Get Rb- 89.doc

Filling out the RB-89.doc form online is a vital step in the process of rebutting an application for reconsideration or full board review. This guide provides clear, step-by-step instructions to help users navigate the form effectively and with confidence.

Follow the steps to complete your RB-89.doc online.

1. Click the ‘Get Form’ button to obtain the RB-89.doc form and open it in your preferred editing application.
2. Fill in the WCB case number and carrier case number in the appropriate fields to identify the relevant claim.
3. Enter the date of injury, followed by the carrier's name in the designated fields.
4. Provide the claimant's name and address to ensure proper identification and communication.
5. Indicate whether the rebuttal is being made on behalf of the claimant, employer/carrier, special funds, or uninsured employers' fund by selecting the correct option.
6. Choose whether the rebuttal is in response to a mandatory or discretionary full board review.
7. Specify the date on which the application was served upon the cited party.
8. Provide the filing date of the Memorandum of Decision that is the subject of the rebuttal application.
9. Select the appropriate contention regarding the application for reconsideration/full board review, detailing whether you contend that it should be denied, affirmed, or modified.
10. Describe any findings of fact or conclusions of law that the rebuttal contests in the provided space.
11. Indicate if the cited record constitutes the full record for review and whether you rest on that record.
12. If there are additional relevant hearings, documents, or transcripts that were not cited, provide this information clearly.
13. Ensure you sign the document in the designated space and provide your title, printed name, and phone number.
14. Complete the affirmation or affidavit section as required, including your certifications and necessary signatures.
15. Finally, choose the method of filing the rebuttal with the board (fax, email, mail, or personal delivery) and complete all relevant details.
16. Once completed, save the changes, download the form, print it, or share it as required.

Complete your RB-89.doc form online today to ensure timely processing of your rebuttal.