Q: What information is required on the MR/IME-1 form?
A: The MR/IME-1 form requires information such as the health provider's name, address, contact information, and professional qualifications.

Q: How long does it take to process the MR/IME-1 form?
A: The processing time for the MR/IME-1 form can vary. It is recommended to submit the form well in advance of the requested examination date.

Q: Is the MR/IME-1 form only applicable in New York?
A: Yes, the MR/IME-1 form is specifically for health providers seeking authorization under the Workers' Compensation Law in New York.

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Form Details:

  • Released on August 1, 2018;
  • The latest edition provided by the New York State Workers' Compensation Board;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MR/IME-1 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.

Download Form MR / IME-1 Health Provider's Application for Authorization Under the Workers' Compensation Law - New York

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