Memorandum No. 2023-08

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Far below normal precipitation has caused a drought and increased fire danger levels. All of Connecticut is currently in a Stage 2 Drought Advisory. Residents are encouraged to be mindful of water consumption and use extra caution to prevent fires. An emergency burn ban remains in effect at all state parks, forests, and wildlife management areas, prohibiting the use of all outdoor grills, firepits, campfires, etc.

MEMORANDUM NO. 2023-08

Form 42 Revised

TO:	WCC Administrative Law Judges, District Administrators, Claimants, Self-Insureds, Insurance Carriers, Attorneys, Unions, and Advisory Board Members
FROM:	Stephen M. Morelli, Chairperson
DATE:	November 3, 2023
RE:	Form 42 Revised

Form 42 has been revised to include a check box indicating "Check, if total impairment rating, inclusive of any prior ratings, for body part." The box should be checked when the rating is for the total impairment inclusive of any previous ratings for the body part. The box should not be checked when the rating is in addition to a previous rating. The revised form can be obtained from our Online Forms page.

State of Connecticut Workers' Compensation Commission

MEMORANDUM NO. 2023-08

Form 42 Revised