I
WORKERS' COMPENSATION COMMISSION.
COMPENSATION COMMISSIONERS
Sec. 31-275. Definitions. As used in this chapter, unless the context otherwise
provides:
(1) "Arising out of and in the course of his employment" means an accidental injury
happening to an employee or an occupational disease of an employee originating while
the employee has been engaged in the line of the employee's duty in the business or
affairs of the employer upon the employer's premises, or while engaged elsewhere upon
the employer's business or affairs by the direction, express or implied, of the employer,
provided:
(A) (i) For a police officer or firefighter, "in the course of his employment" encompasses such individual's departure from such individual's place of abode to duty, such
individual's duty, and the return to such individual's place of abode after duty;
(ii) For an employee of the Department of Correction, (I) when responding to a direct
order to appear at his or her work assignment under circumstances in which nonessential
employees are excused from working, or (II) following two or more mandatory overtime
work shifts on consecutive days, "in the course of his employment" encompasses such
individual's departure from such individual's place of abode directly to duty, such individual's duty, and the return directly to such individual's place of abode after duty;
(iii) Notwithstanding the provisions of clauses (i) and (ii) of this subparagraph, the
dependents of any deceased employee of the Department of Correction who was injured
in the course of his employment, as defined in this subparagraph, on or after July 1,
2000, and who died not later than July 15, 2000, shall be paid compensation on account
of the death, in accordance with the provisions of section 31-306, retroactively to the
date of the employee's death. The cost of the payment shall be paid by the employer or
its insurance carrier which shall be reimbursed for such cost from the Second Injury
Fund as provided in section 31-354 upon presentation of any vouchers and information
that the Treasurer may require;
(B) A personal injury shall not be deemed to arise out of the employment unless
causally traceable to the employment other than through weakened resistance or lowered
vitality;
(C) In the case of an accidental injury, a disability or a death due to the use of alcohol
or narcotic drugs shall not be construed to be a compensable injury;
(D) For aggravation of a preexisting disease, compensation shall be allowed only
for that proportion of the disability or death due to the aggravation of the preexisting
disease as may be reasonably attributed to the injury upon which the claim is based;
(E) A personal injury shall not be deemed to arise out of the employment if the
injury is sustained: (i) At the employee's place of abode, and (ii) while the employee
is engaged in a preliminary act or acts in preparation for work unless such act or acts
are undertaken at the express direction or request of the employer;
(F) For purposes of subparagraph (C) of this subdivision, "narcotic drugs" means
all controlled substances, as designated by the Commissioner of Consumer Protection
pursuant to subsection (c) of section 21a-243, but does not include drugs prescribed in
the course of medical treatment or in a program of research operated under the direction
of a physician or pharmacologist. For purposes of subparagraph (E) of this subdivision,
"place of abode" includes the inside of the residential structure, the garage, the common
hallways, stairways, driveways, walkways and the yard;
(G) The Workers' Compensation Commission shall adopt regulations, in accordance with the provisions of chapter 54, to implement the provisions of this section and
shall define the terms "a preliminary act", "acts in preparation for work", "departure
from place of abode directly to duty" and "return directly to place of abode after duty"
on or before January 1, 2006.
(2) "Commission" means the Workers' Compensation Commission.
(3) "Commissioner" means the compensation commissioner who has jurisdiction
in the matter referred to in the context.
(4) "Compensation" means benefits or payments mandated by the provisions of this
chapter, including, but not limited to, indemnity, medical and surgical aid or hospital and
nursing service required under section 31-294d and any type of payment for disability,
whether for total or partial disability of a permanent or temporary nature, death benefit,
funeral expense, payments made under the provisions of section 31-284b, 31-293a or
31-310, or any adjustment in benefits or payments required by this chapter.
(5) "Date of the injury" means, for an occupational disease, the date of total or
partial incapacity to work as a result of such disease.
(6) "Dependent" means a member of the injured employee's family or next of kin
who was wholly or partly dependent upon the earnings of the employee at the time of
the injury.
(7) "Dependent in fact" means a person determined to be a dependent of an injured
employee, in any case where there is no presumptive dependent, in accordance with the
facts existing at the date of the injury.
(8) "Disfigurement" means impairment of or injury to the beauty, symmetry or
appearance of a person that renders the person unsightly, misshapen or imperfect, or
deforms the person in some manner, or otherwise causes a detrimental change in the
external form of the person.
(9) (A) "Employee" means any person who:
(i) Has entered into or works under any contract of service or apprenticeship with
an employer, whether the contract contemplated the performance of duties within or
without the state;
(ii) Is a sole proprietor or business partner who accepts the provisions of this chapter
in accordance with subdivision (10) of this section;
(iii) Is elected to serve as a member of the General Assembly of this state;
(iv) Is a salaried officer or paid member of any police department or fire department;
(v) Is a volunteer police officer, whether the officer is designated as special or auxiliary, upon vote of the legislative body of the town, city or borough in which the officer
serves;
(vi) Is an elected or appointed official or agent of any town, city or borough in the
state, upon vote of the proper authority of the town, city or borough, including the elected
or appointed official or agent, irrespective of the manner in which he or she is appointed
or employed. Nothing in this subdivision shall be construed as affecting any existing
rights as to pensions which such persons or their dependents had on July 1, 1927, or as
preventing any existing custom of paying the full salary of any such person during
disability due to injury arising out of and in the course of his or her employment;
(vii) Is an officer or enlisted person of the National Guard or other armed forces of
the state called to active duty by the Governor while performing his or her active duty
service; or
(viii) Is elected to serve as a probate judge for a probate district established in section
45a-2.
(B) "Employee" shall not be construed to include:
(i) Any person to whom articles or material are given to be treated in any way on
premises not under the control or management of the person who gave them out;
(ii) One whose employment is of a casual nature and who is employed otherwise
than for the purposes of the employer's trade or business;
(iii) A member of the employer's family dwelling in his house; but, if, in any contract
of insurance, the wages or salary of a member of the employer's family dwelling in his
house is included in the payroll on which the premium is based, then that person shall,
if he sustains an injury arising out of and in the course of his employment, be deemed
an employee and compensated in accordance with the provisions of this chapter;
(iv) Any person engaged in any type of service in or about a private dwelling provided he is not regularly employed by the owner or occupier over twenty-six hours per
week;
(v) An employee of a corporation who is a corporate officer and who elects to be
excluded from coverage under this chapter by notice in writing to his employer and to
the commissioner; or
(vi) Any person who is not a resident of this state but is injured in this state during
the course of his employment, unless such person (I) works for an employer who has a
place of employment or a business facility located in this state at which such person
spends at least fifty per cent of his employment time, or (II) works for an employer
pursuant to an employment contract to be performed primarily in this state.
(10) "Employer" means any person, corporation, limited liability company, firm,
partnership, voluntary association, joint stock association, the state and any public corporation within the state using the services of one or more employees for pay, or the
legal representative of any such employer, but all contracts of employment between an
employer employing persons excluded from the definition of employee and any such
employee shall be conclusively presumed to include the following mutual agreements
between employer and employee: (A) That the employer may accept and become bound
by the provisions of this chapter by immediately complying with section 31-284; (B)
that, if the employer accepts the provisions of this chapter, the employee shall then be
deemed to accept and be bound by such provisions unless the employer neglects or
refuses to furnish immediately to the employee, on his written request, evidence of
compliance with section 31-284 in the form of a certificate from the commissioner, the
Insurance Commissioner or the insurer, as the case may be; (C) that the employee may,
at any time, withdraw his acceptance of, and become released from, the provisions of
this chapter by giving written or printed notice of his withdrawal to the commissioner
and to the employer, and the withdrawal shall take effect immediately from the time of
its service on the commissioner and the employer; and (D) that the employer may withdraw his acceptance and the acceptance of the employee by filing a written or printed
notice of his withdrawal with the commissioner and with the employee, and the withdrawal shall take effect immediately from the time of its service on the commissioner
and the employee. The notices of acceptance and withdrawal to be given by an employer
employing persons excluded from the definition of employee and the notice of withdrawal to be given by the employee, as provided in this subdivision, shall be served
upon the commissioner, employer or employee, either by personal presentation or by
registered or certified mail. In determining the number of employees employed by an
individual, the employees of a partnership of which he is a member shall not be included.
A person who is the sole proprietor of a business may accept the provisions of this
chapter by notifying the commissioner, in writing, of his intent to do so. If such person
accepts the provisions of this chapter he shall be considered to be an employer and shall
insure his full liability in accordance with subdivision (2) of subsection (b) of section
31-284. Such person may withdraw his acceptance by giving notice of his withdrawal,
in writing, to the commissioner. Any person who is a partner in a business shall be
deemed to have accepted the provisions of this chapter and shall insure his full liability
in accordance with subdivision (2) of subsection (b) of section 31-284, unless the partnership elects to be excluded from the provisions of this chapter by notice, in writing
and by signed agreement of each partner, to the commissioner.
(11) "Full-time student" means any student enrolled for at least seventy-five per
cent of a full-time student load at a postsecondary educational institution which has
been approved by a state-recognized or federally-recognized accrediting agency or
body. "Full-time student load" means the number of credit hours, quarter credits or
academic units required for a degree from such institution, divided by the number of
academic terms needed to complete the degree.
(12) "Medical and surgical aid or hospital and nursing service", when requested by
an injured employee and approved by the commissioner, includes treatment by prayer
or spiritual means through the application or use of the principles, tenets or teachings
of any established church without the use of any drug or material remedy, provided
sanitary and quarantine regulations are complied with, and provided all those ministering
to the injured employee are bona fide members of such church.
(13) "Member" includes all parts of the human body referred to in subsection (b)
of section 31-308.
(14) "Nursing" means the practice of nursing as defined in subsection (a) of section
20-87a, and "nurse" means a person engaged in such practice.
(15) "Occupational disease" includes any disease peculiar to the occupation in
which the employee was engaged and due to causes in excess of the ordinary hazards
of employment as such, and includes any disease due to or attributable to exposure to
or contact with any radioactive material by an employee in the course of his employment.
(16) (A) "Personal injury" or "injury" includes, in addition to accidental injury that
may be definitely located as to the time when and the place where the accident occurred,
an injury to an employee that is causally connected with the employee's employment
and is the direct result of repetitive trauma or repetitive acts incident to such employment,
and occupational disease.
(B) "Personal injury" or "injury" shall not be construed to include:
(i) An injury to an employee that results from the employee's voluntary participation
in any activity the major purpose of which is social or recreational, including, but not
limited to, athletic events, parties and picnics, whether or not the employer pays some
or all of the cost of such activity;
(ii) A mental or emotional impairment, unless such impairment arises (I) from a
physical injury or occupational disease, or (II) in the case of a police officer, from such
police officer's use of deadly force or subjection to deadly force in the line of duty,
regardless of whether such police officer is physically injured, provided such police
officer is the subject of an attempt by another person to cause such police officer serious
physical injury or death through the use of deadly force, and such police officer reasonably believes such police officer to be the subject of such an attempt. As used in this
clause, "police officer" means a member of the Division of State Police within the
Department of Emergency Services and Public Protection, an organized local police
department or a municipal constabulary, and "in the line of duty" means any action that
a police officer is obligated or authorized by law, rule, regulation or written condition
of employment service to perform, or for which the police officer is compensated by
the public entity such officer serves;
(iii) A mental or emotional impairment that results from a personnel action, including, but not limited to, a transfer, promotion, demotion or termination; or
(iv) Notwithstanding the provisions of subparagraph (B)(i) of this subdivision, "personal injury" or "injury" includes injuries to employees of local or regional boards of
education resulting from participation in a school-sponsored activity but does not include any injury incurred while going to or from such activity. As used in this clause,
"school-sponsored activity" means any activity sponsored, recognized or authorized by
a board of education and includes activities conducted on or off school property and
"participation" means acting as a chaperone, advisor, supervisor or instructor at the
request of an administrator with supervisory authority over the employee.
(17) "Physician" includes any person licensed and authorized to practice a healing
art, as defined in section 20-1, and licensed under the provisions of chapters 370, 372
and 373 to practice in this state.
(18) "Podiatrist" means any practitioner of podiatry, as defined in section 20-50,
and duly licensed under the provisions of chapter 375 to practice in this state.
(19) "Presumptive dependents" means the following persons who are conclusively
presumed to be wholly dependent for support upon a deceased employee: (A) A wife
upon a husband with whom she lives at the time of his injury or from whom she receives
support regularly; (B) a husband upon a wife with whom he lives at the time of her
injury or from whom he receives support regularly; (C) any child under the age of
eighteen, or over the age of eighteen but physically or mentally incapacitated from
earning, upon the parent with whom he is living or from whom he is receiving support
regularly, at the time of the injury of the parent; (D) any unmarried child who has attained
the age of eighteen but has not attained the age of twenty-two and who is a full-time
student, upon the parent with whom he is living or from whom he is receiving support
regularly, provided, any child who has attained the age of twenty-two while a full-time student but has not completed the requirements for, or received, a degree from a
postsecondary educational institution shall be deemed not to have attained the age of
twenty-two until the first day of the first month following the end of the quarter or
semester in which he is enrolled at the time, or if he is not enrolled in a quarter or semester
system, until the first day of the first month following the completion of the course in
which he is enrolled or until the first day of the third month beginning after such time,
whichever occurs first.
(20) "Previous disability" means an employee's preexisting condition caused by
the total or partial loss of, or loss of use of, one hand, one arm, one foot or one eye
resulting from accidental injury, disease or congenital causes, or other permanent physical impairment.
(21) "Scar" means the mark left on the skin after the healing of a wound or sore,
or any mark, damage or lasting effect resulting from past injury.
(22) "Second disability" means a disability arising out of a second injury.
(23) "Second injury" means an injury, incurred by accident, repetitive trauma, repetitive acts or disease arising out of and in the course of employment, to an employee
with a previous disability.
(1949 Rev., S. 7416; 1949, S. 3037d; 1958 Rev., S. 31-139; 1961, P.A. 491, S. 1; 1967, P.A. 842, S. 1; 1969, P.A. 289;
556, S. 1; 696, S. 1; 806, S. 1; 1972, P.A. 281, S. 2; P.A. 77-614, S. 163, 610; P.A. 78-324, S. 3; P.A. 79-113; 79-540, S.
1; P.A. 80-124, S. 1; 80-284, S. 1; 80-414, S. 1; 80-482, S. 201, 348; 80-483, S. 95, 186; P.A. 82-398, S. 1; P.A. 84-320,
S. 1, 6; P.A. 85-420, S. 1, 4; P.A. 88-184, S. 1, 3; 88-364, S. 50, 123; P.A. 91-32, S. 1, 41; 91-339, S. 1; P.A. 92-31, S. 1,
7; P.A. 93-228, S. 1, 35; P.A. 95-79, S. 117, 189; 95-262, S. 2, 3; P.A. 96-180, S. 104, 166; P.A. 97-205, S. 1; P.A. 99-102, S. 41; P.A. 01-208, S. 2, 3; June 30 Sp. Sess. P.A. 03-6, S. 146(c); P.A. 04-189, S. 1; P.A. 05-208, S. 4; 05-230, S.
1; 05-236, S. 2; P.A. 11-51, S. 134; 11-128, S. 2.)
History: 1961 act entirely replaced previous provisions; 1967 act redefined "commission" as seven rather than five
commissioners, added exception in definition of "dependent" and redefined "employer" as those employing one or more
rather than two or more persons; 1969 acts redefined "arising out of and in the course of his employment" to include special
provision re policemen and firemen, redefined "physician" to include those practicing a healing art and duly licensed rather
than those practicing as chiropractors, added definition of "podiatrist", redefined "occupational disease" to include diseases
resulting from exposure to or contact with radioactive materials and specified "regularly" employed in Subdiv. (d) of
definition of "employer"; 1972 act included persons elected as members of the general assembly in definition of "employee";
P.A. 77-614 made insurance department a division within the department of business regulation with insurance commissioner as its head, effective January 1, 1979 (See Subsec. (6)); P.A. 78-324 included volunteer police officers in definition
of "employee"; P.A. 79-113 divided section into Subsecs. and redefined "employee" and "employer" to include provisions
re persons who are sole proprietors or partners in a business; P.A. 79-540 redefined "commission" to raise number of
commissioners to eight and defined "compensation review division"; P.A. 80-124 substituted "causally" for "casually" in
Subsec. (8); P.A. 80-284 inserted new Subsec. (13) defining "full-time student" and renumbered former Subsec. (13)
accordingly; P.A. 80-414 redefined "commission" and "compensation review division" to reflect increase in number of
commissioners to nine; P.A. 80-482 reinstated insurance department and deleted reference to abolished department of
business regulation; P.A. 80-483 made technical correction; P.A. 82-398 defined "income", including within it all forms
of remuneration to an individual from his employment; P.A. 84-320 amended Subsecs. (2) and (3) to increase the number
of commissioners to ten; P.A. 85-420 amended Subdivs. (2) and (3) to increase the number of commissioners to eleven;
P.A. 88-184 redefined "commission" and "compensation review division" to reflect an increase in number of commissioners
to thirteen; P.A. 88-364 made a technical change in Subsec. (5); P.A. 91-32 replaced existing definitions with Subdivs.
(1) to (22), inclusive; P.A. 91-339 redefined "commission" in Subsec. (2), deleted definition of "compensation review
division" in former Subsec. (5), deleted reference to Sec. 31-308b from renumbered Subsec. (6), added new Subsec. (8)
defining "disfigurement" and added new Subsec. (21) defining "scar", renumbering as necessary; P.A. 92-31 redefined
"compensation" to delete dependency allowances; P.A. 93-228 redefined "arising out of and in the course of his employment", "employee", "employer" and "personal injury" in Subdivs. (1), (9), (10) and (16), respectively, added definition
of "narcotic drugs" in Subdiv. (1), and deleted definitions of "significant disfigurement" and "significant scar" in Subdivs.
(8) and (21), respectively, effective July 1, 1993; P.A. 95-79 redefined "employer" in Subdiv. (10) to include a limited
liability company, effective May 31, 1995; P.A. 95-262 amended Subdiv. (1) to redefine "arising out of and in the course
of his employment" to exclude as a personal injury, any injury sustained at the employee's place of abode while the
employee is engaged in a preliminary act or acts in preparation for work unless at the express direction or request of the
employer, to define "place of abode" and to require the Workers' Compensation Commission to adopt regulations and to
define "a preliminary act" and "acts in preparation for work", effective July 6, 1995 (Revisor's note: The phrase "the
Workers Compensation Commissioner shall adopt regulations" was changed editorially by the Revisors to "the Workers
Compensation Commission shall adopt regulations" to correct an apparent clerical error in the reference to "Commissioner"); P.A. 96-180 amended Subdivs. (9) and (10) to make technical changes, effective June 3, 1996; P.A. 97-205
amended Subdiv. (16)(B) to define "personal injury" and "school-sponsored activity"; P.A. 99-102 amended Subdiv. (17)
by deleting obsolete reference to chapter 371; P.A. 01-208 amended Subdiv. (1) by making technical changes throughout,
designating existing Subpara. (A) as Subpara. (A)(i), adding Subpara. (A)(ii) re dependents of certain deceased employees
of the Department of Correction and designating portions of existing Subpara. (E) as Subparas. (F) and (G), effective July
13, 2001; June 30 Sp. Sess. P.A. 03-6 replaced Commissioner of Consumer Protection with Commissioner of Agriculture
and Consumer Protection, effective July 1, 2004; P.A. 04-189 repealed Sec. 146 of June 30 Sp. Sess. P.A. 03-6, thereby
reversing the merger of the Departments of Agriculture and Consumer Protection, effective June 1, 2004; P.A. 05-208
amended Subdiv. (16)(B)(ii) to exempt mental or emotional impairment of police officer arising from use of or subjection
to deadly force from general mental or emotional impairment exclusion from definition of "personal injury" or "injury"
and made technical changes throughout Subdiv. (16); P.A. 05-230 amended Subdiv. (1)(A) by adding new clause (ii)
defining "in the course of his employment" for employees of Department of Correction, redesignating existing clause (ii)
as clause (iii) and making a conforming change therein, and amended Subdiv. (1)(G) by requiring Workers' Compensation
Commission to define "departure from place of abode directly to duty" and "return directly to place of abode after duty"
by regulation on or before January 1, 2006; P.A. 05-236 amended Subdiv. (9)(A) by making technical changes in clause
(vi) and adding clause (vii) to redefine "employee" to include members of the National Guard or other armed forces of the
state called to active duty by Governor while performing active duty service, effective July 1, 2005; pursuant to P.A. 11-51, "Department of Public Safety" was changed editorially by the Revisors to "Department of Emergency Services and
Public Protection" in Subdiv. (16)(B)(ii), effective July 1, 2011; P.A. 11-128 added Subdiv. (9)(A)(viii) to redefine "employee" to include a person elected to serve as probate judge for a probate district established in Sec. 45a-2, effective July
1, 2011.
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Sec. 31-280. Chairman of the Workers' Compensation Commission. Powers
and duties. Budget. Report of expenses. (a) There shall continue to be a chairman of
the Workers' Compensation Commission selected by the Governor as provided in section 31-276. The chairman may not hear any matter arising under this chapter, except
appeals brought before the Compensation Review Board and except as provided in
subdivision (14) of subsection (b) of this section. The chairman shall prepare the forms
used by the commission, shall have custody of the insurance coverage cards, shall prepare and keep a list of self-insurers, shall prepare the annual report to the Governor and
shall publish, when necessary, bulletins showing the changes in the compensation law,
with annotations to the Connecticut cases. The chairman shall be provided with sufficient
staff to assist him in the performance of his duties. The chairman may, within available
appropriations, appoint acting compensation commissioners on a per diem basis from
among former workers' compensation commissioners or qualified members of the bar
of this state. Any acting compensation commissioner appointed under this subsection
shall be paid on a per diem basis in an amount to be determined by the Commissioner
of Administrative Services, subject to the provisions of section 4-40, and shall have all
the powers and duties of compensation commissioners. The Workers' Compensation
Commission shall not be construed to be a commission or board subject to the provisions
of section 4-9a.
(b) The chairman of the Workers' Compensation Commission shall:
(1) Establish workers' compensation districts and district offices within the state,
assign compensation commissioners to the districts to hear all matters arising under this
chapter within the districts and may reassign compensation commissioners once each
year, except that when there is a vacancy, illness or other emergency, or when unexpected
caseload increases require, the chairman may reassign compensation commissioners
more than once each year;
(2) Adopt such rules as the chairman, in consultation with the advisory board, deems
necessary for the conduct of the internal affairs of the Workers' Compensation Commission;
(3) Adopt regulations, in consultation with the advisory board and in accordance
with the provisions of chapter 54, to carry out his responsibilities under this chapter;
(4) Prepare and adopt an annual budget and plan of operation in consultation with
the advisory board;
(5) Prepare and submit an annual report to the Governor and the General Assembly;
(6) Allocate the resources of the commission to carry out the purposes of this
chapter;
(7) Establish an organizational structure and such divisions for the commission,
consistent with this chapter, as the chairman deems necessary for the efficient and
prompt operation of the commission;
(8) Establish policy for all matters over which the commission has jurisdiction,
including education, statistical support and administrative appeals;
(9) Appoint such supplementary advisory panels as the chairman deems necessary
and helpful;
(10) Establish, in consultation with the advisory board, (A) an approved list of practicing physicians, surgeons, podiatrists, optometrists and dentists from which an injured
employee shall choose for examination and treatment under the provisions of this chapter, which shall include, but not be limited to, classifications of approved practitioners
by specialty, and (B) standards for the approval and removal of physicians, surgeons,
podiatrists, optometrists and dentists from the list by the chairman;
(11) (A) Establish standards in consultation with the advisory board for approving
all fees for services rendered under this chapter by attorneys, physicians, surgeons,
podiatrists, optometrists, dentists and other persons;
(B) In consultation with employers, their insurance carriers, union representatives,
physicians and third-party reimbursement organizations establish, not later than October
1, 1993, and publish annually thereafter, a fee schedule setting the fees payable by an
employer or its insurance carrier for services rendered under this chapter by an approved
physician, surgeon, podiatrist, optometrist, dentist and other persons, provided the fee
schedule shall not apply to services rendered to a claimant who is participating in an
employer's managed care plan pursuant to section 31-279. On and after April 1, 2008,
the chairman shall implement and annually update relative values based on the Medicare
resource-based relative value scale and implement coding guidelines in conformance
with the Correct Coding Initiative used by the federal Centers for Medicare and Medicaid
Services. The conversion to the Medicare resource-based relative value scale shall be
revenue-neutral. The fee schedule shall limit the annual growth in total medical fees to
the annual percentage increase in the consumer price index for all urban workers. The
chairman may make necessary adjustments to the fee schedule for services rendered
under this chapter where there is no established Medicare resource-based relative value.
Payment of the established fees by the employer or its insurance carrier shall constitute
payment in full to the practitioner, and the practitioner may not recover any additional
amount from the claimant to whom services have been rendered;
(C) Issue, not later than October 1, 1993, and publish annually thereafter, guidelines
for the maximum fees payable by a claimant for any legal services rendered by an
attorney in connection with the provisions of this chapter, which fees shall be approved
in accordance with the standards established by the chairman pursuant to subparagraph
(A) of this subdivision;
(12) Approve applications for employer-sponsored medical care plans, based on
standards developed in consultation with a medical advisory panel as provided in section
31-279;
(13) Establish procedures for the hiring, dismissing or otherwise disciplining and
promoting employees of the commission, subject where appropriate to the provisions
of chapter 67;
(14) Control the hearing calendars of the compensation commissioners, and if necessary, preside over informal hearings in regard to compensation under the provisions
of this chapter in order to facilitate the timely and efficient processing of cases;
(15) Enter into contracts with consultants and such other persons as necessary for
the proper functioning of the commission;
(16) Direct and supervise all administrative affairs of the commission;
(17) Keep and maintain a record of all advisory board proceedings;
(18) Assign and reassign a district manager and other staff to each of the commission's district offices;
(19) Collect and analyze statistical data concerning the administration of the Workers' Compensation Commission;
(20) Direct and supervise the implementation of a uniform case filing and processing system in each of the district offices that will include, but not be limited to, the
ability to provide data on the number of cases having multiple hearings, the number of
postponed hearings and hearing schedules for each district office;
(21) Establish staff development, training and education programs designed to improve the quality of service provided by the commission, including, but not limited to,
a program to train district office staff in the screening of hearing requests;
(22) Develop standard forms for requesting hearings and standard policies regarding limits on the number of informal hearings that will be allowed under this chapter,
and limits on the number of postponements that will be permitted before a formal hearing
is held pursuant to section 31-297;
(23) Develop guidelines for expediting disputed cases;
(24) Establish an ongoing training program, in consultation with the advisory board,
designed to assist the commissioners in the fulfillment of their duties pursuant to the
provisions of section 31-278, which program shall include instruction in the following
areas: Discovery, evidence, statutory interpretation, medical terminology, legal decision
writing and the purpose and procedures of informal and formal hearings;
(25) Evaluate, in conjunction with the advisory board, the performance of each
commissioner biannually and, notwithstanding the provisions of subsection (b) of section 1-210 and chapter 55, make the performance evaluation of any commissioner available only to the Governor, the members of the joint standing committee on the judiciary
and the respective commissioner prior to any public hearing on the reappointment of
any such commissioner. Any information disclosed to such persons shall be used by
such persons only for the purpose for which it was given and shall not be disclosed to
any other person;
(26) (A) In consultation with insurers and practitioners, establish not later than
October 1, 1993, and publish annually thereafter, practitioner billing guidelines for employers, workers' compensation insurance carriers and practitioners approved by the
chairman pursuant to subdivision (10) of this subsection. The guidelines shall include
procedures for the resolution of billing disputes and shall prohibit a practitioner from
billing or soliciting payments from a claimant for services rendered to the claimant
under the provisions of this chapter (i) during a payment dispute between the practitioner
and the employer or its workers' compensation insurance carrier, or (ii) in excess of the
maximum fees established pursuant to subparagraph (B) of subdivision (11) of this
subsection;
(B) In consultation with practitioners and insurers, develop not later than July 1,
1994, practice protocols for reasonable and appropriate treatment of a claimant under
the provisions of this chapter, based on the diagnosis of injury or illness. The commission
shall annually publish the practice protocols for use by approved practitioners, employers, workers' compensation insurance carriers and commissioners in evaluating the necessity and appropriateness of care provided to a claimant under the provisions of this
chapter;
(C) In consultation with practitioners and insurers, develop not later than July 1,
1994, utilization review procedures for reasonable and appropriate treatment of a claimant under the provisions of this chapter. The chairman shall annually publish the procedures for use by approved practitioners, employers, workers' compensation insurance
carriers and commissioners in evaluating the necessity and appropriateness of care provided to a claimant under the provisions of this chapter.
(c) The chairman, as soon as practicable after April first of each year, shall submit
to the Comptroller an estimated budget of expenditures which shall include all direct
and indirect costs incurred by the Workers' Compensation Commission for the succeeding fiscal year commencing on July first next. The Workers' Compensation Commission, for the purposes of administration, shall not expend more than the amounts
specified in such estimated budget for each item of expenditure except as authorized
by the Comptroller. The chairman shall include in his annual report to the Governor a
statement showing the expenses of administering the Workers' Compensation Act for
the preceding fiscal year.
(d) The chairman and the Comptroller, as soon as practicable after August first in
each year, shall ascertain the total amount of expenses incurred by the commission,
including, in addition to the direct cost of personnel services, the cost of maintenance
and operation, rentals for space occupied in state leased offices and all other direct and
indirect costs, incurred by the commission and the expenses incurred by the Bureau
of Rehabilitative Services in providing rehabilitation services for employees suffering
compensable injuries in accordance with the provisions of section 31-283a, during the
preceding fiscal year in connection with the administration of the Workers' Compensation Act and the total noncontributory payments required to be made to the Treasurer
towards commissioners' retirement salaries as provided in sections 51-49, 51-50, 51-50a
and 51-50b. An itemized statement of the expenses as so ascertained shall be available for
public inspection in the office of the chairman of the Workers' Compensation Commission for thirty days after notice to all insurance carriers, and to all employers permitted
to pay compensation directly affected thereby.
(1949 Rev., S. 7438; September, 1957, P.A. 11, S. 13; 1958 Rev., S. 31-144; 1961, P.A. 491, S. 6; 1969, P.A. 696, S.
3; 1971, P.A. 366; 639, S. 7; P.A. 77-614, S. 130, 610; P.A. 78-303, S. 32, 136; P.A. 79-376, S. 39; 79-540, S. 2; P.A. 80-414, S. 3; P.A. 90-116, S. 3; P.A. 91-339, S. 6, 55; P.A. 93-228, S. 4, 35; P.A. 97-205, S. 2; P.A. 07-31, S. 1; P.A. 11-61,
S. 84, 85.)
History: 1961 act entirely replaced previous provisions; 1969 act deleted requirement that chairman publish a digest
of compensation decisions and added Subsecs. (b) and (c) re budget and record of expenditures; 1971 acts substituted
"disposition" of business for "dispensation" of business in Subsec. (a) and required inclusion of "noncontributory payments
required to be made to the treasurer towards commissioners' retirement salaries" as part of expenses incurred under Subsec.
(c); P.A. 77-614 transferred power to appoint at-large commissioner from personnel policy board to commissioner of
administrative services "subject to the provisions of section 4-40"; P.A. 78-303 specified that commission is not a commission or board subject to Sec. 4-9a in Subsec. (a); P.A. 79-376 replaced "workmen's compensation" with "workers' compensation"; P.A. 79-540 specified that chairman of board of compensation commissioners is also chairman of compensation
review division in Subsec. (a); P.A. 80-414 clarified duties of chairman as administrative, granting him powers to control
hearing calendars to expedite processing of claims and power to hear matters and required that chairman be provided with
sufficient staff to perform his duties in Subsec. (a); P.A. 90-116 amended Subsec. (a) to allow for the appointment of
temporary commissioners at the discretion of any commissioner within available appropriations; P.A. 91-339 changed
"board of compensation commissioners" to "workers' compensation commission", deleted provisions re chairman of
the compensation review division, added provisions re hearing of matters by the chairman, and deleted provisions re
administrative nature of the chairman's duties, commissioners at large and the chairman's control over the hearing calendars
of the commissioners in Subsec. (a), added new Subsec. (b) re powers and duties of the chairman of the workers' compensation commission, redesignated existing Subsec. (b) as Subsec. (c) and required estimated budget to include all direct and
indirect costs incurred by the commission, redesignated existing Subsec. (c) as Subsec. (d) and made technical changes;
P.A. 93-228 amended Subsec. (b) to apply provisions to optometrists, to require chairman to establish medical fee schedule,
attorney fee guidelines, commissioner training program, medical billing guidelines, practice protocols and utilization
review procedures, to evaluate commissioners' performance and, when necessary, to preside over informal workers' compensation hearings, effective July 1, 1993; P.A. 97-205 amended Subsec. (b)(1) to permit the chairman to reassign compensation commissioners; P.A. 07-31 amended Subsec. (b)(11)(B) by including fees for additional providers in fee schedule
and adding provisions re Medicare resource-based relative value scale and coding guidelines used by Centers for Medicare
and Medicaid Services as bases for fee schedule; P.A. 11-61 amended Subsec. (b)(8) by deleting "rehabilitation" re matter
for which chairman shall establish policy and amended Subsec. (d) by adding provision re expenses incurred by Bureau
of Rehabilitation Services, effective July 1, 2011 (Revisor's note: In Subsec. (d), "Bureau of Rehabilitation Services" was
changed editorially by the Revisors to "Bureau of Rehabilitative Services" to conform with changes made by P.A. 11-44).
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Sec. 31-283a. Rehabilitation programs for employees suffering compensable
injuries. (a) The Bureau of Rehabilitative Services shall provide rehabilitation programs
for employees suffering compensable injuries within the provisions of this chapter,
which injuries disabled them from performing their customary or most recent work. The
director of the Bureau of Rehabilitative Services shall establish rehabilitation programs
which shall best suit the needs of injured employees and shall make the programs available in convenient locations throughout the state. After consultation with the Labor
Commissioner, the director may establish fees for the programs, so as to provide the
most effective rehabilitation programs at a minimum rate. In order to carry out the
provisions of this section, the director shall adopt regulations, in accordance with the
provisions of chapter 54, and, subject to the provisions of chapter 67, provide for the
employment of necessary assistants.
(b) The director of the Bureau of Rehabilitative Services shall be authorized to (1)
enter into agreements with other state or federal agencies to carry out the purposes of this
section and expend money for that purpose, and (2) on behalf of the state of Connecticut,
develop matching programs or activities to secure federal grants or funds for the purposes
of this section and may pledge or use funds supplied from the administrative costs fund,
as provided in section 31-345, to finance the state's share of the programs or activities.
(1967, P.A. 569, S. 1; P.A. 79-376, S. 40; P.A. 85-133, S. 1; P.A. 91-32, S. 4, 41; 91-339, S. 8, 55; P.A. 95-265, S. 1,
7; P.A. 96-216, S. 1, 5; P.A. 11-44, S. 47.)
History: P.A. 79-376 replaced "workmen's compensation" with "workers' compensation"; P.A. 85-133 required that
the commission adopt regulations on or before October 1, 1986, concerning the operations of the division of workers'
rehabilitation; P.A. 91-32 designated existing section as Subsec. (a), made technical changes and added Subsecs. (b) and
(c), re method of financing cost of rehabilitation division and re director's powers; P.A. 91-339 amended Subsec. (a) by
requiring that the director be appointed by the chairman of the workers' compensation commission, that the chairman
approve the establishment of fees and that the director report to the chairman, and by authorizing the chairman to adopt
regulations, deleted Subsec. (b), redesignated Subsec. (c) as Subsec. (b) and made technical changes; P.A. 95-265 amended
Subsec. (a) by eliminating the Division of Workers Rehabilitation and the full-time salaried director, transferring to Workers
Compensation Commission chairman the authority to establish rehabilitation programs, and to cap funds appropriated for
rehabilitation program to no more than $550,000 and made technical corrections in Subsec. (b), effective July 1, 1995;
P.A. 96-216 amended Subsec. (a) to make a technical correction concerning approval of the chairman before establishing
fees and removed the limitation on the amount of funds used as grants to implement the section, effective June 4, 1996;
P.A. 11-44 replaced "Workers' Compensation Commission" with "Bureau of Rehabilitative Services" and replaced "chairman" with "director of the Bureau of Rehabilitative Services" and "director", effective July 1, 2011.
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II
EMPLOYERS' LIABILITY
Sec. 31-286a. Insurance requirements for contractors on public works projects and renewals of state business licenses. (a) Notwithstanding any provision of any
general statute, special act, charter or ordinance, neither the state, or its agents, nor any
political subdivision of the state, or its agents, may enter into any contract on or after
October 1, 1986, for the construction, remodeling, refinishing, refurbishing, rehabilitation, alteration or repair of any public works project before receiving from each of the
other parties to such contract (1) sufficient evidence of compliance with the workers'
compensation insurance and self-insurance requirements of subsection (b) of section
31-284, and (2) a current statement from the State Treasurer that, to the best of his
knowledge and belief, as of the date of the statement, the particular party was not liable
to the state for any workers' compensation payments made pursuant to section 31-355.
(b) On and after October 1, 1986, no state department, board or agency may renew
a license or permit to operate a business in this state unless the applicant first presents
sufficient evidence of current compliance with the workers' compensation insurance
coverage requirements of section 31-284.
(c) This section shall not be construed to create any liability on the part of the
state or any political subdivision thereof to pay workers' compensation benefits or to
indemnify the Second Injury Fund, any employer or any insurer who pays workers'
compensation benefits.
(d) For purposes of this section, "sufficient evidence" means (1) a certificate of
self-insurance issued by a workers' compensation commissioner pursuant to section 31-284, (2) a certificate of compliance issued by the Insurance Commissioner pursuant to
section 31-286, (3) a certificate of insurance issued by any stock or mutual insurance
company or mutual association authorized to write workers' compensation insurance
in this state or its agent, or (4) in lieu of a physical certificate of insurance being presented
for the issuance or renewal of licenses and permits issued by the Department of Consumer Protection or the Department of Public Health, the entrance by the applicant on
the renewal form of the name of the insurer, insurance policy number, effective dates
of coverage, and a certification that the same is truthful and accurate.
(P.A. 86-87; P.A. 91-207, S. 2, 9; P.A. 09-104, S. 1; P.A. 10-9, S. 9; P.A. 11-242, S. 18.)
History: P.A. 91-207 made a technical change to fund's name in Subsec. (c); P.A. 09-104 amended Subsec. (d) by
adding Subdiv. (4) re entrance of specified information on Department of Consumer Protection license or permit renewal
form in lieu of presentation of physical certificate of insurance and by making technical changes, effective June 2, 2009;
P.A. 10-9 amended Subsec. (d)(4) to change "renewals" to "the issuance or renewal" of licenses and permits, effective
May 5, 2010; P.A. 11-242 amended Subsec. (d)(4) by adding reference to Department of Public Health.
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Sec. 31-293. Liability of third persons to employer and employee. Limitations
on liability of architects and engineers. Limitations on liability of insurers, self-insurance service organizations and unions relating to safety matters. (a) When any
injury for which compensation is payable under the provisions of this chapter has been
sustained under circumstances creating in a person other than an employer who has
complied with the requirements of subsection (b) of section 31-284, a legal liability to
pay damages for the injury, the injured employee may claim compensation under the
provisions of this chapter, but the payment or award of compensation shall not affect
the claim or right of action of the injured employee against such person, but the injured
employee may proceed at law against such person to recover damages for the injury;
and any employer or the custodian of the Second Injury Fund, having paid, or having
become obligated to pay, compensation under the provisions of this chapter may bring
an action against such person to recover any amount that he has paid or has become
obligated to pay as compensation to the injured employee. If the employee, the employer
or the custodian of the Second Injury Fund brings an action against such person, he shall
immediately notify the others, in writing, by personal presentation or by registered or
certified mail, of the action and of the name of the court to which the writ is returnable,
and the others may join as parties plaintiff in the action within thirty days after such
notification, and, if the others fail to join as parties plaintiff, their right of action against
such person shall abate unless the employer, insurance carrier or Second Injury Fund
gives written notice of a lien in accordance with this subsection. In any case in which
an employee brings an action against a party other than an employer who failed to
comply with the requirements of subsection (b) of section 31-284, in accordance with
the provisions of this section, and the employer is a party defendant in the action, the
employer may join as a party plaintiff in the action. The bringing of any action against an
employer shall not constitute notice to the employer within the meaning of this section. If
the employer and the employee join as parties plaintiff in the action and any damages
are recovered, the damages shall be so apportioned that the claim of the employer, as
defined in this section, shall take precedence over that of the injured employee in the
proceeds of the recovery, after the deduction of reasonable and necessary expenditures,
including attorneys' fees, incurred by the employee in effecting the recovery. If the
action has been brought by the employee, the claim of the employer shall be reduced
by one-third of the amount of the benefits to be reimbursed to the employer, unless
otherwise agreed upon by the parties, which reduction shall inure solely to the benefit
of the employee, except that such reduction shall not apply if the reimbursement is to
the state of Connecticut or a political subdivision of the state including a local public
agency, as the employer, or the custodian of the Second Injury Fund. The rendition of
a judgment in favor of the employee or the employer against the party shall not terminate
the employer's obligation to make further compensation which the commissioner thereafter deems payable to the injured employee. If the damages, after deducting the employee's expenses as provided in this subsection, are more than sufficient to reimburse the
employer, damages shall be assessed in his favor in a sum sufficient to reimburse him
for his claim, and the excess shall be assessed in favor of the injured employee. No
compromise with the person by either the employer or the employee shall be binding
upon or affect the rights of the other, unless assented to by him. For the purposes of this
section, the claim of the employer shall consist of (1) the amount of any compensation
which he has paid on account of the injury which is the subject of the suit, and (2) an
amount equal to the present worth of any probable future payments which he has by
award become obligated to pay on account of the injury. The word "compensation", as
used in this section, shall be construed to include incapacity payments to an injured
employee, payments to the dependents of a deceased employee, sums paid out for surgical, medical and hospital services to an injured employee, the burial fee provided by
subdivision (1) of subsection (a) of section 31-306, payments made under the provisions
of sections 31-312 and 31-313, and payments made under the provisions of section 31-284b in the case of an action brought under this section by the employer or an action
brought under this section by the employee in which the employee has alleged and been
awarded such payments as damages. Each employee who brings an action against a
party in accordance with the provisions of this subsection shall include in his complaint
(A) the amount of any compensation paid by the employer or the Second Injury Fund
on account of the injury which is the subject of the suit, and (B) the amount equal to
the present worth of any probable future payments which the employer or the Second
Injury Fund has, by award, become obligated to pay on account of the injury. Notwithstanding the provisions of this subsection, when any injury for which compensation is
payable under the provisions of this chapter has been sustained under circumstances
creating in a person other than an employer who has complied with the requirements
of subsection (b) of section 31-284, a legal liability to pay damages for the injury and
the injured employee has received compensation for the injury from such employer, its
workers' compensation insurance carrier or the Second Injury Fund pursuant to the
provisions of this chapter, the employer, insurance carrier or Second Injury Fund shall
have a lien upon any judgment received by the employee against the party or any settlement received by the employee from the party, provided the employer, insurance carrier
or Second Injury Fund shall give written notice of the lien to the party prior to such
judgment or settlement.
(b) When an injury for which compensation is payable under the provisions of this
chapter is determined to be the result of a motor vehicle accident or other accident or
circumstance in which a third person other than the employer was negligent and the
claim is subrogated by the employer or its workers' compensation insurance carrier, the
insurance carrier shall provide a rate adjustment to the employer's workers' compensation policy to reflect the recovery of any compensation paid by the insurance carrier
prior to subrogation.
(c) Notwithstanding the provisions of subsection (a) of this section, no construction
design professional who is retained to perform professional services on a construction
project, or any employee of a construction design professional who is assisting or representing the construction design professional in the performance of professional services
on the site of the construction project, shall be liable for any injury on the construction
project for which compensation is payable under the provisions of this chapter, unless
responsibility for safety practices is specifically assumed by contract. The immunity
provided by this subsection to any construction design professional shall not apply to
the negligent preparation of design plans or specifications. For the purposes of this
subsection "construction design professional" means (1) any person licensed as an architect under the provisions of chapter 390, (2) any person licensed, or exempted from
licensure, as an engineer under the provisions of chapter 391, or (3) any corporation
organized to render professional services through the practice of either or both of such
professions in this state.
(d) Notwithstanding the provisions of subsection (a) of this section, the furnishing
of or the failure to furnish safety inspections or safety advisory services (1) by an insurer
incident to providing workers' compensation insurance to an employer, (2) pursuant
to a contract providing for safety inspections or safety advisory services between an
employer and a self-insurance service organization incident to providing workers' compensation related services or (3) by a union representing employees of the employer,
shall not subject the insurer or self-insurance service organization or their agents or
employees, or the union, its members or the members of its safety committee, to third
party liability for damages for injury, death or loss resulting therefrom unless the liability
arises from a breach of a duty of fair representation of its members by a union. The
immunity from liability extended under this subsection shall not be extended to any
insurer or self-insurance service organization other than where the immunity is incident
to the provision of workers' compensation insurance or workers' compensation related
services.
(1949 Rev., S. 7425; 1949, 1951, S. 3040d; 1958 Rev., S. 31-156; 1961, P.A. 491, S. 15; 1967, P.A. 692, S. 4; 842, S.
27; P.A. 86-266, S. 1; P.A. 90-145; P.A. 91-32, S. 9, 41; 91-191, S. 2, 3; P.A. 93-228, S. 7, 35; P.A. 96-65, S. 2; P.A. 11-205, S. 1.)
History: 1961 act entirely replaced previous provisions; 1967 acts allowed employer to be party plaintiff in cases where
employee brings an action against a third party, specified that bringing action against employer does not constitute notice
and increased burial fee from $500 to $1,000; P.A. 86-266 added Subsec. (b), limiting the civil liability of certain architects,
engineers and their employees for injuries compensable under workers' compensation which occur on construction projects;
P.A. 90-145 added Subsec. (c) concerning limitations on the liability of insurers, self-insurance service organizations and
unions in relation to safety inspections and safety advisory services; P.A. 91-32 made technical changes; P.A. 91-191
amended the definition of "compensation" in Subsec. (a) to include payments made under Sec. 31-284b in certain cases;
P.A. 93-228 amended Subsec. (a) to specify required contents of employees' complaints against third parties and to give
employers liens on judgments or settlements paid by third parties to employees, added new Subsec. (b) to prohibit insurers
from adjusting employers' workers' compensation insurance rates if payments made by insurers will be recovered from
negligent third party, and redesignated existing Subsecs. (b) and (c) as (c) and (d), respectively, effective July 1, 1993;
P.A. 96-65 amended Subsec. (a) to make technical changes for consistency and to include references to the custodian of
the Second Injury Fund and employers who fail to comply with Sec. 31-284(b); P.A. 11-205 amended Subsec. (a) to add
provision re right of action of parties that do not join as parties plaintiff to abate "unless the employer, insurance carrier
or Second Injury Fund gives written notice of a lien in accordance with this subsection" and add provision re reduction of
claim of employer by one-third of amount of benefits to be reimbursed to the employer if action has been brought by
employee, effective July 1, 2011.
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Sec. 31-296. Voluntary agreements. (a) If an employer and an injured employee,
or in case of fatal injury the employee's legal representative or dependent, at a date
not earlier than the expiration of the waiting period, reach an agreement in regard to
compensation, such agreement shall be submitted in writing to the commissioner by the
employer with a statement of the time, place and nature of the injury upon which it is
based; and, if such commissioner finds such agreement to conform to the provisions of
this chapter in every regard, the commissioner shall so approve it. A copy of the
agreement, with a statement of the commissioner's approval, shall be delivered to each
of the parties and thereafter it shall be as binding upon both parties as an award by the
commissioner. The commissioner's statement of approval shall also inform the employee or the employee's dependent, as the case may be, of any rights the individual
may have to an annual cost-of-living adjustment or to participate in a rehabilitation
program administered by the Bureau of Rehabilitative Services under the provisions of
this chapter. The commissioner shall retain the original agreement, with the commissioner's approval thereof, in the commissioner's office and, if an application is made to the
superior court for an execution, the commissioner shall, upon the request of said court,
file in the court a certified copy of the agreement and statement of approval.
(b) Before discontinuing or reducing payment on account of total or partial incapacity under any such agreement, the employer or the employer's insurer, if it is claimed
by or on behalf of the injured employee that such employee's incapacity still continues,
shall notify the commissioner and the employee, by certified mail, of the proposed
discontinuance or reduction of such payments. Such notice shall specify the reason for
the proposed discontinuance or reduction and the date such proposed discontinuance
or reduction will commence. No discontinuance or reduction shall become effective
unless specifically approved in writing by the commissioner. The employee may request
a hearing on any such proposed discontinuance or reduction not later than fifteen days
after receipt of such notice. Any such request for a hearing shall be given priority over
requests for hearings on other matters. The commissioner shall not approve any such
discontinuance or reduction prior to the expiration of the period for requesting a hearing
or the completion of such hearing, whichever is later. In any case where the commissioner finds that an employer has discontinued or reduced any payments made in accordance with this section without the approval of the commissioner, such employer shall
be required to pay to the employee the total amount of all payments so discontinued or
the total amount by which such payments were reduced, as the case may be, and shall
be required to pay interest to the employee, at a rate of one and one-quarter per cent per
month or portion of a month, on any payments so discontinued or on the total amount
by which such payments were reduced, as the case may be, plus reasonable attorney's
fees incurred by the employee in relation to such discontinuance or reduction.
(c) The employer's or insurer's notice of intention to discontinue or reduce payments shall (1) identify the claimant, the claimant's attorney or other representative, the
employer, the insurer, and the injury, including the date of the injury, the city or town
in which the injury occurred and the nature of the injury, (2) include medical documentation that (A) establishes the basis for the discontinuance or reduction of payments, and
(B) identifies the claimant's attending physician, and (3) be in substantially the following form:
IMPORTANT
STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION
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Sec. 31-300. Award as judgment. Interest. Attorney's fee. Procedure on discontinuance or reduction. As soon as may be after the conclusion of any hearing, but
no later than one hundred twenty days after such conclusion, the commissioner shall
send to each party a written copy of the commissioner's findings and award. The commissioner shall, as part of the written award, inform the employee or the employee's
dependent, as the case may be, of any rights the individual may have to an annual cost-of-living adjustment or to participate in a rehabilitation program administered by the
Bureau of Rehabilitative Services under the provisions of this chapter. The commissioner shall retain the original findings and award in said commissioner's office. If no
appeal from the decision is taken by either party within twenty days thereafter, such
award shall be final and may be enforced in the same manner as a judgment of the
Superior Court. The court may issue execution upon any uncontested or final award of
a commissioner in the same manner as in cases of judgments rendered in the Superior
Court; and, upon the filing of an application to the court for an execution, the commissioner in whose office the award is on file shall, upon the request of the clerk of said
court, send to the clerk a certified copy of such findings and award. In cases where,
through the fault or neglect of the employer or insurer, adjustments of compensation
have been unduly delayed, or where through such fault or neglect, payments have been
unduly delayed, the commissioner may include in the award interest at the rate prescribed
in section 37-3a and a reasonable attorney's fee in the case of undue delay in adjustments
of compensation and may include in the award in the case of undue delay in payments
of compensation, interest at twelve per cent per annum and a reasonable attorney's fee.
Payments not commenced within thirty-five days after the filing of a written notice of
claim shall be presumed to be unduly delayed unless a notice to contest the claim is
filed in accordance with section 31-297. In cases where there has been delay in either
adjustment or payment, which delay has not been due to the fault or neglect of the
employer or insurer, whether such delay was caused by appeals or otherwise, the commissioner may allow interest at such rate, not to exceed the rate prescribed in section
37-3a, as may be fair and reasonable, taking into account whatever advantage the employer or insurer, as the case may be, may have had from the use of the money, the
burden of showing that the rate in such case should be less than the rate prescribed in
section 37-3a to be upon the employer or insurer. In cases where the claimant prevails
and the commissioner finds that the employer or insurer has unreasonably contested
liability, the commissioner may allow to the claimant a reasonable attorney's fee. No
employer or insurer shall discontinue or reduce payment on account of total or partial
incapacity under any such award, if it is claimed by or on behalf of the injured person
that such person's incapacity still continues, unless such employer or insurer notifies
the commissioner and the employee of such proposed discontinuance or reduction in
the manner prescribed in section 31-296 and the commissioner specifically approves
such discontinuance or reduction in writing. The commissioner shall render the decision
within fourteen days of receipt of such notice and shall forward to all parties to the claim
a copy of the decision not later than seven days after the decision has been rendered. If
the decision of the commissioner finds for the employer or insurer, the injured person
shall return any wrongful payments received from the day designated by the commissioner as the effective date for the discontinuance or reduction of benefits. Any employee
whose benefits for total incapacity are discontinued under the provisions of this section
and who is entitled to receive benefits for partial incapacity as a result of an award, shall
receive those benefits commencing the day following the designated effective date for
the discontinuance of benefits for total incapacity. In any case where the commissioner
finds that the employer or insurer has discontinued or reduced any such payment without
having given such notice and without the commissioner having approved such discontinuance or reduction in writing, the commissioner shall allow the claimant a reasonable
attorney's fee together with interest at the rate prescribed in section 37-3a on the discontinued or reduced payments.
(1949 Rev., S. 7449; 1951, S. 3049d; 1958 Rev., S. 31-176; 1961, P.A. 491, S. 22; 1967, P.A. 692, S. 1; 842, S. 10;
P.A. 75-122; P.A. 79-80; P.A. 83-114, S. 2; P.A. 84-180, S. 2; 84-299, S. 3; P.A. 85-64, S. 1, 2; P.A. 88-106, S. 3; P.A.
89-17; 89-316, S. 1; P.A. 91-339, S. 19; P.A. 93-228, S. 13, 35; P.A. 01-22, S. 3; P.A. 11-44, S. 49.)
History: 1961 act entirely replaced previous provisions; 1967 acts deleted references to "original findings" and specified
that claimant may be allowed reasonable attorneys fees where commissioner finds that employer or insurer has unreasonably
contested liability; P.A. 75-122 added provisions re procedure for discontinuance of payments; P.A. 79-80 specified that
6% interest applies "in the case of undue delay in adjustments of compensation", allowed 12% interest where there is
undue delay in payments and defined undue delay; P.A. 83-114 provided that the commissioner shall inform the individual,
as part of the written award, of his rights to an annual cost-of-living adjustment under this chapter; P.A. 84-180 required
the commissioner to inform the employee in the award of his right to participate in a rehabilitation program; P.A. 84-299
provided that payments not made within 35 days after the filing of a claim shall be considered "unduly delayed" unless
the claim has been timely contested; P.A. 85-64 required the commissioner to send each party a written copy of his award
within 120 days of the conclusion of hearings on the claim; P.A. 88-106 added the provisions regarding reduction of
benefits and provided for an award of attorneys' fees in cases of undue delay in adjustments and payments resulting from
the fault or neglect of an employer or insurer; P.A. 89-17 increased the rate of interest from 6% to 10% for all cases except
cases where payments are discontinued or reduced without notice and approval; P.A. 89-316 changed the rates of allowable
interest from specific percentages enacted under P.A. 89-17 to the rate prescribed in Sec. 37-3a; P.A. 91-339 required the
commissioner to send to each party a written copy of his findings; P.A. 93-228 added provisions modifying procedures re
discontinuances or reductions in workers' compensation benefits, effective July 1, 1993; P.A. 01-22 increased time for
taking an appeal from the decision of the commissioner from 10 to 20 days and made technical changes for the purpose of
gender neutrality; P.A. 11-44 added provision re rehabilitation program administered by Bureau of Rehabilitative Services,
effective July 1, 2011.
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Sec. 31-345. Insurance Commissioner to approve form of policy. Assessments
against employers for administrative costs. Surpluses. (a) No insurer or employer
to whom a certificate of solvency pursuant to subsection (b) of section 31-284 has been
issued, shall issue any policy of insurance purporting to cover the liability of an employer
under the provisions of this chapter until a copy of the form of such policy has been
filed with and approved by the Insurance Commissioner. No insurer or employer who
is self-insured in whole or in part shall engage in writing insurance under this chapter
or providing the compensation and benefits directly to employees unless he files with
the Insurance Commissioner a receipt from the State Treasurer or the Comptroller on
or before the first day of October, that the employer has paid his pro rata cost of administration required by this section or if the self-insured employer has not, prior to July first
of any year, provided compensation and benefits under this chapter, the self-insured
employer shall file such receipt on or before October first, annually that he has paid an
amount equal to one-quarter of one per cent of the self-insured employer's payroll for
the twelve months immediately preceding such July first.
(b) (1) When, after the close of a fiscal year ending prior to July 1, 1990, the chairman of the Workers' Compensation Commission and the Comptroller have determined
the total amount of expenses of the Workers' Compensation Commission in accordance
with the provisions of subsection (d) of section 31-280, the Treasurer shall thereupon
assess upon and collect from each employer, other than the state and any municipality
participating for purposes of its liability under this chapter as a member in an interlocal
risk management agency pursuant to chapter 113a, the proportion of such expenses that
the total compensation and payment for hospital, medical and nursing care made by
such self-insured employer or private insurance carrier acting on behalf of any such
employer bore to the total compensation and payments for hospital, medical and nursing
care made by all such insurance carriers and self-insurers. The amount so secured shall
be used to reimburse the Treasurer for appropriations theretofore made by the state for
the payment in the first instance of the expenses of administering this chapter. On and
after July 1, 1986, the Treasurer shall, as soon as possible after the close of a fiscal year
ending prior to July 1, 1990, estimate the pro rata cost to each employer based upon the
costs assessed to such employer in the immediately preceding fiscal year and shall assess
upon and collect from each such employer such estimated costs annually which shall
be payable as provided in subsection (a) of this section except each annual assessment
shall include an amount which represents the difference between the payments collected
and the actual costs assessed to such employer for the immediately preceding fiscal
year. The Treasurer is authorized to make credits or rebates for overpayments made
under this subsection by any employer for any fiscal year.
(2) The chairman of the Workers' Compensation Commission shall annually, on
or after July first of each fiscal year, determine an amount sufficient in the chairman's
judgment to meet the expenses incurred by the Workers' Compensation Commission
and the Bureau of Rehabilitative Services in providing rehabilitation services for employees suffering compensable injuries in accordance with section 31-283a. Such expenses shall include (A) the costs of the Division of Workers' Rehabilitation and the
programs established by its director, for fiscal years prior to the fiscal year beginning
July 1, 2011, (B) the costs of the Division of Worker Education and the programs established by its director, and (C) funding for the occupational health clinic program created
pursuant to sections 31-396 to 31-402, inclusive. The Treasurer shall thereupon assess
upon and collect from each employer, other than the state and any municipality participating for purposes of its liability under this chapter as a member in an interlocal risk
management agency pursuant to chapter 113a, the proportion of such expenses, based
on the immediately preceding fiscal year, that the total compensation and payment for
hospital, medical and nursing care made by such self-insured employer or private insurance carrier acting on behalf of any such employer bore to the total compensation and
payments for the immediately preceding fiscal year for hospital, medical and nursing
care made by such insurance carriers and self-insurers. For the fiscal years ending June
30, 2000, and June 30, 2001, such assessments shall not exceed five per cent of such
total compensation and payments made by such insurance carriers and self-insurers.
For the fiscal years ending June 30, 2002, and June 30, 2003, such assessments shall
not exceed four and one-half per cent of such total compensation and payments made
by such insurance carriers and self-insurers. For any fiscal year ending on or after June
30, 2004, such assessment shall not exceed four per cent of such total compensation
and payments made by such insurance carriers and self-insurers. Such assessments and
expenses shall not exceed the budget estimates submitted in accordance with subsection
(c) of section 31-280. For each fiscal year, such assessment shall be reduced pro rata
by the amount of any surplus from the assessments of prior fiscal years. Said surplus
shall be determined in accordance with subdivision (3) of this subsection. Such assessments shall be made in one annual assessment upon receipt of the chairman's expense
determination by the Treasurer. All assessments shall be paid not later than sixty days
following the date of the assessment by the Treasurer. Any employer who fails to pay
such assessment to the Treasurer within the time prescribed by this subdivision shall
pay interest to the Treasurer on the assessment at the rate of eight per cent per annum
from the date the assessment is due until the date of payment. All assessments received
by the Treasurer pursuant to this subdivision to meet the expenses of the Workers'
Compensation Commission shall be deposited in the Workers' Compensation Administration Fund established under section 31-344a. All assessments received by the Treasurer pursuant to this subdivision to meet the expenses incurred by the Bureau of Rehabilitative Services in providing rehabilitation services for employees suffering
compensable injuries in accordance with section 31-283a shall be deposited in the Workers' Compensation Administration Fund. The Treasurer is hereby authorized to make
credits or rebates for overpayments made under this subsection by any employer for
any fiscal year.
(3) As soon as practicable after the close of the state fiscal year, the Comptroller
shall examine the Workers' Compensation Administration Fund and shall direct the
State Treasurer to set aside within said fund amounts in excess of fifty per cent of the
expenditures of the Workers' Compensation Commission for the most recently completed fiscal year, which shall be considered a surplus for purposes of subdivision (2)
of subsection (b) of this section.
(1949 Rev., S. 7485; 1958 Rev., S. 31-212; 1961, P.A. 491, S. 71; 1969, P.A. 696, S. 13; 1971, P.A. 334; P.A. 73-32;
P.A. 76-246, S. 1, 3; P.A. 77-614, S. 163, 610; P.A. 78-241, S. 1, 2; P.A. 81-469, S. 5, 8; P.A. 85-189, S. 4; P.A. 90-311,
S. 1, 3; P.A. 91-191, S. 1, 3; 91-339, S. 34, 55; June Sp. Sess. P.A. 91-14, S. 18, 30; P.A. 92-31, S. 5, 7; P.A. 96-267, S.
25; P.A. 99-214, S. 1, 2; June Sp. Sess. P.A. 01-9, S. 29, 131; P.A. 11-61, S. 83.)
History: 1961 act entirely replaced previous provisions; 1969 act made previous provisions applicable to employers
who have been issued a certificate of solvency, added provisions requiring payment of pro rata share of administration
costs and other specified payments before insurer or self-insured employer writes insurance and added Subsec. (b) re
assessment of administration expenses; 1971 act deleted requirement that insurer pay $1,000 if it has not, prior to July first
in any year, paid out any compensation or benefits before it writes insurance, in Subsec. (a); P.A. 73-32 required that filing
of receipt proving payment of pro rata share of administration costs be made on or before October first rather than September
first in Subsec. (a); P.A. 76-246 added provisions re quarterly installments of estimated pro rata costs and credits and
rebates of overpayments; P.A. 77-614 placed insurance commissioner within the department of business regulation and
made insurance department a division within that department, effective January 1, 1979 (provisions later repealed by P.A.
80-482); P.A. 78-241 made payments of estimated costs payable on annual rather than quarterly basis; P.A. 81-469 amended
Subsec. (b) to provide that the amount of compensation and payments made by a carrier due to the state's liabilities as an
employer shall be exempted when calculating the amount due under the subsection; P.A. 85-189 provided that each employer, other than the state and certain municipalities, is liable for the assessments used to cover administrative costs; P.A.
90-311 added Subsec. (b)(2) re assessment of expenses on or after July 1, 1990; P.A. 91-191 amended Subsec. (b)(2) to
replace quarterly assessment with a single annual assessment; P.A. 91-339 amended Subsec. (b) to include the costs of the
rehabilitation division and the division of worker education in the expenses of the workers' compensation commission
and to limit assessments to 4% of the total compensation and payments; June Sp. Sess. P.A. 91-14 amended Subsec. (b)(2)
to provide that on and after July 1, 1991, all assessments received by treasurer pursuant to said subdivision shall be deposited
in workers' compensation administration fund; P.A. 92-31 amended Subsec. (b)(2) to require employers who fail to pay
assessments within the prescribed time to pay interest at the rate of 8% and to delete provision authorizing pro rata reduction
of assessments in accordance with prior years' surplus; P.A. 96-267 amended Subdiv. (b)(2) to require a pro rata assessment
reduction equal to any prior fiscal year surplus, and added Subdiv. (3) to calculate such surplus and to direct the State
Treasurer to set aside the surplus; P.A. 99-214 amended Subsec. (b)(2) by increasing, for fiscal years 2000 and 2001, the
employer assessment cap from 4% to 5% of employers' workers' compensation expenses for the prior year, reducing the
cap to 4% for fiscal years commencing on or after 2002, and requiring the chairman to include the cost of funding occupational health clinic programs in determining the amount necessary to meet the Workers' Compensation Commission's
annual expenses, effective July 1, 1999; June Sp. Sess. P.A. 01-9 amended Subsec. (b)(2) to add provision re 4.5% maximum
annual employer assessment for the fiscal years ending June 30, 2002, and June 30, 2003, and to provide for a 4% maximum
annual employer assessment for fiscal years ending on or after June 30, 2004, effective July 1, 2001; P.A. 11-61 amended
Subsec. (b)(2) by adding provision re expenses incurred by Bureau of Rehabilitative Services, designating existing provision
re costs of Division of Workers' Rehabilitation and program as Subpara. (A) and amending same to make inclusion of
costs of division and program applicable for fiscal years prior to fiscal year beginning July 1, 2011, designating existing
provision re costs of Division of Worker Education and programs as Subpara. (B), designating existing provision re funding
for occupational health clinic program as Subpara. (C), and adding provisions re assessments to be deposited into the
Workers' Compensation Administration Fund, effective July 1, 2011.
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Sec. 31-349b. Certificate for permanent vocational disability. Employer reimbursed by Second Injury Fund for insurance premiums for certified employees.
(a) Any employee who has suffered a compensable injury under the provisions of this
chapter, and who is receiving benefits for such injury from the Second Injury Fund
pursuant to the provisions of section 31-349, may file a written request with the commissioner in the district where the original claim was filed for a hearing to determine whether
the employee's injury constitutes a permanent vocational disability. The hearing shall
be held within sixty days of the date the request was filed. Upon the request of the
commissioner and prior to the conclusion of such hearing, the director of the Bureau of
Rehabilitative Services shall, after receiving such information on the case which the
commissioner deems necessary, submit written recommendations concerning the case
to the commissioner for his consideration. The commissioner shall issue his decision,
in writing, within ten days after the conclusion of the hearing. If the commissioner
determines that the employee's injury is a permanent vocational disability, the employee
shall be issued a certificate of disability by the commissioner. Such certificate shall be
effective for a stated period of time of from one to five years, as determined by the
commissioner. The decision of the commissioner may be appealed in accordance with
the provisions of section 31-301.
(b) (1) Whenever any individual who has been issued a certificate of disability,
pursuant to the provisions of subsection (a) of this section, is thereafter employed, the
employer, upon written application and presentation of sufficient proof to the State
Treasurer, shall be reimbursed from the Second Injury Fund for any workers' compensation insurance premiums paid by the employer which are attributable to such individual's
employment during the effective period of such certificate. (2) Whenever any such
certified individual is hired by an employer to whom a certificate of self-insurance has
been issued pursuant to section 31-284, the employer, upon written application and
presentation of sufficient proof to the State Treasurer, shall be reimbursed from the
Second Injury Fund at the rate of two per cent of the gross wages paid to the individual
for work performed during the effective period of his certificate. No employer may
make more than one such application related to a certified employee within a twelve-month period.
(c) Upon the expiration of any certificate of disability or of an extension of such
certificate, the person to whom such certificate was issued may file a written request
with the commissioner for an extension of the effective period of such certificate. The
determination as to whether such an extension should be granted shall be made by
the commissioner in accordance with the provisions of subsection (a) of this section,
provided such extension shall be effective for a stated period of time of from one to five
years.
(P.A. 86-33; P.A. 91-207, S. 7, 9; P.A. 95-277, S. 10, 19; P.A. 11-44, S. 50.)
History: P.A. 91-207 made technical changes re name of fund; P.A. 95-277 in Subsec. (a) eliminated the reference to
"section 31-325", effective July 1, 1995; P.A. 11-44 amended Subsec. (a) to replace "Division of Workers' Rehabilitation
within the Workers' Compensation Commission" with "Bureau of Rehabilitative Services", effective July 1, 2011.
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