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If you wish to participate in an appeal filed by an appellant, you must complete and return this form to Workers Compensation Appeal Tribunal within 21 days from receipt, otherwise we will assume you do not wish to participate in the appeal, and you will receive no further...

This Notice of Appeal must be received by WCAT within 30 days of the date of the Internal Reconsideration (IR) decision.

All participants before the Appeal Tribunal may choose to be represented. You could choose the Worker Advisor, Employer Advisor, or someone else like a lawyer, friend, or union rep. Complete this form if you choose to be represented or you wish to change your representative.