Get Ny Rb-89.1 2011

Filling out the NY RB-89.1 form online may seem daunting, but this guide will support you through each step. By following the instructions provided, you will gain a clearer understanding of how to complete the Rebuttal of Application for Board Review effectively.

Follow the steps to complete the form accurately

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Locate the WCB case number(s) and fill them in the first section of the form. You will find fields for both the carrier case number(s) and the carrier code, which should be completed accurately.
3. Input the carrier's name and the claimant's name in the designated sections. Ensure that the names are spelled correctly to prevent any issues during processing.
4. Enter the date of injury in the provided field. It is essential to use the correct date format as prescribed in the form.
5. Provide the address of the claimant as requested on the form. Double-check for any errors to ensure delivery correspondence is accurate.
6. Indicate on whose behalf the rebuttal is filed by selecting one of the provided options: Claimant, Employer/Carrier, or Special Funds. Fill in the relevant name field for clarity.
7. Specify the application this rebuttal responds to by selecting one option from the following: Uninsured Employers' Fund, Review of WCLJ Decision, or Rehearing or Reopening.
8. Document the date upon which the application was served on the party mentioned. Next, enter the filing date of the decision that is being reviewed.
9. In the section that contends the nature of the rebuttal, select how the rebuttal should be handled – whether it should be denied, corrected, affirmed, or modified.
10. Provide any necessary details regarding findings or conclusions of law. Clearly articulate any contentions to support your argument.
11. Indicate whether the record cited in the application represents the full record for review. If not, specify any additional documents and evidence that are important for consideration.
12. Complete the certification section by signing and dating the document. Make sure to write your name and title clearly below your signature.
13. Fill out the affirmation section if you are an attorney, and provide your signature. Ensure that all necessary details are included.
14. Choose the method by which you are filing the rebuttal with the Board. Provide dates and any additional required information for each method selected.
15. Finally, include the names and addresses of all parties served. Attach additional sheets if necessary to ensure comprehensive documentation.
16. Once all fields are completed accurately, save the changes. You may then download, print, or share the form as needed.

Begin completing your NY RB-89.1 form online today to ensure timely and accurate submission.