Wc r1catee 2026

1. Click ‘Get Form’ to open the wc r1catee in the editor.
2. Begin by filling out Section 1, which includes your identifying information. Enter your last name, first name, middle initial, Social Security Number or Board Tracking Number, date of injury, occupation, county of injury, birthdate, treating physician's specialty, and diagnosis.
3. In Section 2, specify the catastrophic rehabilitation supplier you are requesting. Ensure that you provide the name clearly as this will be crucial for the Board's Administrative Decision.
4. Complete Section 3 by detailing your education level and work history for the past 15 years. Include physical requirements for each job such as lifting weights and hours spent standing or sitting.
5. Attach a statement from your authorized treating physician regarding your work ability. This must be dated within one year prior to mailing the form.
6. Fill out Section 4 with your Certificate of Service details to confirm that copies have been sent to all relevant parties.
7. Finally, review all sections for accuracy before submitting your request through our platform.

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