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If your business has employees in the state of Connecticut, you’ll need to make sure you adhere to Connecticut’s Workers’ Compensation Insurance laws. Workers’ Compensation provides medical and financial benefits for employees who suffer work-related injuries or illnesses or for their survivors in the case of an employee death.
Who needs Workers’ Compensation Insurance in Connecticut?
Connecticut requires all employers with one or more employees to obtain Workers’ Compensation Insurance. In Connecticut, an “employee” is usually defined as any person who has entered into or works under a contract of service or apprenticeship with an employer.
The Connecticut Workers’ Compensation Act (WCA) defines all of the requirements for Workers’ Comp in Connecticut, and the Connecticut Workers’ Compensation Commission (WCC) monitors, enforces, and administers the program. Ensuring your company is in compliance is critical, as there are serious penalties and fines for those who fail to abide by state regulations.
What employees are covered under Workers’ Compensation in Connecticut?
Almost all workers are covered under Workers’ Compensation in Connecticut. If you provide work or services for an employer, and you are not an independent contractor, you will likely be eligible for Workers’ Compensation Insurance.
The following are categories of employees that are eligible for Workers’ Comp coverage:
- Full-time and part-time employees
- Apprentices and interns
- Sole proprietors or business partners
- Undocumented workers (eligible for most coverage)
The following are categories of employees that are generally excluded from Workers’ Comp coverage:
- Casual employees
- Independent contractors
- Domestic workers who are not regularly employed for more than 26 hours per week
- Corporate officers who wish to be excluded from coverage and submit notice in writing
What Workers’ Compensation benefits do employees receive?
Under Workers’ Compensation in Connecticut, employers are required to provide the following benefits to employees who are injured in the course of employment:
- Employers are required to provide full coverage of all medical expenses considered necessary by a physician.
- Mileage reimbursement is provided for transportation to and from medical appointments, as well as payment for ambulance or taxi rides if required.
Temporary Total Disability Benefits
- Employees who are unable to work due to a work-related injury are eligible for Temporary Total Disability (TTD) benefits, which provides 75 percent of the worker’s average weekly wage before injury.
- The WCC establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred from October 1, 2020, to September 30, 2021, the maximum TTD benefit was $1,373 per week, and the minimum benefit amount was $274.60 per week.
- Employees can continue to receive TTD benefits for as long as they are unable to work due to a work-related condition.
Temporary Partial Disability Benefits
- If injured employees are able to return to work in a partial or limited capacity while recovering, they may be eligible for Temporary Partial Disability (TPD) benefits. TPD benefits provide 75 percent of the difference between a worker’s pre- and post-injury average weekly wage.
- The WCC establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred from October 1, 2020, to September 30, 2021, the maximum TPD benefit was $1,174 per week, and there was no minimum.
- TPD benefits are available for a maximum of 520 weeks.
Permanent Partial Disability Benefits
- Employees who recover from a covered injury but suffer a permanent partial impairment may be eligible for Permanent Partial Disability (PPD) benefits.
- The number of benefit weeks available from PPD can vary based on the body part that was injured and the severity of the injury. The WCA’s schedule of injuries explains how long benefits will be paid and what benefits are available for different types of injuries.
- The WCA establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred from October 1, 2020, to September 30, 2021, the maximum PPD benefit was $1,174 per week, and the minimum benefit amount was $50 per week.
- In addition to other benefits, employees may be eligible for up to 520 weeks of PPD benefits if an injury diminishes their ability to earn wages. This benefit will pay 75 percent of the difference between average weekly wages pre-injury and the wages the employee will be able to earn after the injury.
Permanent Total Disability Benefits
- Employees who are permanently disabled and unable to earn any wages may be eligible for Permanent Total Disability (PTD) benefits.
- Permanent disabilities include loss of sight in both eyes or reduction to one-tenth or less of normal vision; loss of two major members or a combination of members of the body such as eyes, arms, hands, legs, or feet; paralysis of both arms, both legs, or one arm and one leg; or incurable mental illness.
- PTD benefits provide 75 percent of a worker’s average weekly wage pre-injury, payable as long as the employee remains permanently and totally disabled and is unable to earn wages.
- The WCC establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred from October 1, 2020, to September 30, 2021, the maximum PTD benefit was $1,373 per week, and the minimum benefit amount was $274.60 per week.
- There are no limits to the number of weeks that PTD benefits are payable.
- Employees may be eligible for benefits if they suffer a serious disfigurement or scar on the face, head, or neck. Disfigurements or scars to other parts of the body are also eligible if they prevent the employee from working.
- Up to 208 weeks of benefits equal to an employee’s TTD benefit rate are available for disfigured employees.
- Employers are required to pay burial expenses of $4,000.
- A worker’s dependents may be eligible to receive 75 percent of the worker’s average weekly wage, up to the maximum amount allowed by the WCC. For accidents that occurred from October 1, 2020, to September 30, 2021, the minimum benefit was $20 and the maximum was $1,373.
- Death benefits can be paid to a surviving spouse for life but will be terminated upon remarriage. Dependent children can receive benefits until they are 18, or until they are 22 if they are full-time students and are not married.
What are the penalties for breaking Connecticut Workers’ Compensation laws?
Failure to adhere to the Workers’ Compensation laws set out by the WCA can result in significant fines and even imprisonment. In order to avoid any costly penalties, it’s important to consult the WCA or your insurer to ensure you are in compliance. Below are the major ways in which companies can be penalized:
General Failure to Comply
- Employers that willfully fail to comply with any provision of the WCA may be fined $250 for each failure. Self-insured employers may also lose their status as self-insurers.
Failure to Maintain Coverage
- Failure to maintain workers’ compensation coverage is punishable by a penalty of no less than $500 per employee or $5,000 (whichever is less) up to a maximum of $50,000.
- For employers that continue to violate coverage requirements after previous fines, there is an additional penalty of $100 per day of non-compliance up to $50,000.
- Employers that willfully fail to maintain adequate coverage may be legally prohibited from doing business in the state.
- Employers may face Class D felony charges if they willfully violate coverage requirements. Class D felonies are punishable by one to five years imprisonment, a fine of up to $5,000, or both.
Failure to Report Injuries or Claims
- If employers fail to report an employee’s work-related injury or fail to provide the WCC with a copy of the claim, the WCC may increase the amount of compensation that must be paid to the injured employee.
Undue Delay in Adjusting a Claim or Paying Benefits
- Claims that are unduly delayed could lead to civil penalties of up to $1,000 for each delay, and employers may also be ordered to pay interest and attorney fees for the injured employee.
- Employers must begin paying benefits within 35 days of a claim being filed. Delays could result in penalties of up to $1,000 for each delay, interest on the payment amount, and attorney fees.
- For permanent partial disability benefits, employers must begin paying within 30 days of the date the injured employee reaches maximum medical improvement. Employers that do not make payment in a timely manner may be required to pay 10 percent interest on the amount owed to the employee.
- In cases involving benefits of less than $2,000, employers may be charged with a Class C felony. This is punishable by a fine of up to $10,000 and one to 10 years imprisonment.
- In cases involving benefits of more than $2,000, employers may be charged with a Class B felony punishable by a fine of up to $15,000 and up to 20 years imprisonment.
- Employers may also be held liable for triple the amount of damages caused by misrepresentation or failure to disclose.
How much does Workers’ Compensation Insurance cost in Connecticut?
According to the National Academy of Social Insurance Workers’ Compensation Report (November 2020), the average employer cost for Workers’ Compensation in Connecticut was $1.10 per $100 of covered wages. This figure is estimated across all insurers and all industries, so the cost to your particular business may vary.
How does the Workers’ Compensation claims process work in Connecticut?
Employees should immediately notify their employers of any work-related injuries. Claims must be received within one year from the date of an accident or three years from the date occupational disease symptoms first arise. Employers must notify the WCC of any injuries that result in an employee being unable to work for one day or longer. The notification should be submitted within one week of the report of the injury.
Within 28 days of receiving a claim notice, employers must either begin paying workers’ comp benefits or send a written dispute notice to the WCC and the employee. Employers can dispute claims after beginning payment as long as the dispute is made within one year of the claim notice.
In the case of a dispute, the WCA requires parties to attempt to reach a voluntary resolution before requesting a hearing. If a resolution cannot be reached, employers or employees may request a hearing in the case of a dispute. Commissioners may hold a formal or informal hearing to resolve the dispute. If the hearings do not lead to a voluntary agreement, the WCC will make a decision and award any benefits.
Connecticut Workers’ Compensation Insurance Resources
For more information on Connecticut Workers’ Compensation laws and requirements, please visit the following resources: