Report an accessibility issue.
Over the next few days, Connecticut will experience a blast of arctic temperatures. Governor Lamont has activated the Severe Cold Weather Protocol. A list of shelters is available at 211ct.org or by calling 2-1-1. [Read more about the Severe Cold Weather Protocol]
Connecticut’s Official State Website Logo State of Connecticut
×
 
Close Search
  • Arabic
  • Chinese (Simplified)
  • Chinese (Traditional)
  • English
  • French
  • German
  • Haitian Creole
  • Hindi
  • Italian
  • Korean
  • Pashto
  • Polish
  • Portuguese (Brazil)
  • Russian
  • Spanish
  • Filipino
  • Ukrainian
  • Vietnamese
Workers' Compensation Commission
CT Logo
Workers' Compensation Commission
Workers' Compensation Commission
☰ Workers' Compensation Commission Main Menu
× Close
⮐ Back
⮐ Back
  • Home
  • Workers
  • Employers
  • eServices
  • Insurance & Medical Providers
  • Attorneys
  • News & Resources
    • Forms
    • Laws & Regulations
  • About Us
    • Divisions & units
  • FAQ

You are about to Logout

Are you sure you want to log out of your account? If you do want to logout, please click Logout.
Logout
  • CT.gov Home
  • wcc
  • Workers' Compensation Forms
  • Current: Forms : Coverage Election Forms
  • HOME
  • Workers' Comp Forms
  • Building Permit Forms
  • Claim Forms
  • Coverage Election Forms
  • Employer Applications
  • Employer Forms
  • Hearing Forms
  • Insurance Forms
  • Medical Forms
  • Rehabilitation Forms
  • Stip & Commutation Forms
  • Voluntary Agreement Forms
  • Worksheets
Workers' Compensation Commission
Filtered Topic Search

This webpage has moved to Coverage Election Forms

Workers' Compensation Commission

21 Oak Street, 4th Floor
Hartford, CT 06106

ct.gov logo with flag embelishment
  • About CT
  • Policies
  • Accessibility
  • Directories
  • Social Media
  • For State Employees
US Flag Status icon
United States
Mast: (Full)
CT Flag Status icon
Connecticut
Mast: (Half)

© 2025 CT.gov - Connecticut's Official State Website