Connecticut Report of Occupational Injury or Illness

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US-427EM
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Description

This form is used to document information concerning an injury or illness suffered by an employee on company property.

How to fill out Report Of Occupational Injury Or Illness?

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FAQ

How are occupational diseases identified?Strength of Association. The stronger the association, the more likely that the relationship is causal.Consistency.Specificity of Association.Temporal Relationship.Biological Gradient (Dose-Response Relationship)Plausibility.Coherence.Experimental Evidence.More items...?

Family and Medical Leave Obligations Generally, the FMLA allows employees that are eligible to take leave up to 12 weeks in any 12-month period (Connecticut allows 16 weeks in any 24-month period) for situations that include the serious health condition of the employee.

The State of Connecticut Workers' Compensation Program requires that an employee report a work-related injury or illness to his/her employer immediately. For injuries prohibiting the employee from immediately notifying his/her supervisor, the supervisor, on behalf of the injured employee, can directly report the claim.

Generally, occupational injuries occur instantly and are the result of a single traumatic event that causes physical harm, while occupational illnesses occur over time and are the result of long-term, continuous exposure to a harmful work environment.

An injury or illness is considered by the Occupational Safety and Health Administration to be work-related if an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing condition.

If the employee suffers an accidental injury during the course of their employment, then he or she has a time period of up to one year to file an official claim for workers' compensation.

If the employee suffers an accidental injury during the course of their employment, then he or she has a time period of up to one year to file an official claim for workers' compensation.

The Form 36 is to be completed by the respondent (employer/workers' compensation insurance carrier) to notify the Workers' Compensation Commissioner, the claimant (employee/decedent), and all parties to the claim of its intention to reduce or discontinue payment of the claimant's workers' compensation benefits.

Workers' CompensationFor Assistance: 860-807-6932.DAS Public Safety Fax Number: 1-860-707-1846.Email: DASRfaxWCPS@ct.gov.Medical Claim Contact: 860-256-3409.Denise Miller 860-256-3453.

The general rule is that all injuries and illnesses which result from events or exposures on the employer's premises are presumed to be work related. Furthermore, if it seems likely that an event or exposure in the work environment either caused or contributed to the case, the case is considered work related.

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Connecticut Report of Occupational Injury or Illness