Where authorization fits in an open claim
Treatment authorization is the step that connects a doctor’s recommendation to the insurance carrier’s obligation to pay for it. It applies after a claim already exists, meaning the injury has been reported, a Form C-3 has reached the Workers’ Compensation Board, and a case number is moving through eCase. Authorization does not decide whether you are covered; it decides whether a specific proposed treatment will be paid for under the rules that govern your case.
New York runs most of this through OnBoard, the Board’s online portal. Your authorized treating provider initiates the request inside OnBoard, the carrier responds within a fixed window, and the decision posts to the case file. The patient is rarely the one filing these requests, but the timing of them controls how quickly care can proceed, so it helps to understand the mechanics.
When a request is required, and who files it
Not every treatment needs a separate request. A large share of care for common injuries is already pre-authorized because it falls within the Medical Treatment Guidelines (MTG). When a recommended treatment matches what the guidelines list for your body part and stage of recovery, your provider can generally proceed without asking first.
A request becomes necessary when the proposed care sits outside that pre-approved zone or crosses a cost or frequency threshold the rules flag. The common request types inside OnBoard include a prior authorization request for certain procedures, a request to exceed a guideline limit, and a variance request when a provider wants treatment the MTG does not recommend for your condition. Each type has its own form path and its own response clock.
In every case it is the treating provider, not the patient, who submits the request through OnBoard. The provider identifies the proposed treatment, ties it to the established injury, and supplies the clinical reasoning. The request then lands with the carrier, which must respond inside the deadline set for that request type. A non-response within the window can itself carry consequences for the carrier under Board rules.
What the carrier's response means for your care
The carrier’s medical reviewer can grant the request, grant it in part, or decline it. If the response is anything short of a full grant, the case file records the reason, and the provider and patient can see it in eCase. What to do about a declined request is a dispute question handled elsewhere; the point here is procedural, since the response is what tells your provider whether the planned treatment is cleared to go forward.
Because authorization runs on deadlines, the practical lever is documentation reaching the right place on time. A request supported by current exam findings and a clear tie to the work injury moves faster than one the carrier has to question. Keeping your treating provider current on your symptoms, and confirming that your reports are actually posting to the case file, removes the most common source of stall. Where a request stands is visible in OnBoard and eCase, so you can see whether a treatment was pre-authorized under the guidelines or required a separate request rather than guessing at the timing.
Common OnBoard request types
- Prior authorization request — for certain procedures that need sign-off before they proceed.
- Request to exceed a guideline limit — when recommended care passes a frequency or duration cap.
- Variance request — when the proposed treatment departs from the Medical Treatment Guidelines.
Each type has its own form path and its own response clock, and in every case the treating provider — not the patient — files it.
A quick way to keep care moving
- Keep your provider current on your symptoms, so requests rest on fresh exam findings.
- Confirm your reports are posting to eCase.
- Watch OnBoard/eCase to see whether care was pre-authorized or needs a request.
- Note the carrier’s response and its date when one posts.
This is general educational information about how treatment authorization works in New York workers’ compensation, not medical or legal advice. A denied request is a dispute matter best raised with the Workers’ Compensation Board or a qualified attorney.