NY MG-2 Variance Request Form: Filing, OnBoard Submission, and Denials

The paper NY MG-2 variance request form is no longer accepted. Since May 2, 2022, New York’s Workers’ Compensation Board has required all variance requests to be submitted electronically through the OnBoard system as a Prior Authorization Request (PAR).¹ The purpose is the same as it was under the old form: when a patient needs treatment that falls outside the Medical Treatment Guidelines, or needs more sessions than the guidelines allow, the variance PAR is how a provider gets it authorized and paid.

When You Actually Need to File a Variance

New York’s Medical Treatment Guidelines set evidence-based standards for treating common workplace injuries to the neck, back, shoulder, and knee, including which treatments are appropriate and how long a course of care should run. A variance is required only when the proposed treatment deviates from those recommendations, either because the treatment isn’t listed in the guidelines at all or because the patient needs more sessions or longer duration than the guidelines recommend.²

Do not file a variance for care the guidelines already pre-approve. The Board will deny it.² Check the applicable guideline section first.

What to Gather Before You Open OnBoard

A weak variance request is an easy denial. The Board expects four core elements in every variance: the provider’s medical opinion supporting the proposed care, an explanation of why deviating from the guidelines is medically necessary, a statement of why the guideline-recommended alternatives are insufficient or inappropriate, and confirmation that the patient agrees to the proposed treatment.³

If the treatment isn’t recommended or isn’t addressed by the guidelines, you also need to describe the signs and symptoms that failed to improve under guideline-consistent care.³ Show the Board you tried the standard approach and it didn’t work. Peer-reviewed literature supporting the proposed treatment strengthens the request but isn’t strictly required.

Objective Functional Improvement

The Board expects documentation of “positive patient response,” meaning functional gains you can measure objectively: range of motion, strength and endurance, positional tolerances, or activities of daily living. Your documentation should include an initial evaluation of the patient’s functional abilities after the injury, a re-evaluation of current functional abilities, and a statement of expected goals for the next evaluation period.³ Without that before-and-after framework, the insurer has nothing to measure the variance against, and denial becomes easy to justify.

Claim Identifiers

You’ll need the patient’s Workers’ Compensation Board Case Number and the exact date of injury to search for the claim in OnBoard. If you don’t have them, check the patient’s C-4 treatment form or contact the insurance carrier.

Submitting the Variance PAR in OnBoard

Paper MG-2 forms can no longer be faxed, emailed, or mailed. Board-authorized and out-of-state healthcare providers must submit through OnBoard, which automatically forwards the PAR to the appropriate claim administrator. Separate service on the carrier is no longer required.⁴

Inside OnBoard, the submission runs through these steps:⁵

From your dashboard, select “Submit a Request,” then “Prior Authorization (PAR).”
Select your name and the correct license, then use “Claim Search” to locate the patient’s case.
Choose the “Treatment/Testing” PAR category. Enter the CPT code or description, select the MTG site (choose “None” if the treatment isn’t tied to a specific guideline), and enter the Medical Treatment Guide Reference, body part, and side.
Select “Add Details,” pick the type of service, and fill in frequency and duration. Then open “Medical Necessity/Supporting Medical.”
Enter or upload your statement of medical necessity. Use “Upload Relevant Clinical Information” to attach supporting documents.
Select “Review and Submit,” preview the generated PAR, read the attestation, and select “Attest and Submit.”

One thing to watch: draft requests sitting unsubmitted in OnBoard for more than 30 days are automatically deleted.⁵ If you need extra time to gather clinical evidence, don’t let the draft sit.

How Long the Insurer Has to Respond

Once the carrier receives the variance PAR, they have 15 calendar days to grant it in full, authorize it partially, or deny it.³

If the insurer wants an independent medical examination or a records review before deciding, they must notify the Board’s Chair within five business days of receiving the request. That extends the window to 30 calendar days from the date the PAR was received. A denial must state the basis in detail and either attach the IME report or identify it by document number and the date the Board received it.⁶

If the insurer misses both the 15-day and 30-day deadlines, the variance may be deemed approved by an Order of the Chair.³ The word “may” matters. The Board reviews whether the request was properly completed before issuing a deemed-approval order. A sloppy submission won’t be rescued by the carrier’s missed deadline.

If the Variance Is Denied

When an insurer denies a variance, the treating provider can request review through the Board. The revised MG-2.1 process lets the provider choose between review by a medical arbitrator or review through Workers’ Compensation Board adjudication. If adjudication is selected, the Board decides whether the case proceeds to a hearing or is resolved through a proposed decision.⁷

Under OnBoard, it’s typically the treating provider, not the patient or the patient’s attorney, who initiates the denial review.⁸ This is a meaningful shift from the paper process. An injured worker whose treatment was denied may need to coordinate with the doctor’s office rather than assume an attorney can file the review independently. Denials of non-MTG PARs over $1,000 are addressed at a priority hearing scheduled by the Board.⁹

1
New York State Workers’ Compensation Board. Workers’ Compensation Board All Common Forms
2
New York State Workers’ Compensation Board. Medical Director’s Office Bulletin MDO-2011 #2
3
New York State Workers’ Compensation Board. Understanding Variances and The Drug Formulary
4
New York State Workers’ Compensation Board. OnBoard: Health Care Providers
5
New York State Workers’ Compensation Board. OnBoard Training: Health Care Providers Treatment/Testing PAR
6
New York State Workers’ Compensation Board. Medical Treatment Guidelines Frequently Asked Questions
7
New York State Workers’ Compensation Board. Subject Number 046-1048 Revised Medical Authorization Request Forms
8
LaborPress. Workers’ Comp Board Launches a “Medical Portal” for Treatment Requests
9
New York State Workers’ Compensation Board. OnBoard: Payers