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When You File A Connecticut Workers’ Compensation Claim You MUST Receive This Form

If you are injured on the job for more than 3 days and you file a Connecticut workers’ compensation claim statute requires that the insurance company issue you a voluntary agreement (VA). The only case in which the insurance company is not required to issue this agreement is if they are denying your claim.

If there is no denial of the claim you are required by law to receive a voluntary agreement which will need to be signed by all parties involved. This form must also be approved by the Workers’ Compensation Commissioner. The insurance company must issue this agreement which is a statement of acceptance of responsibility of the claim. 

The law requires that you receive the VA within a month of your disability and if you do not receive the agreement from the insurance company in that window you should contact them as it is their responsibility to produce it for you. It is also your right to have this for your records.

If you are on the lookout for this form after you’ve filed your claim you should be looking for the official Connecticut form that is green. 

There are requirements that insurance companies must follow when assessing and agreeing to terms of a Connecticut workers’ compensation claim. It is the responsibility of the insurance company and their legal obligation to provide you with this information. If you need a board certified attorney to review your claim, reach out to our office and one of our attorneys will do that.