In addition to healing and the impartation of spiritual gifts we now enjoy in the New Covenant, the Old Testament contains a unique use of laying on of hands. In the principle of substitutionary and vicarious sacrifice, we find that guilt was actually transferred from the sinner to the sacrificial victim. For this reason, the animal could die and shed his blood in the offerer’s place. Similarly the scapegoat received all the sins of Israel through the laying on of hands and the prayer of confession. Transfer of guilt was not merely ceremonial-that is with symbolic meaning-but actual. 

And he shall put his hand upon the head of the burnt offering; and it shall be accepted for him to make atonement for him (Leviticus 1:4).