Reminder: There Must Be a Timely Response to Workers' Compensation Claims

The workers’ compensation process is usually routine. An employee injured at the workplace receives treatment, which could range from first aid to transport to an emergency room, the employer completes a first report of injury and informs its workers’ compensation insurance carrier, and the insurance company deals with any claim filed by the employee.  But in fact the Workers’ Compensation Act imposes strict requirements for the initial response to a claim, and lapses in the response can result in serious liability for the employer.

A workers’ compensation claim is formally initiated by an employee filing a form known as Form 30C with the Workers’ Compensation Commission.  That filing starts a 28-day period in which an employer (or its insurance carrier) that wishes to challenge whether the injury arose out of and in the course of employment must file a response, known as Form 43, giving notice of an intent to contest liability.  If the Form 43 is not timely filed, the claim is deemed compensable, and any defense to liability will be precluded.

A recent decision by the Connecticut Appellate Court provides examples of the consequences of failing to file a timely Form 43.  The decision involved an employee who filed her Form 30C claiming repetitive trauma injuries, but did not lose any time from work and did not seek medical treatment.  In an earlier case cited by the court, the employee fell and injured his knee following a business call away from his workplace, but similarly did not seek immediate medical attention or miss time from work.

In both cases the employers received the Form 30C’s, but did not file timely Form 43 responses, perhaps because the claims fell outside their normal routine. Consequently, the employers were not able to later contest their liability to provide workers’ compensation benefits.

These two examples provide a further lesson. One of the employers did eventually file a Form 43 using a proper filing method.  Although filed outside the 28-day period for contesting liability, the late filing was within a one-year period which allowed the employer to contest the extent of the employee’s disability; in other words, although the employer (in reality its insurance company) could not dispute whether it had to pay a claim, it could dispute how much it had to pay.

The other employer eventually sent a Form 43 to the Workers’ Compensation Commission, but sent it by fax, rather than using one of the three proper filing methods of personal delivery, registered mail, or certified mail. The Appellate Court ruled that this mistake precluded the employer from contesting either liability or the extent of disability.

The takeaway is that the Workers’ Compensation Act imposes strict compliance requirements on employers, so employers must strictly comply with their own reporting policies to ensure that no deadlines are missed.

This blog/web site presents general information only. The information you obtain at this site is not, nor is it intended to be, legal advice, and you should not consider or rely on it as such. You should consult an attorney for individual advice regarding your own situation. This website is not an offer to represent you. You should not act, or refrain from acting, based upon any information at this website. Neither our presentation of such information nor your receipt of it creates nor will create an attorney-client relationship with any reader of this blog. Any links from another site to the blog are beyond the control of Pullman & Comley, LLC and do not convey their approval, support or any relationship to any site or organization. Any description of a result obtained for a client in the past is not intended to be, and is not, a guarantee or promise the firm can or will achieve a similar outcome.

PDF
Subscribe to Updates

About Our Labor, Employment and Employee Benefits Law Blog

Alerts, commentary, and insights from the attorneys of Pullman & Comley’s Labor, Employment Law and Employee Benefits practice on such workplace topics as labor and employment law, counseling and training, litigation, immigration law and union issues, as well as employee benefits and ERISA matters.

Other Blogs by Pullman & Comley

Connecticut Health Law Blog

Education Law Notes

For What It May Be Worth

Recent Posts

Archives

Jump to Page