Workers' Compensation Guidelines for …
1 | Page . Workers’ Compensation . Guidelines for . Determining Impairment . First Edition, November 22, 2017
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PLEASE READ CAREFULLY THE FOLLOWING …
www.wcb.ny.govThe undersigned requests written authorization for the following special service(s) costing over $1,000 or requiring pre-authorization pursuant to …
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PLEASE READ CAREFULLY THE FOLLOWING …
www.wcb.ny.govI request that the Workers' Compensation Board review the insurer's denial of my doctor's request for approval to vary from the Medical Treatment Guidelines.
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