Where can health care providers find forms and fee schedules?
The Connecticut Workers’ Compensation Commission recommends you use these forms to make sure your paperwork is:
- Up to date
- Correct
- Follow the State’s laws
Most forms are PDFs you can fill out online, print, and save. Others you can send electronically.
Health care providers often use the forms below. You’ll find fee schedules with rates and rules and guidelines for them.
To learn about how to get licensed to treat workers’ comp patients, check out:
Facility licenses, including hospitals and clinics
Doctors, nurses, therapists, and more
Authorization for Release of Medical Records (PDF) - To share a worker’s medical records.
Fee schedules - Show what providers get paid for treating work injuries.
Form 42: Report impairment (PDF) - Assesses how much the worker is hurt.
Employee Medical and Work Status (PDF) - To report a worker’s progress and abilities to a payor.
Professional guides - Find medical protocols, provider guidelines, and legal guides for health care providers navigating Connecticut’s workers’ compensation system.
Learn which forms to send with our Electronic Form Submission Service
Use GovQA to send forms, request important documents, verify coverage, and more