Connecticut Workers Comp Forms
Find Connecticut workers compensation forms and helpful coverage guides.
At Workers Compensation Shop.com we attempt to offer free access to Connecticut's workers' compensation forms, applications and guides. We strive to keep our library up to date with the latest versions of every form you may need.
As with all the information we provide, please verify the accuracy of this information with the Connecticut Workers' Compensation Commission.
If you have questions about a workers comp form feel free to contact a specialist at T888-611-7467. We want to be your source for workers compensation information, rates and quotes in Connecticut.
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Connecticut Workers Compensation Insurance Forms
The standard Acord 130 application form for workers comp coverage in Connecticut.
CT First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
This form is to display contact information for the workers' compensation insurance carrier and the State of Connecticut Workers' Compensation Commission office.
Complete this form if you are seeking coverage election by an employee who is an officer of a corporation, manager of an LLC, or member of a multiple-member LLC. coverage.
Complete this form if you are a sole-proprietor or with no employees and would like to be exempt from coverage.
This form allows selection of Coverage Election by Employee who is an Officer of a Corporation, Manager of an LLC, or Member of a Multiple-Member LLC for the state of Connecticut.
Complete this form if you are a partnership or with no employees and would like to be exempt from coverage.
A map of the Connecticut districts for use in workers' compensation claims.
Form for the reduction or discontinuation of Workers Compensation in Connecticut.
FEmployer/Respondents form for confirmation of claim information and verification of the validity of the claim.
Form to request the standard wage rate for certain service professionals.
Form for verification of filing status and dependencies.
State Resources for Connecticut
State Resources for Connecticut
Connecticut Insurance Department
P.O. Box 816
Hartford, CT 06142-0816
Connecticut Workers' Compensation Commission
21 Oak Street, Fourth Floor
Hartford, Connecticut 06106
Workers compensation insurance is required by law for Connecticut employers.
Connecticut forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers compensation form your need for Connecticut.
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