Connecticut designed its workers’ compensation system to cover all injuries or illnesses that might occur in the course of one’s employment. Workers’ compensation supposedly covers all injuries or illnesses that might occur during the course of employment, including both traumatic and occupational illnesses.

Traumatic, a slightly misleading term, are the injuries that result from a one-off accident at work like a broken arm. In contrast, occupational illnesses are those that occur over a set period of time, such as exposure to toxic fumes or carpal tunnel syndrome.

Who qualifies?

If injured during the course of one’s employment, e.g., not while driving to lunch, first report the injuries to the employer.  

What to do

The employer should complete an “Employer’s First Report of Injury” form to provide to the insurer and to Connecticut’s Workers’ Compensation Commission. In addition to providing the employer with notice of the incident, filing an official Notice of Claim for Compensation (Form 30C) with the employer and the Workers’ Compensation Commission within one year of your accident or within three years of the onset of an occupational illness.

This parallel filing from both employer and employee is an important step in the workers’ compensation process. Once the employer receives the filed Form 30C, the employer has 28 days to accept, deny, or begin payments. If the employer fails to commence any of the 3 possible actions within 28 days, Connecticut considers the claim to be accepted. In an emergency situation requiring an immediate response, the doctor or hospital doesn’t really matter.

In non-emergency situations, the employer may select the initial consultation. Following that initial consultation, if the employer has an established program for work-related injuries, the employer might require claimants to continue with the doctors that they have an existing relationship with. If such a mandated selection of doctors does not exist, claimants should go to their preferred doctor. In general, the employer will usually advise about their respective managed care plan before the injuries, usually in the initial stages of being hired.

Through workers’ compensation, Connecticut requires compensation for all reasonable and necessary medical treatment related to employment injury, including doctors’ visits, hospital bills, medical prescriptions, etc. Injured employees can also be reimbursed for travel costs. Finally, along with medical benefits, injured employees might be able to receive temporary or permanent disability payments to adequately compensate them for their injuries.

What happens?

If the workers’ compensation claim was denied either by the employer or the insurance company during any part of the claim process, injured employees have the right to request a hearing before the Workers’ Compensation Commission. To request this hearing, a “Hearing Request” form must be filed with the Workers’ Compensation Commission.

During this hearing, the injured employee will speak before a specifically designated workers’ compensation judge, who will then issue a formal written decision. If the judge’s decision is unfavorable to the injured employee, an appeal can then be filed with the Compensation Review Board and so on.

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Connecticut requires employers to carry insurance for workers’ compensation claims, which creates a no-fault system designed to compensate employees for their medical bills, lost wages, and possibly permanent injuries. However, to take advantage of such benefits, injured employees must correctly follow the process as designated by Connecticut law. This process requires notifying the employer of the injury, contemporaneously filing the appropriate forms by both the employer and employee and depending on the type of injury receiving an initial consultation and subsequent visits to the employer-mandated physician.

By following the required process, injured employees can ensure that they receive compensation for all reasonable and necessary medical treatment related to the employment injury, with a possible hearing to the Connecticut Workers’ Compensation Commission and possible hearing in the event that the claim is denied. 

Call us at (203) 624-6115 for more information from Knight & Cerritelli or to schedule a consultation in our office in New Haven.

NOTE: This is for informational purposes only and does not constitute legal advice.