The Connecticut Workers’ Compensation Act (WCA) outlines employers’ responsibilities relating to workers’ compensation in the state. The Connecticut Workers’ Compensation Commission (Commission) administers the workers’ compensation system and enforces employer responsibilities under the WCA.
COVERAGE REQUIREMENTS
The WCA requires all employers to maintain adequate workers’ compensation coverage for their employees. “Employer” is defined as any person or organization that uses the services of one or more employees for pay.
An employer may meet the coverage requirement by either obtaining coverage from an insurance company or becoming self-insured. Employers may also use a combination of insurance coverage and self-insurance or a substitute system of insurance if the Commission approves it.
A self-insured employer uses its assets, rather than an insurance policy, to insure against its obligations under the WCA. Employers must obtain the Commission’s approval to self-insure. If the Commission approves an employer for self-insurance, the employer is only authorized to self-insure for one year and must apply for renewals each year.
Employers that obtain a workers’ compensation policy through an insurance carrier must file a copy of the policy with the Commission or provide other written evidence of WCA compliance.
COVERAGE NOTICE REQUIREMENTS
Employers must post and maintain a printed notice regarding their workers’ compensation coverage in each workplace where their covered employees work. The notice must be published in a place that is readily accessible to all employees. Employers are responsible for keeping the notices current and revising them each time a new workers’ compensation policy is issued.
INJURY REPORTING REQUIREMENTS
Employers must notify the Commission of any injury or disease that causes an employee to miss at least one day of work due to incapacity.
The notification must be submitted on an Employer’s First Report of Occupational Injury or Illness form within one week of when the employee first reports the injury. Employers must also give the injured employee a copy of the completed form.
PROVIDING MEDICAL CARE
Employers must pay for all medical treatment that an approved physician, surgeon, or advanced practice registered nurse deems reasonable or necessary to treat a work-related injury. All medical bills, including costs of prescription medications, are payable directly to the medical providers.
An employer may designate a physician, surgeon, or advanced practice registered nurse to provide the initial medical treatment. After the initial treatment, the employee may choose their physician, surgeon, or advanced practice registered nurse to provide ongoing care.
However, employers may exert some control over their employees’ treatment by establishing a managed-care plan before an injury takes place. An employer with an established managed-care plan must provide injured employees with a list of approved providers within two days of an injury. The injured employee must then receive treatment from one of the listed providers.
In addition to the medical expenses, employers are responsible for paying an injured employee’s total hourly wages for any time the employee spends receiving medical treatment. This is not required if the employee is eligible for other workers’ compensation benefits at the time of the medical treatment.
TRANSFER TO SUITABLE WORK
Suppose an employee’s injury disables them from performing their customary or most recent work. In that case, the employer must transfer them to full-time work suitable to the employee’s physical condition. This requirement applies when the employee is under medical treatment or rehabilitation for a work-related injury or disease.
VOLUNTARY AGREEMENTS
Suppose an employee sustains an injury that results in temporary disability for more than three days, and the employer accepts it as compensable. In that case, the employer must prepare a voluntary agreement and present it to the employee. The agreement should outline all the temporary or permanent disability payments the employer agrees to make for the compensable injury.
The employer must submit the signed agreement to the Connecticut Workers’ Compensation Commission within three weeks after first having actual knowledge of the injury and that the disability would extend beyond three days. The agreement becomes binding for all parties once the Commission issues a statement of approval.
An employer that wishes to discontinue or terminate payments that it had agreed to make under a voluntary agreement must first provide written notice to the Commission and the employee. The notice must specify the reason for the proposed discontinuance or reduction and the date it would commence. Employers may not discontinue or reduce the payments until after the Commission grants permission in writing.
PAYING COMPENSATION BENEFITS
When an employee files a properly drafted and served claim notice with the Connecticut Workers’ Compensation Commission (or the employer), the employer must begin paying any monetary benefits due or send a written Dispute Notice (Form 43) to both the Commission and the employee within 28 days of the claim notice. Suppose an employer fails to commence payments or send the dispute notice timely. In that case, the Commission will conclude that the employer has accepted compensability of the claim, and interest may begin accruing on the past-due benefit payments.
Suppose a physician determines that an employee has sustained a permanent partial disability (PPD) due to a compensable injury. In that case, the employer must begin paying PPD benefits within 30 days of the determination. Any ongoing disability benefits must be paid to the injured employee at least monthly.
REDUCING THE COST OF WORKERS’ COMPENSATION INSURANCE
Workers’ compensation insurance premiums are determined primarily by the employer’s industry. For example, workers’ compensation insurance premiums are more expensive for a construction or manufacturing company than for a professional services firm. However, employers across all industries can take steps to reduce the cost of maintaining workers’ compensation insurance.
SAFETY PLANS
Implementing a quality safety program is the easiest and most effective way to reduce frequent workers’ compensation claims. Safety programs can help employers identify safety issues that employees face daily. Safety programs should also establish safe work practices and educate employees on reducing risk. When creating a safety plan, employers should analyze the factors that cause frequent claims.
For some employers, the WCA imposes an affirmative obligation to establish and administer committees that promote health and safety in their places of employment. This requirement applies to employers that:
- Have 25 or more employees (including temporary and seasonal workers) working at a single worksite; or
- Have less than 25 employees working at any worksite but have an above-average incident rate for work-related injuries and illnesses.
REPORTING FRAUD
Fraud is expensive and can drastically raise premiums. Suppose an employer suspects an employee has submitted a fraudulent workers’ compensation claim. In that case, the matter should be promptly reported to the Connecticut Workers’ Compensation Fraud Unit within the Division of Criminal Justice for an investigation.
The Connecticut Workers’ Compensation Act (WCA) outlines employers’ responsibilities relating to workers’ compensation in the state. The Connecticut Workers’ Compensation Commission (Commission) administers the workers’ compensation system and enforces employer responsibilities under the WCA.
COVERAGE REQUIREMENTS
The WCA requires all employers to maintain adequate workers’ compensation coverage for their employees. “Employer” is defined as any person or organization that uses the services of one or more employees for pay.
An employer may meet the coverage requirement by either obtaining coverage from an insurance company or becoming self-insured. Employers may also use a combination of insurance coverage and self-insurance or a substitute system of insurance if the Commission approves it.
A self-insured employer uses its assets, rather than an insurance policy, to insure against its obligations under the WCA. Employers must obtain the Commission’s approval to self-insure. If the Commission approves an employer for self-insurance, the employer is only authorized to self-insure for one year and must apply for renewals each year.
Employers that obtain a workers’ compensation policy through an insurance carrier must file a copy of the policy with the Commission or provide other written evidence of WCA compliance.
COVERAGE NOTICE REQUIREMENTS
Employers must post and maintain a printed notice regarding their workers’ compensation coverage in each workplace where their covered employees work. The notice must be published in a place that is readily accessible to all employees. Employers are responsible for keeping the notices current and revising them each time a new workers’ compensation policy is issued.
INJURY REPORTING REQUIREMENTS
Employers must notify the Commission of any injury or disease that causes an employee to miss at least one day of work due to incapacity.
The notification must be submitted on an Employer’s First Report of Occupational Injury or Illness form within one week of when the employee first reports the injury. Employers must also give the injured employee a copy of the completed form.
PROVIDING MEDICAL CARE
Employers must pay for all medical treatment that an approved physician, surgeon, or advanced practice registered nurse deems reasonable or necessary to treat a work-related injury. All medical bills, including costs of prescription medications, are payable directly to the medical providers.
An employer may designate a physician, surgeon, or advanced practice registered nurse to provide the initial medical treatment. After the initial treatment, the employee may choose their physician, surgeon, or advanced practice registered nurse to provide ongoing care.
However, employers may exert some control over their employees’ treatment by establishing a managed-care plan before an injury takes place. An employer with an established managed-care plan must provide injured employees with a list of approved providers within two days of an injury. The injured employee must then receive treatment from one of the listed providers.
In addition to the medical expenses, employers are responsible for paying an injured employee’s total hourly wages for any time the employee spends receiving medical treatment. This is not required if the employee is eligible for other workers’ compensation benefits at the time of the medical treatment.
TRANSFER TO SUITABLE WORK
Suppose an employee’s injury disables them from performing their customary or most recent work. In that case, the employer must transfer them to full-time work suitable to the employee’s physical condition. This requirement applies when the employee is under medical treatment or rehabilitation for a work-related injury or disease.
VOLUNTARY AGREEMENTS
Suppose an employee sustains an injury that results in temporary disability for more than three days, and the employer accepts it as compensable. In that case, the employer must prepare a voluntary agreement and present it to the employee. The agreement should outline all the temporary or permanent disability payments the employer agrees to make for the compensable injury.
The employer must submit the signed agreement to the Connecticut Workers’ Compensation Commission within three weeks after first having actual knowledge of the injury and that the disability would extend beyond three days. The agreement becomes binding for all parties once the Commission issues a statement of approval.
An employer that wishes to discontinue or terminate payments that it had agreed to make under a voluntary agreement must first provide written notice to the Commission and the employee. The notice must specify the reason for the proposed discontinuance or reduction and the date it would commence. Employers may not discontinue or reduce the payments until after the Commission grants permission in writing.
PAYING COMPENSATION BENEFITS
When an employee files a properly drafted and served claim notice with the Connecticut Workers’ Compensation Commission (or the employer), the employer must begin paying any monetary benefits due or send a written Dispute Notice (Form 43) to both the Commission and the employee within 28 days of the claim notice. Suppose an employer fails to commence payments or send the dispute notice timely. In that case, the Commission will conclude that the employer has accepted compensability of the claim, and interest may begin accruing on the past-due benefit payments.
Suppose a physician determines that an employee has sustained a permanent partial disability (PPD) due to a compensable injury. In that case, the employer must begin paying PPD benefits within 30 days of the determination. Any ongoing disability benefits must be paid to the injured employee at least monthly.
REDUCING THE COST OF WORKERS’ COMPENSATION INSURANCE
Workers’ compensation insurance premiums are determined primarily by the employer’s industry. For example, workers’ compensation insurance premiums are more expensive for a construction or manufacturing company than for a professional services firm. However, employers across all industries can take steps to reduce the cost of maintaining workers’ compensation insurance.
SAFETY PLANS
Implementing a quality safety program is the easiest and most effective way to reduce frequent workers’ compensation claims. Safety programs can help employers identify safety issues that employees face daily. Safety programs should also establish safe work practices and educate employees on reducing risk. When creating a safety plan, employers should analyze the factors that cause frequent claims.
For some employers, the WCA imposes an affirmative obligation to establish and administer committees that promote health and safety in their places of employment. This requirement applies to employers that:
- Have 25 or more employees (including temporary and seasonal workers) working at a single worksite; or
- Have less than 25 employees working at any worksite but have an above-average incident rate for work-related injuries and illnesses.
REPORTING FRAUD
Fraud is expensive and can drastically raise premiums. Suppose an employer suspects an employee has submitted a fraudulent workers’ compensation claim. In that case, the matter should be promptly reported to the Connecticut Workers’ Compensation Fraud Unit within the Division of Criminal Justice for an investigation.
The Last Word
Workers’ Compensation can become complicated. Visit the Connecticut Workers’ Compensation Commission website for more information on workers’ compensation laws in Connecticut.
For an easier approach, get in touch with an InsureGood Advisor today to help you manage the complexities of workers’ compensation.
