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The Request for Further Action by Insurer/Employer (Form RFA-2) has been modified to better align with the process for resolving payer denials of the Workers' Compensation Board's New York Medical Treatment Guidelines (MTGs) Variance and MTG Special Services Prior Authorization Requests (PARs).
- Workers’ Compensation Forms Health Care Providers
MG-2 (4/18) As of 5/2/22, this form is no longer being...
- Injured Worker Workers' Compensation Forms
Commonly Used Injured Worker Forms available for printing...
- Workers’ Compensation Forms Health Care Providers
This form is used for a workers' compensation, volunteer firefighters' or volunteer ambulance workers' benefit case as follows: To request approval to vary the treatment of the claimant identified on this form from the relevant Medical Treatment Guidelines.
Download a fillable version of Form MG-2 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board. Download Form MG-2 Attending Doctor's Request for Approval of Variance and Carrier's Response - New York
MG-2 (4/18) As of 5/2/22, this form is no longer being accepted by the Board. All requests are to be submitted using OnBoard. Attending Doctor's Request for Approval of Variance and Carrier's Response: Physician; Nurse Practitioner; Podiatrist; Chiropractor; Workers' Compensation Board, Insurance Carrier, Injured Employee and their representative
Commonly Used Injured Worker Forms available for printing and mailing to the Workers' Compensation Board
The prescribing physician must complete an MG-2 variance form to request this permission. This form is a critical first step and can be accessed online: MG-2 Variance Form. Importance of timing in treatment. The timing of when medical marijuana treatment begins is crucial in the eyes of the law.
View, download and print fillable Mg-2 Nys -attending Doctor's Request For Approval Of Variance And Carrier's Response in PDF format online. Browse 1 Mg2 Form Templates collected for any of your needs.
