Form IS-4 Report of Impartial Specialist Examination or Record Review - New York

What Is Form IS-4?

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 Form IS-4?
A: Form IS-4 is the Report of Impartial Specialist Examination or Record Review.

Q: What is the purpose of Form IS-4?
A: The purpose of Form IS-4 is to document the findings and opinions of an impartial specialist after an examination or review of records.

Q: Who is required to complete Form IS-4?
A: An impartial specialist, such as a physician or psychologist, is required to complete Form IS-4.

Q: What type of information is included in Form IS-4?
A: Form IS-4 includes information about the specialist's qualifications, the purpose of the examination or review, a summary of the findings, and the specialist's opinions.

Q: Is Form IS-4 specific to New York?
A: Yes, Form IS-4 is specific to New York.

Q: Are there any fees associated with submitting Form IS-4?
A: No, there are no fees associated with submitting Form IS-4.

Q: Is Form IS-4 confidential?
A: Yes, the information provided on Form IS-4 is confidential and protected by privacy laws.

Q: Who can request a specialist examination or review?
A: Either the claimant or the insurance carrier can request a specialist examination or review.

Q: Is Form IS-4 required for every specialist examination or review?
A: Yes, Form IS-4 is required for every specialist examination or review conducted in New York.