Appealing a Denial of Your Connecticut Workers’ Compensation Claim
Here's how to appeal a workers' comp decision in Connecticut.
If your workers’ comp claim has been denied, or you have a dispute with the insurance company about your benefits, you can request a formal hearing before the Workers’ Compensation Commission. (For an overview of eligibility and benefits, see our article on filing a Connecticut workers’ comp claim.)
If your workers’ comp claim has been denied, you may request an informal conference by filing a Hearing Request with the Workers’ Compensation Commission. On the Hearing Request form, check the box next to “Informal” to specify the type of hearing you are requesting. You’ll also need to show that you, or your attorney, have tried unsuccessfully to settle your dispute with your employer or its insurance company.
Send a copy of the Hearing Request to your employer or its insurer, as well as to the Workers’ Compensation Commission, at the district office that corresponds to the city where you were injured. For a list of the eight district offices, see the Commission’s website.
The informal conference will take place at the district office that covers the city in which you were injured. A Commissioner will preside over the meeting and try to help you and the insurer reach an agreement. The process is very informal and may last only 15 minutes or so.
In most cases, the Commission will end the conference with a recommendation for resolving the dispute. If both parties agree, the decision will become binding. If the parties don’t agree, the Commissioner may schedule another informal hearing, or you may move on to the formal hearing.
Requesting a Formal Hearing
If you’re not able to resolve the dispute at the Informal Hearing, you can request a formal hearing before a workers’ comp Commissioner. To do so, you can use the same Hearing Request form described above, checking the box next to “Formal” instead. You must file the form with the Workers’ Compensation Commission, at the same district office to which you sent your request for an informal hearing. Your employer and its insurer should receive a copy as well.
Once the Commission receives your request, it will schedule an in-person hearing before a workers’ comp Commissioner and send notice to the parties.
Before your formal hearing, there may be a pre-formal hearing before the workers’ comp Commissioner who will be presiding over your hearing. The purpose of this pre-formal hearing is to define the scope of what is going to be covered at the hearing. The Commissioner will ask the parties to describe the issues in dispute and what evidence and testimony will be presented. The parties will be expected to stick to the scope of these issues and not present on matters not discussed at this pre-formal hearing.
The Formal Hearing
The formal hearing is a more formal legal process, during which the parties will present arguments and evidence. Formal hearings can take up to several hours or may require the parties to continue in a second session.
During the hearing, each party will have the opportunity to question witnesses, submit documents, and make legal arguments. A workers’ comp Commissioner will preside over the hearing and mail a written decision to the parties within 120 days. Unless one of the parties appeals this decision, it will be final and binding.
Although workers’ compensation hearings are less formal than court proceedings, there are still procedural rules that must be followed. And, in most cases, your employer will have a lawyer representing its interests. To avoid being at a disadvantage, you should consult with a workers’ compensation attorney to represent you. In most cases, you won’t have to pay for attorneys’ fees out of pocket. Workers’ comp attorneys typically work on a contingency fee basis, which means that they take a percentage of anything recovered on your behalf.
If you disagree with the Commissioner’s decision, you may appeal to the Compensation Review Board. To do so, you must file a Petition for Review with the Board within 20 days. The Board will review the evidence presented at the initial hearing and make a decision. The Board typically will not review any new evidence, unless there is a good reason why it was not presented at the hearing.
If you’re not satisfied with the Board’s decision, you may file an appeal with the a Connecticut Appellate Court.
Hiring an Attorney
To find an experienced workers’ compensation attorney in your area, see our online lawyer directory.