Most workers in Connecticut know that they are entitled to benefits under the state’s workers’ compensation law if they suffer an injury on the job, but most employees lack a detailed understanding of how the claims process works. While every claim is unique and every worker has a unique story to tell, the basic steps in the claims process must be followed by every claimant. An understanding of the workers’ compensation claims process is essential to filing a successful claim and obtaining an award of benefits.
Every workers’ compensation claim begins with a worker who suffers a work-related injury. An injured worker must begin the claims process by notifying his employer of the injury within one year from the date of the accident. If the employer agrees to pay the claim, the worker will begin receiving benefits at the level determined by the statute. If the employer denies the claim, the worker may request a hearing. Hearings come in five distinct levels: informal, in which the parties meet to discuss the claim; emergency, in which the parties meet to resolve a claim in which benefits may be necessary to prevent permanent injury or severe financial injury; pre-formal, in which the parties meet with an administrative law judge in an attempt to resolve the claim; formal, in which the parties present evidence in front of an administrative law judge who issues a written decision; and an appeal to the Compensation Review Board, which issues a binding decision on the claim. Either party may seek judicial review of the decision of the Board.
Benefits cover several kinds of loss, including medical expenses, lost wages, rehabilitation and temporary and permanent disability. The amount of benefits is generally determined by the legislature and is related to the wages earned by the injured worker prior to the injury. Disability claims are generally difficult to resolve because the benefits payable for either a total permanent or partial permanent disability may involve thousands of dollars. Anyone who has suffered a work-related injury may be eligible for significant workers’ compensation benefits.