Pursuant to the Guidelines a treatment provider, when it is determined that care which varies from the treatment guidelines is appropriate and medically necessary for the claimant, must file a <a href="https://thelomad.com/getmad.today/wp-contentwww.getmad.today/blog/2014/11/in-kigin-v-wcb-the-court-of-appeals-upholds-the-presumption-that-treatment-outside-the-mtgs-is-not-medically-necessary-and-the-attending-physician-has-the-burden-of-proof-of-the-need-for-a-variance/">variance for treatment</a> sought from the Carrier or Special Fund