Administrative Regulation : Illustration of the Petition for Review Form

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Petition for Review

Illustration of the Petition for Review (PFR) Form

_{Workers' Compensation Administrative Regulation regarding}
Appeal from Compensation Commissioner (CRB Appeal Procedure)

The Workers’ Compensation Commission’s “Petition for Review” form shown below is included in the codified version of the state’s Administrative Regulations regarding Appeal from Compensation Commissioner (CRB Appeal Procedure).

Illustration of the "Petition for Review" Form

_{Effective May 24, 1976}

State of Connecticut Workers' Compensation Commission

Petition for Review

Illustration of the Petition for Review (PFR) Form