As part of her 2026 State of the State agenda, New York Gov. Kathy Hochul proposed legislation to universally authorize all eligible licensed health care providers to treat New York’s injured workers. 

As an occupational medicine specialist practicing in Saratoga County since 1989, I know firsthand how helpful this change would be for injured workers, health care providers and for New York State as a whole. 

Under the current system, eligible health care providers must apply for special authorization by the New York State Workers’ Compensation Board to treat injured workers. Physicians also must pay an application fee to their county medical society to become board-authorized. These added steps and expenses create an unnecessary barrier to provider participation in a system that desperately needs more treating providers, especially in rural communities. 

Take, for example, a back strain injury. If a patient injures his back lifting something at home or working on the deck doing renovations, he seeks treatment from his primary care physician, who is well-qualified to care for a patient with this very common condition. However, if that same patient sustains that same injury at work, he can see only a board-authorized physician who had to go through unnecessary extra “learning modules” regarding how the WCB wants these injuries treated. Most primary care physicians do not see the need for obtaining this extra authorization for something they commonly treat on a regular basis. For this reason, most primary care physicians (family practice, internal medicine) do not seek this extra authorization, so most patients cannot see their own doctor for common musculoskeletal injuries if they occurred at work.  

Consider also occupational asthma, a not uncommon workplace medical condition caused by exposure to airborne irritants or allergens. Diagnosing and managing it often requires a pulmonologist to perform specialized testing, confirm the diagnosis, determine severity and identify the underlying cause. That determination not only helps guide treatment, but also when it is safe for a worker to return to the job and what precautions may be needed.  

Today, across 16 rural New York State counties — Allegany, Cattaraugus, Chenango, Delaware, Essex, Franklin, Greene, Hamilton, Herkimer, Lewis, Schuyler, Steuben, Sullivan, Washington, Wyoming and Yates — there are only seven board-authorized pulmonologists. In 11 of those counties, there is not a single one. For workers in those communities, that can mean longer travel, delays in care, and a slower recovery. 

Board-authorized providers are so few in some areas that some workers have inordinately long wait times to be seen for even the simplest injuries. The injured worker suffers from this; prompt healing and early return to work are impaired by these delays, costing the workers and their employers money and productivity.

This is not an isolated problem. Statewide, only about 10% of providers who can be board-authorized actually complete the process. That should tell us something. New York’s providers already undergo rigorous licensing requirements through the New York State Education Department and the New York State Department of Health; many have hospital privileges that demand additional credentialing requirements and proof of competency.

They already meet the professional standards required to practice medicine. There is no need to go through an additional board-authorization process to treat injured workers, nor are the additional “training modules” necessary for physicians to know how to treat these common conditions.  

Hochul’s proposal would increase provider participation and expand access to care. Injured workers would have far more options, including the ability to receive treatment from their own primary care provider — someone they already know and trust. Better, faster access to care can lead to better outcomes and a faster, healthier return to work.  

The time, effort and cost of applying for board authorization discourage too many providers from participating. New York State can and should change that. 

Dr. Michael G. Holland is the Saratoga Hospital Employee Health medical director and the Saratoga Medical Group director of Occupational Medicine.