WCB IME Application

Workers’ Compensation Board Independent Medical Examinations
​In September of 2001, Governor George E. Pataki signed into law a new measure requiring all medical providers to seek authorization from the Chairman of the Workers’ Compensation Board (WCB) in order to perform independent medical examinations (IMEs).  The new law took effect March 20, 2001.  Physicians who perform IMEs may apply for authorization by submitting their application to NYSOMS.
Physicians who wish to perform IMEs may apply for authorization by submitting your application directly to the New York State Osteopathic Medical Society.

As a special benefit to NYSOMS members, this service is offered free of charge (nonmember fee is $200).
Required Documents
​Two IME applications with original signature
Copy of:
Board Certification
Board Recertification (if applicable)
NYS Medical License
Verification of completion of residency
Non-NYSOMS members: $200 processing fee or NYSOMS application with appropriate dues

All WCB applications and documentation should be forwarded to:
        WCB Review Committee
        NYIT de Seversky Mansion, Room 107
        Old Westbury, NY 11568
Additional requirements of the NYS Workers’ Compensation Board:
  1. A copy of the application (face sheet only) must be filed with the:
            State of New York WORKERS' COMPENSATION BOARD
            Medical Director's Office - Riverview Center
            150 Broadway - Suite 195
            Menands, NY 12204
  2. It is necessary that all office addresses listed on the MR/IME-1 are registered with the NYS Office of Education. Failure to register all office addresses will delay processing of application by the Workers Compensation Board.

    To register an address call NYS Dept of Education (518) 474-3817 ext 410 with the following information: Physician’s name, license number, primary address, date of birth, last four digits of social security number and new address. There is a $10 fee per address.

    NYSOMS can process our portion of the application while the address registration is pending. However, WCB will not approve the application unless all addresses are registered.
For additional information regarding your WCB application call NYSOMS at
(800) 841-4131