Form MG-1 Attending Doctor's Request for Optional Prior Approval and Carrier's / Employer's Response - New York

Form MG-1 Attending Doctor's Request for Optional Prior Approval and Carrier's / Employer's Response - New York

What Is Form MG-1?

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form MG-1?
A: Form MG-1 is the Attending Doctor's Request for Optional Prior Approval and Carrier's/Employer's Response.

Q: What is the purpose of Form MG-1?
A: Form MG-1 is used in New York to request optional prior approval for medical treatment and to provide the carrier/employer's response.

Q: Who can fill out Form MG-1?
A: Form MG-1 can be completed by the attending doctor treating the injured worker or the injured worker themselves.

Q: What information needs to be included in Form MG-1?
A: Form MG-1 requires information about the injured worker, the medical treatment being requested, and the medical necessity of the treatment.

Q: What is the deadline to submit Form MG-1?
A: Form MG-1 should be submitted as soon as possible, but no later than 30 days after the treatment is requested or received.

Q: Can the carrier/employer deny the request on Form MG-1?
A: Yes, the carrier/employer can deny the request for optional prior approval if they determine that the treatment is not medically necessary or related to the work injury.

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Form Details:

  • Released on April 1, 2018;
  • The latest edition provided by the New York State Workers' Compensation Board;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form MG-1 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.

Download Form MG-1 Attending Doctor's Request for Optional Prior Approval and Carrier's / Employer's Response - New York

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