Get 091230 Filed October 15, 2009 This Appeal Arises Pursuant To The Texas Workers' Compensation Act

Filling out the 091230 form online can be a straightforward process if approached methodically. This guide is designed to help users effectively navigate the sections of the form to ensure all necessary information is accurately provided.

Follow the steps to complete the form online:

1. Click the ‘Get Form’ button to retrieve the document and open it for editing.
2. Review the introductory information on the form carefully. Ensure you understand the purpose of the appeal and the relevant sections of the Texas Workers' Compensation Act.
3. Locate the section for the date of injury. Enter the exact date when the injury occurred in the designated field.
4. In the section detailing the extent of injury, accurately describe all injuries being appealed, using specific medical terms as listed in the appeal documentation.
5. If applicable, note the carrier waiver details. This section will require stating whether there has been a waiver of the right to contest compensability.
6. Complete any additional sections that pertain to the appeal, providing all required information as accurately as possible.
7. Once all sections are filled out, review the completed form for any errors or omissions. Make necessary corrections.
8. Final steps include saving your changes. You may also choose to download, print, or share the form as needed.

Complete your documents online today for a smooth filing experience.