Connecticut workers’ compensation pays important benefits to workers with occupational injuries or illnesses. These benefits include medical treatment, compensation for wage loss, and other financial assistance. However, injured workers must follow a specific claims process in order to collect benefits.
Unlike most personal injury claims, workers’ compensation is a no-fault system. Benefits will usually be paid as long as your injury happened at work or was caused by your job duties. You do not have to prove that your employer was careless or intentionally caused your injuries. Likewise, you may be eligible for benefits even if your carelessness caused the injury.
However, in exchange for this no-fault system, injured workers are only entitled to specific benefits. You cannot receive compensation for your pain and suffering in a workers’ compensation claim. However, eligible workers may receive:
The exact benefits you receive will vary depending on the severity of your injury or illness. To learn more, see Types of Workers' Compensation Benefits or contact a workers' comp lawyer for assistance.
In Connecticut, you must promptly notify your employer of a work-related injury. Prompt reporting will result in earlier medical treatment, increasing your chance of a full recovery. Additionally, employers and insurance companies tend to be skeptical of delayed claims. Giving notice and getting treatment early on will reduce the likelihood of a claim denial.
Your notice may be oral or in writing, and it should include:
Once you report your injury, your employer should send you to an occupational doctor. (For your initial appointment, you must treat with your employer’s designated doctor.) You should provide the doctor with accurate information about how you hurt yourself and the severity of your symptoms. Insurance companies rely heavily on initial medical records when they evaluate claims. Either downplaying or exaggerating your symptoms may result in a denial of benefits.
Your employer must also complete an Employer’s First Report of Injury and submit it to its insurance company and the Connecticut Workers' Compensation Commission. However, this report does not officially begin your workers’ compensation claim. You must also file a Notice of Claim (Form 30C) with the Commission and your employer within:
If you do not file a Notice of Claim within these deadlines, you will lose your right to collect benefits (even if you promptly reported the injury to your employer).
Once your employer receives a Notice of Claim, it must forward the form to its insurance company. The insurance company will then investigate your claim and determine your eligibility for benefits. This may involve:
Under Connecticut law, the insurance company must either approve or deny your workers’ compensation benefits within 28 days of receiving your claim. If your claim is approved, you will start receiving disability payments and other benefits. Unfortunately, insurance companies deny many workers’ compensation claims. (For common grounds for a denial, see Denied Workers’ Compensation Claims.)
If your claim is denied, you have the right to appeal. Connecticut appeals involve a series of informal and formal hearings. Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. A lawyer can help you prepare for trial, negotiate with the insurance company, and present your case to the Commissioner. To learn more, see Should I Hire a Workers' Comp Attorney or Can I Handle My Own Case?.