Workers Compensation Rating Application Proceedure:
Applications can be found on the WCB website:

Please submit all applications and documents to:
Westchester County Medical Society
40 Sunshine Cottage Road
Valhalla, NY 10595

Please contact Kalli Voulgaris with any questions:
  • Application (form MR/IME-1 (8-18) filled out in duplicate, both with original signatures
  • Proof of completion of Residency and any Specialty Fellowship Training
  • Certificate from a specialty board recognized by the American Board of Medical Specialties or the American Board of Osteopathic Association.
  • Application processing fee of $785.00 made payable to the Westchester County Medical Society.*
  • Department of Education Registration Certificate.  Please be aware that your principal office address must be within Westchester or Putnam Counties, must match the address that appears on your DOE Registration Certificate, and all of your office addresses must be registered with the Department. Please contact the New York State Education – Division of Professional Licensing at (518) 474-3817 or go to .  (Please refer to section #4 of the application).
Once we receive all of the items, your application will be forwarded to our Committee Chair for approval. Once approved and given a WC rating, the packet will be forwarded to the New York State Workers Compensation Board.
Once the application has been received by the Workers Compensation Board in Albany, the Workers Compensation Board will communicate with the provider and/or medical practice directly (not the Westchester County Medical Society), should any follow-up be necessary.  

 * Please Note: If you are a member of the Medical Society or would like to become a     member, whatever dues have been paid for the current year, will be applied to the WC application processing fee.