State of Connecticut Workers' Compensation Commission

MEMORANDUM NO. 2020-16

Stipulation Questionnaire Revised

 

TO: WCC Commissioners, District Administrators, Self-Insureds, Insurance Carriers, Attorneys, Unions, and Advisory Board Members
FROM: Stephen M. Morelli, Chairman
DATE: September 18, 2020
RE: Stipulation Questionnaire Revised

 

The Commission's Stipulation Questionnaire has been revised, effective September 18, 2020. Please use this newest revision of the Stipulation Questionnaire, which can be obtained below or from our Online Forms page.
 

link opens in new browser tab  Stipulation Questionnaire
(PDF File: 1 page; Last revised September 18, 2020)