Free Workers Compensation Insurance Study Guide
Connecticut Property & Casualty exam — Workers Compensation Insurance.
The national guide explains the workers' compensation bargain and the standard policy: Part One pays statutory benefits, Part Two is employers liability, and premium is based on payroll by class and the experience mod. Connecticut's Workers' Compensation Act is Chapter 568 of the General Statutes (31-275 and following). Claims are administered by the Workers' Compensation Commission, not the Insurance Department.
Administration and coverage
- The Workers' Compensation Commission and its administrative law judges administer claims (31-275).
- The Insurance Department regulates the insurers. Workers' comp rate filings have a 30-day waiting period, which the Commissioner may extend by up to 30 more days (38a-676(b)).
- Employer: anyone using the services of one or more employees for pay (31-275(10)).
- Securing coverage: employers insure their full liability or prove the solvency to self-insure (31-284(b)).
- Exclusive remedy: an employee receives statutory benefits instead of suing the employer in tort. If the employer fails to insure, the employee may sue the employer for damages (31-284).
- Employers post a notice of the availability of compensation in at least 10-point bold type (31-284(f)).
- Who is not an employee:
- People working in or around a private home who aren't regularly employed there more than 26 hours a week (31-275(9)(B)(iv)).
- Corporate officers who elect out by written notice to the employer and the administrative law judge.
- Partners and sole proprietors:
- Partners are deemed covered unless every partner signs an agreement to elect out.
- Sole proprietors may elect in by notifying the chairperson in writing.
What is compensable
- Injuries arising out of and in the course of employment, including occupational disease.
- Not compensable:
- injuries from voluntary social or recreational activities, such as company picnics or athletic events
- mental or emotional impairment caused by a personnel action such as a transfer, demotion or termination
- No compensation is paid when the injury was caused by the employee's willful and serious misconduct or intoxication (31-284(a)).
Benefits
| Benefit | Connecticut rule |
|---|---|
| Waiting period | Nothing for incapacity of 3 days or less. If incapacity lasts 7 days, benefits are paid from the date of injury. The employer pays full wages for the day of injury (31-295) |
| Total incapacity | 75% of average weekly earnings after federal and state income tax and FICA, up to the maximum rate (31-307) |
| Maximum weekly rate | 100% of the statewide average weekly earnings, rounded up to the next even dollar (31-309) |
| Minimum | 20% of the maximum rate, but not more than 75% of the employee's own average wage (31-307) |
| Safety violation | If a cited, unabated OSHA violation caused the injury, the benefit is 100% of average weekly earnings (31-307(b)) |
| Partial incapacity | Paid during the partial incapacity, up to 520 weeks (31-308(a)) |
| Specific losses | A statutory schedule. For example, 168 weeks for the master hand at or above the wrist and 208 weeks for the master arm (31-308(b)) |
| Medical | Reasonable medical, surgical, hospital and prescription care from a competent provider (31-294d) |
| Burial | $12,000 for deaths on or after June 23, 2021, adjusted annually for inflation (31-306) |
| Surviving spouse | Paid until death or remarriage when the spouse is the sole dependent (31-306) |
Deadlines
- Notice of claim: written notice within one year of the accident, or three years from the first symptom of an occupational disease (31-294c(a)).
- Contesting a claim: an employer that neither contests nor starts paying by the 28th day is conclusively presumed to have accepted the claim (31-294c(b)).
- Late injury report: the administrative law judge may reduce the award only to the extent the employer proves it was harmed by the delay (31-294b).
Second Injury Fund
- The Second Injury Fund pays an award when the employer and its insurer fail or are unable to pay (31-355).
- Transfers of old claims to the Fund were limited to injuries before July 1, 1995 (31-349h).
Exam traps
- Benefits are 75% of after-tax earnings, not 66 2/3% of gross.
- Benefits are paid back to day one once incapacity lasts 7 days. The minimum waiting period is 3 days.
- Notice of claim is due within 1 year for injuries and 3 years for occupational disease. The employer must contest by day 28.
- The Commission runs claims. The Insurance Department regulates insurers and rates.
Practice Workers Compensation Insurance questions All Property & Casualty topics
Practice questions are study aids generated for exam preparation and are not actual exam questions. Content is provided for educational purposes and is not legal advice. Verify current statutes, rules, and exam specifications with the Insurance Department and the exam administrator before relying on it.
