Worker's Compensation Commission

The Commission has recently revised and redesigned four of its most-often used forms:  (1) the 30C "Notice of Claim for Compensation" form, (2) the "Hearing Request" form, (3) the "Petition for Review" form, and (4) the "Notification of Appearance" form.

You can print and fill out the newly revised forms online at:

http://wcc.state.ct.us/download/forms.htm

For hard copies of the new forms, please contact:

Workers' Compensation Commission
Education Services
21 Oak Street, 4th Floor
Hartford, CT  06106-8011

Phone: (860) 493-1500
Fax: (860) 247-1361
Email:
wcc.chairmansoffice@po.state.ct.us