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Get Ct 30c 2019
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How to fill out the CT 30C online
The CT 30C is a crucial form for individuals who have sustained work-related injuries, allowing them to claim compensation. This guide provides step-by-step instructions on accurately completing the CT 30C online, ensuring your claim is submitted correctly and promptly.
Follow the steps to complete the CT 30C form with ease.
- Click ‘Get Form’ button to obtain the CT 30C form and open it in your preferred editor.
- In the 'INJURED WORKER' section, type or neatly print the full name of the injured worker, include their date of birth, check the box if they are a minor, and fill in their address, town, state, zip code, and telephone number.
- In the 'EMPLOYER' section, type or print the name and address of the employer (organization name, not the individual's direct supervisor). Mark if the injury occurred at the employer's location and specify the actual location if it differs from the employer address.
- In the 'INJURY' section, enter the date and town of the injury. Describe the injury and its cause, indicating body parts affected. Check applicable boxes for occupational disease, multiple employers, or PTSD claims.
- In the 'SIGNATURE OF INJURED WORKER OR REPRESENTATIVE' section, affix the signature and date. If you are signing on behalf of the injured worker, include your name, firm (if applicable), address, town, state, zip code, and telephone number.
- Type or print the WCC File Number in the designated box if known, but this can be left blank if uncertain.
- Make two copies of the completed CT 30C form.
- Send the original form to the employer via Certified or Registered mail, ensuring you keep proof of sending. Additionally, send a copy to the appropriate Workers’ Compensation Commission District Office.
- Retain the final copy of the CT 30C form for your personal records.
Complete the CT 30C form online today to ensure your workers’ compensation claim is filed correctly and efficiently.
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Filing a workers' comp claim in Connecticut involves completing several steps, starting with the Form 30C. After notifying your employer, you can submit the form to the Workers' Compensation Commission. Using platforms like USLegalForms can help simplify this process by providing the necessary forms and guidance for your CT 30C filing.
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