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Subject Number 046-1503 Changes in Request for Assistance/Further Action Forms Relating to OnBoard: Limited Release

Board Bulletins and Subject Numbers

February 24, 2022

The Chair has announced that the following Request for Assistance/Further Action (RFA) forms will be changing to align with the implementation of the third phase of OnBoard: Limited Release:

The Board will start accepting the new versions of the RFA forms on May 2, 2022, the same day the third phase of OnBoard: Limited Release launches. Their use will become mandatory on June 6, 2022.

All three forms will be the mechanism to request Adjudication review during the prior authorization request (PAR) process, so the Board has added checkboxes to align the forms with those scenarios where Adjudication review is appropriate.

In addition, revisions were made to remove the former ā€œfā€ and ā€œjā€ fields that were on the prior version of Form RFA-2. These fields were previously used when insurers were seeking to transfer liability to the Special Fund for Reopened Cases under WCL §25-a. Because the Special Fund for Reopened Cases was closed by legislative action in 2014, no new applications seeking a transfer of liability to the Fund may be submitted.

If you need an advance draft copy of one of these forms to update computer systems prior to the May 2 implementation date, you may request a copy from

For general questions about the OnBoard project, email

Clarissa M. Rodriguez