Connecticut:

Connecticut Printable Free Workers Compensation Law Posters Connecticut Workers' Compensation Commission Poster Mandatory

The Connecticut Workers' Compensation Commission is a Connecticut workers compensation law poster provided for businesses by the Connecticut Department Of Labor. This is a required poster for all Connecticut employers, and any business that fails to post this notification may be subject to penalties or fines.

This mandatory fill-in poster is a summary of how individual employers are covering for their employees. Spaces for insurance company information and medical care are included for filling out. Contact information is also included as well.

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NOTICE
State of Connecticut Workers’ Compensation Commission
The Workers’ Compensation Act (Connecticut General Statutes Chapter 568) requires your employer,
to provide benefits to you in case of injury or occupational disease in the course of employment.
Section 31-294b of the Workers’ Compensation Act states “Any employee who has sustained an injury 
in the course of his employment shall immediately report the injury to his employer, or some person 
representing  his  employer.  If  the  employee  fails  to  report  the  injury  immediately,  the  administrative 
law  judge  may  reduce  the  award  of  compensation  proportionately  to  any  prejudice  that  he  finds  the 
employer has sustained by reason of the failure, provided the burden of proof with respect to such 
prejudice shall rest upon the employer.”
An injury report by the employee is NOT an official written notice of claim for workers’ compensation 
benefits; the Workers’ Compensation Commission’s Form 30C is necessary to satisfy this requirement.
NOTE:	 You	must	comply	with	P.	A.	17-141	(see	next	box,	below)	when	filing	a	compensation	claim.
The INSURANCE COMPANY or SELF-INSURANCE ADMINISTRATOR is:
Name
Address Telephone
City/Town  State Zip Code
Approved Medical Care Plan  Yes No
The State of Connecticut Workers’ Compensation Commission office for this workplace is located at:
Address Telephone
City/Town  State Zip Code
Public Act 17-141 allows an employer the option to designate and post – “in the workplace location 
where  other  labor  law  posters  required  by  the  Labor  Department  are  prominently  displayed”  and  on 
the  Workers’  Compensation  Commission’s  website  [wcc.state.ct.us]  –  a  location  where  employees 
must file claims for compensation.
If your employer has listed a location below, you  MUST file your compensation claim there.
When filing your claim, you are also required – by law – to send it by certified mail.
If blank below, ask your employer where to file your claim.
Employer Name
Address Telephone
City/Town  State Zip Code
TO EMPLOYEES
THIS NOTICE MUST BE IN TYPE OF NOT LESS THAN TEN 
POINT  BOLD-FACE  AND  POSTED  IN  A  CONSPICUOUS 
PLACE  IN  EACH  PLACE  OF  EMPLOYMENT.  FAILURE  TO 
POST THIS NOTICE WILL SUBJECT THE EMPLOYER TO 
STATUTORY PENALTY (Section 31-279 C.G.S.).
Date Posted:	Any questions as to your rights under the 
law or the obligations of the employer or 
insurance company should be addressed 
to the employer, the insurance company, or 
the Workers’ Compensation Commission  
(1-800-223-9675).	
Revised 10-01-2021

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More Connecticut Labor Law Posters 13 PDFS

Minimum-Wage.org provides an additional twelve required and optional Connecticut labor law posters that may be relevant to your business. Be sure to also print and post all required state labor law posters, as well as all of the mandatory federal labor law posters.

Connecticut Poster Name Poster Type
Required Paid Sick Leave General Labor Law Poster
Required Paid Sick Leave - Spanish General Labor Law Poster
Required Connecticut Workers' Compensation Commission Workers Compensation Law
Required Electronic Monitoring Poster Surveillance Law
Required Connecticut OHA Managed Care Poster General Labor Law Poster

List of all 13 Connecticut labor law posters


Connecticut Labor Law Poster Sources:

Labor Poster Disclaimer:

While Minimum-Wage.org does our best to keep our list of Connecticut labor law posters updated and complete, we provide this free resource as-is and cannot be held liable for errors or omissions. If the poster on this page is out-of-date or not working, please send us a message and we will fix it ASAP.

** This Document Provided By Minimum-Wage.org **
Source: http://www.minimum-wage.org/connecticut/labor-law-posters/67-connecticut-workers-compensation-commission