WORKERS COMPENSATION CLAIMS

The workers compensation claims process in Connecticut is governed by specific statutes. The process can be confusing to claimants because the statutes identify many forms by number, and they use many abbreviations and acronyms. The purpose of this section is to provide a brief explanation of the claims process and the most common forms, abbreviations and acronyms.

Filing a Claim (Form 30C)

Voluntary Agreements

Employer Denies Liability (Form 43)

Employer Intends to Discontinue Benefits (Form 36)

Informal Hearing

Formal Hearing

Temporary Total Benefits (TT)

Light Duty Work Capacity

Temporary Partial Benefits (TP)

Maximum Medical Improvement (MMI)

Permanent Partial Disability (PPD)

Independent Medical Examination (IME)

Full and Final Stipulation (Stip)

• Filing a Claim (Form 30C)

Most workers compensation claims are initiated when the injured worker files a formal notice of the injury. This form is identified by the workers compensation commission as “Form 30C”, and it contains information about the claimant, the employer, and a brief explanation of the injury. It is always advisable to file a Form 30C at the beginning of each case, and each time the employee suffers an additional injury. The workers compensation commission requires that a Form 30C be filed within one years from the date of the injury. With certain exceptions, a workers compensation claim is barred unless a Form 30C is filed in a timely manner.

• Voluntary Agreements

If your employer admits that you sustained an injury during the course of your employment with them AND ALSO admits that your injury was a direct result, they will accept your claim by filing voluntary agreements. By definition, these agreements are “voluntary”, which means that the employer is not required to file them.

• Employer Denies Liability (Form 43)

If your employer denies that you sustained an injury during the course of your employment it will file a “Form 43”. This form provides a brief summary from the employer explaining why it believes it is not responsible for your injury. The law requires the employers to file a Form 43 within twenty-eight days of its receipt of a Form 30C. If an employer fails to file a Form 43 in a timely manner, it can be precluded from contesting the case.

• Employer Intends to Discontinue Benefits (Form 36)

If you are receiving worker compensation benefits and your employer intends to stop paying benefits, it must first file a formal notice known as a “Form 36”. This form requires employers to provide an explanation regarding why it believes it is entitled to stop paying you benefits. You should notify your attorney immediately if you receive a Form 36, because an employer’s request to terminate benefits will be granted if an objection is not filed within ten days of your receipt of the form.

• Informal Hearing

Essentially, an informal hearing is a brief meeting between the parties which is supervised by a Workers Compensation Commissioner.

• Formal Hearing

A formal hearing is the equivalent of a trial. It is conducted in a courtroom setting with the Commissioner acting as a judge.

•Temporary Total Benefits (TT)

If your treating physician confirms that you are unable to work for more than three days, you are entitled to collect temporary total benefits for the period of time you are unable to work.

•Light Duty Work Capacity

If your treating physician confirms that you are not able to perform the normal physical requirements of your job, but believes that you are able to perform some type of work, then you will be assigned a light duty work capacity.

•Temporary Partial Benefits (TP)

If your employer offers you light duty work at full pay, no workers compensation benefits are due. If your employer offers you a reduced pay scale, or reduced hours, you are eligible to receive TP benefits for seventy-five percent of the difference in pay, after taxes. If you have a light duty work capacity and your employer is not able to accommodate you, you are required to look for suitable employment. If you contact five prospective new employers each week, you will be entitled to collect TP benefits until you find suitable employment.

•Maximum Medical Improvement (MMI)

When your treating physician believes that your injury has reached a stable condition that is not likely to change, this is referred to as reaching “maximum medical improvement”.

•Permanent Partial Disability (PPD)

If your treating physician determines that you have sustained a permanent disability after you have reached maximum medical improvement, you will receive a disability rating. This disability rating is expressed as a percentage of the body part which was injured.

•Independent Medical Examination (IME)

If your employer does not agree with the conclusions of your treating physician, it has the right to request you to submit to a medical exam conducted by a physician of its choice. This type of examination is referred to as an IME. If your employer asks for an IME they must pay for it. If you refuse to submit to an IME, your benefits may be suspended.

•Full and Final Stipulation (Stip)

At the end of a compensation claim you may be able to negotiate a full and final settlement. A settlement must be agreed to by both parties, and it is important to understand that your employer and its insurance company are not required by the compensation statutes to offer you a settlement.