Rb 89 3 2026

1. Click ‘Get Form’ to open the rb 89 3 in the editor.
2. Begin by entering the WCB Case Number(s) for the claims being appealed in the designated field.
3. Next, input the Carrier Case Number(s) if applicable, noting that this section does not apply to discrimination claims.
4. Fill in the Carrier Code of the insurer related to your claim, ensuring accuracy for proper processing.
5. Provide the Carrier's Name and Date of Injury/Leave, which are crucial for identifying your case.
6. Enter your complete name and address as the Claimant, including any alternate mailing addresses if necessary.
7. Indicate who is filing this Rebuttal and specify whether it responds to a Mandatory or Discretionary Full Board Review application.
8. Complete all remaining fields, including requested outcomes and responses to issues raised in the application.
9. Finally, ensure you sign and date the form, certifying its good faith basis before submitting it through our platform.

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