Employer Applications

 

link opens in new browser tab  Employer Medical Care Application

PDF File:  23 pages; Last revised October 1, 2021
 

Employer Medical Care Application Information Packet

Information package for employers wishing to apply for approval to provide medical care and treatment for their injured employees by means of a medical care plan under the Workers’ Compensation Act, along with the required forms and documents.

 


 

link opens in new browser tab  Employer Safety and Health Committee Information Package

PDF File:  5 pages; Last revised March 25, 1998
 

Implementation of Safety & Health Connecticut Administrative Regulations 31-40v-1 through 31-40v-11

Information package to assist employers in complying with the state’s Safety & Health Committee regulations, along with the Commission’s required Inspection Form.

 


 

link opens in new browser tab  Employer Self-Insurance Application

PDF File:  25 pages; Last revised March 1, 2022
 

Information on Self-Insurance

Information package for employers wishing to self-insure their workers’ compensation liabilities, along with the required forms and documents.

 


 

The Workers' Compensation Commission recommends the use of Adobe's free Adobe Acrobat Reader software application when accessing or using its PDF forms and publications.

Get the Adobe Acrobat Reader by clicking the following button:   Get Adobe Acrobat Reader

The Workers' Compensation Commission's recommendation of Adobe's free Adobe Acrobat Reader software application is based solely on technical considerations inherent in the PDF files this agency produces, and does not constitute an endorsement of Adobe Software as a company or of its commercially-available products. There are a multitude of free and commercial software applications offered by various software makers that are capable of opening and displaying our PDF documents, but only the Adobe Acrobat Reader application makes full and accurate use of the capabilities we have built into our documents; the agency has found over a period of many years that the Adobe Acrobat Reader provides the best, most trouble-free experience using this Commission's PDF files.