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                Get Ct Wcc 43 2009
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How to fill out the CT WCC 43 online
The CT WCC 43 form is a critical document for notifying the Workers' Compensation Commission about an intention to contest an employee's right to compensation benefits. This guide provides step-by-step instructions on how to fill out this form online effectively and accurately.
Follow the steps to complete the CT WCC 43 form online.
- To start, click the ‘Get Form’ button to obtain the CT WCC 43 form and open it in the editor for modifications.
- In the EMPLOYEE section, enter the name of the employee, the date of injury, the employee's date of birth (required), and the date of death if applicable. Also, provide the address, city/town of injury, state, and zip code.
- In the INJURY section, specify the body part(s) affected and describe the nature of the injury. If it is an occupational disease or repetitive trauma, check the appropriate box.
- In the ATTORNEY OR REPRESENTATIVE OF EMPLOYEE section, fill in the name of the representative, firm name, address, city/town, state, and zip code. Include their telephone number.
- Next, provide the REASON(S) FOR CONTEST section. Clearly state and explain the specific reasons for contesting the employee's right to compensation benefits.
- In the EMPLOYER section, enter the employer's name, address, city/town, state, zip code, and telephone number.
- In the INSURER section, provide the claim number, the insurer's name, address, city/town, state, and zip code.
- At the bottom of the form, include the signature of the person filing, along with the date and contact person’s details, including name, telephone number, and title.
- Once you have completed the form, ensure that all information is accurate before saving any changes. You can then download, print, or share the form as necessary.
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        While on workers' comp in CT, you should not lose your health insurance. Workers' comp benefits are separate from your health insurance coverage. However, it's wise to stay informed about your specific policy to ensure continuous coverage throughout your recovery period. Always consult a legal expert if you have concerns about your health insurance while dealing with CT WCC 43.
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