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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo


Subject No. 046-551

Mandatory Use of Updated Medical Treatment Guidelines
Forms MG-1 and MG-2

Date: June 21, 2013

On March 1, 2013 the Medical Treatment Guidelines Improvements were announced by the Workers' Compensation Board (Board), including the announcement of revised Medical Treatment Guidelines forms, via Subject Number 046-516. These new forms contain changes necessary for the implementation of procedural improvements recommended by stakeholders and adopted by regulation.

Effective July 1, 2013 only the following versions of variance requests and optional approval requests will be scanned and processed by the Board:

Form MG-2 (2-13) Attending Doctor's Request for Approval of Variance and Carrier's Response

Form MG-1 (2-13) Attending Doctor's Request for Optional Prior Approval and Carrier's/Employer's Response

Older versions of these forms, and replies to older versions of these forms, will not be scanned or processed by the Board after June 30, 2013.

Please contact the Board's Medical Director's Office at (800) 781-2362 if you have any questions regarding Medical Treatment Guidelines. Additional information on additions and improvements, as well as updated frequently asked questions, may also be found on the Board's website under Medical Treatment Guidelines Program.

Thank you for your cooperation.

 

Robert E. Beloten
Chair