reglab/statecodes huggingface dataset:
Connecticut Administrative Code › Title 31 - Labor › 273 - Collection of Overpayments of Unemployment Compensation Benefits › Section 31-273-4 - Waiver

Current through July 10, 2024
(a) The Administrator shall determine that
			 repayment or recoupment of any benefits found to be overpaid pursuant to
			 Section
			 31-273-2
			 of the Regulations of Connecticut State Agencies would defeat the purpose of
			 the benefits or would be against equity and good conscience and shall be waived
			 only if the individual did not receive such benefits by reason of fraud, wilful
			 misrepresentation or wilful nondisclosure by the individual or through the
			 agency of another of a material fact, and one of the following conditions
			 exists:
(1) it has been established by
			 evidence or statements, that the individual's prospects for securing full-time
			 employment are severely limited as a result of physical or mental disability,
			 poor health or any other circumstances which would be detrimental to the
			 individual's employability; or
(2)
			 the benefits were overpaid to the individual as a result of retrospective
			 application of a legislative change; or
(3) the benefits were overpaid as a direct
			 result of gross administrative error; or
(4) the benefits were overpaid as the result
			 of a decision by an Appeals Referee, the Employment Security Board of Review or
			 any court of law reversing a prior decision, and adequate notice was not given
			 to the individual that the individual would be required to repay benefits in
			 the event of any reversal upon appeal; or
(5) it has been established by evidence or
			 statements, that the individual substantially, detrimentally and irreversibly
			 changed such individual's position in reliance upon the receipt of unemployment
			 compensation by foregoing receipt of any public welfare benefits for which the
			 individual would have been entitled but for the receipt of such unemployment
			 compensation; or
(6) the
			 individual-
(A) has been overpaid benefits in
			 an amount equal to or greater than two times the individual's weekly benefit
			 amount at the time the overpayment was made; and
(B) the individual's annualized family
			 income, as determined under subsection (c) of this section, does not exceed one
			 hundred and fifty percent of the poverty level, most recently published in the
			 Federal Register by the United States Department of Commerce, Census Bureau,
			 which corresponds to the size of the individual's family unit; or
(7) the individual is deceased;
			 or
(8) the benefits were overpaid
			 as a direct result of an employer's failure to respond timely or adequately to
			 a request of the Administrator for information relating to the individual's
			 claim for unemployment compensation benefits in a manner prescribed by the
			 Administrator.
Connecticut Administrative Code › Title 31 - Labor › 273 - Collection of Overpayments of Unemployment Compensation Benefits › Section 31-273-6 - Administrative penalty for overpayments established prior to October 1, 2013

Current through July 10, 2024
(a) Whenever the Administrator determines,
			 prior to October 1, 2013, pursuant to Section
			 31-273-5(e)
			 of the Regulations of Connecticut State Agencies, that any individual has
			 himself or herself or through the agency of another made a claim for benefits
			 and knowingly made a false statement or representation or knowingly failed to
			 disclose a material fact in order to obtain benefits or to increase the amount
			 of benefits to which such individual may be entitled, such individual shall
			 forfeit benefits for not less than one nor more than thirty-nine compensable
			 weeks following determination of such offense or offenses, during which weeks
			 the individual would otherwise have been eligible to receive benefits. For the
			 purposes of Section
			 31-231b
			 of the Connecticut General Statutes, such person shall be deemed to have
			 received benefits for such forfeited weeks.
(b) Except as provided in subsections (d) and
			 (e) of this section, the number of weeks of benefits to be forfeited shall be
			 the lesser of:
(1) the number of weeks of
			 benefits fraudulently claimed multiplied by one, up to a maximum of
			 thirty-nine; or
(2) that number of
			 weeks which corresponds to the total dollar amount fraudulently claimed on the
			 Administrative Penalty Table in subsection (c) of this section.
Connecticut Administrative Code › Title 31 - Labor › 273 - Collection of Overpayments of Unemployment Compensation Benefits › Section 31-273-6a - Administrative penalty for overpayments established on or after October 1, 2013

Current through July 10, 2024
(a) For any
			 determination of an overpayment made on or after October 1, 2013, whenever the
			 Administrator determines, pursuant to Section
			 31-273-5(e)
			 of the Regulations of Connecticut State Agencies, that any individual has,
			 himself or herself or through the agency of another, made a claim for benefits
			 and knowingly made a false statement or representation or knowingly failed to
			 disclose a material fact in order to obtain benefits or to increase the amount
			 of benefits to which the individual may be entitled, such individual shall be
			 subject to a penalty of fifty (50) percent of the amount of overpayment for the
			 first offense and a penalty of one hundred (100) percent of the amount of
			 overpayment if any subsequent offense, regardless of whether the overpayment
			 was established prior to October 1, 2013 or on or subsequent to October 1,
			 2013. This penalty shall be in addition to the liability to repay the full
			 amount of overpayment and shall not be confined to a single benefit year. The
			 penalty amounts computed in this subsection shall be rounded to the nearest
			 dollar with fractions of a dollar of exactly fifty cents rounded
			 upward.
(b) The Administrator shall
			 not consider any restitution by the individual of benefits overpaid in
			 determining the amount of the penalty to be imposed pursuant to this
			 section.
(c) Any penalty imposed
			 pursuant to this section shall remain in full force and effect until such time
			 as said penalty has been satisfied in full, as determined by the
			 Administrator.
(d) For the purposes
			 of this section, an offense is a single week or a series of weeks within a
			 given time period with respect to which the Administrator has established that
			 an individual has made a claim for benefits and has, himself or herself or
			 through the agency of another, made a false statement or representation or has
			 knowingly failed to disclose a material fact for the purpose of obtaining
			 benefits or increasing the amount of benefits to which such individual may be
			 entitled.
Connecticut Administrative Code › Title 31 - Labor › 273 - Collection of Overpayments of Unemployment Compensation Benefits › Section 31-273-7 - Fraud overpayment recovery

Current through July 10, 2024
(a) Where the
			 Administrator determines that an individual has been overpaid as the result of
			 fraud, wilful misrepresentation or wilful nondisclosure by himself or herself
			 or through the agency of another of a material fact, pursuant to Section
			 31-273-5(e)
			 of the Regulations of Connecticut State Agencies, any resultant determination
			 that the individual is liable for repayment, recoupment by one hundred percent
			 offset from benefits, or any administrative penalty imposed pursuant to
			 sections
			 31-273-6
			 and
			 31-273-6a
			 of the Regulations of Connecticut State Agencies shall be effective upon
			 issuance.
(b) At any time where the
			 Administrator makes a determination of overpayment pursuant to subsection (a)
			 of this section, the Administrator may request the Commissioner of
			 Administrative Services to intercept the individual's State Income Tax refund,
			 if any, pursuant to section
			 12-742
			 of the Connecticut General Statutes.
(c)
(1)
			 Notwithstanding the provisions of subsections (a) and (b) of this section,
			 where the offset of an overpayment made on or after October 1, 1995 is
			 insufficient to recoup the full amount of the overpayment, the Administrator
			 shall establish a repayment schedule for the remaining amount. At the
			 discretion of the Administrator, the repayment schedule may be modified or
			 suspended as conditions warrant.
(2) For any determination of an overpayment
			 made on or after July 1, 2005, the repayment schedule shall impose interest at
			 a rate of one percent of the amount overpaid per month.
Connecticut Administrative Code › Title 31 - Labor › 273 - Collection of Overpayments of Unemployment Compensation Benefits › Section 31-273-8 - Fact-finding process

Current through July 10, 2024
(a) In any
			 fact-finding process conducted pursuant to Section
			 31-273-2
			 or Section
			 31-273-5
			 of the Regulations of Connecticut State Agencies, each party shall be afforded,
			 subject to the Administrator' s control:
(1)
			 The right to be represented by any person, including an attorney;
(2) The right to inspect or copy any
			 documents in the Administrator's file which are material to the subject matter
			 of the fact-finding and not exempt from disclosure by law;
(3) The right to present evidence, documents
			 and witness statements; and
(4) If
			 a hearing is deemed necessary by the Administrator or the Administrator's
			 representative for purposes of the fact-finding, the right to cross-examine
			 witnesses and parties, so long as the Administrator deems such
			 cross-examination to be material and relevant.
Connecticut Administrative Code › Title 31 - Labor › 273 - Collection of Overpayments of Unemployment Compensation Benefits › Section 31-273-9 - Employer fraud: contested case hearing

Current through July 10, 2024
(a) If, after
			 investigation, the Administrator determines that there is probable cause to
			 believe that a person, firm or corporation has wilfully failed to declare
			 payment of wages in a payroll record, pursuant to section
			 31-273(d)
			 of the Connecticut General Statutes, the Administrator shall provide an
			 opportunity for hearing.
(b)
(1) If the person, firm or corporation
			 requests a hearing, it shall be conducted pursuant to the rules of procedure
			 for hearings in contested cases to be conducted by the Labor Commissioner as
			 provided in Sections
			 31-1-1
			 through
			 31-1-9,
			 inclusive, of the Regulations of Connecticut State Agencies.
(2) Notice of the time, place, reason for
			 such hearing and right of representation shall be provided to the person, firm
			 or corporation requesting the hearing.
Connecticut Administrative Code › Title 31 - Labor › 275 - Preliminary Acts in Preparation for Work and Employee's Place of Abode › Section 31-275-1 - Definitions

Current through July 10, 2024
As used in subdivision (1) of section
				31-275 of
				the general statutes:
(1) "A
			 Preliminary Act" and "Acts In Preparation For Work" mean acts performed prior
			 to the start of the employee's work day, and include, but are not limited to,
			 the following acts, except when undertaken at the express direction or request
			 of the employer:
(a) Personal
			 activities;
(b) Household
			 chores;
(c) Personal grooming or
			 hygiene, such as showering, dressing, brushing teeth, ironing clothes, drying
			 and combing hair, applying makeup, and shaving;
(d) Preparing meals, including a lunch or
			 snack to take to work;
(e) Removal
			 of obstacles from one's walkway, driveway or yard, including but not limited to
			 snow, ice, trash cans, recycling containers, or stones, in order to facilitate
			 entry from one's residence onto a public thoroughfare, unless said removal is
			 necessary to accommodate work required by the employer; and
(f) any other acts necessary in order to
			 prepare oneself for work.
Connecticut Administrative Code › Title 31 - Labor › 275 - Preliminary Acts in Preparation for Work and Employee's Place of Abode › Section 31-275-2 - Definitions applicable to Department of Correction employees as required by section 31-275(1)(G) of the Connecticut General Statutes

Current through July 10, 2024
As used in subparagraph (A)(ii) of subdivision (1) of section
				31-275 of
				the Connecticut General Statutes:
(a)
			 "Departure from place of abode directly to duty" means the direct trip to the
			 employee's place of employment that occurs following the receipt of a direct
			 order informing an employee that he or she is required to report directly to
			 work, regardless of whether the employee is physically at his or her place of
			 residence at the time the communication is received. For employees who receive
			 an order to work a previously unscheduled shift, an employee's trip directly to
			 duty includes any detours immediately essential to the employee's ability to
			 report.
(b) "Direct order" means
			 any communication that informs an employee that he or she must report to work
			 under circumstances in which nonessential employees are excused from
			 working.
(c) "Return directly to
			 place of abode after duty" means the direct trip to the employee's abode
			 following his or her work shift, including any immediately essential detour
			 necessitated by a call to work.
(d)
			 "Two or more mandatory overtime work shifts" means a situation in which an
			 employee is required to work a regular shift and an additional full shift on
			 consecutive days (approximately a 16-hour shift each day), or situations in
			 which an employee is required to work a regular shift and two consecutive full
			 overtime shifts (approximately one 24-hour shift).
Connecticut Administrative Code › Title 31 - Labor › 279 - Assignment and Postponement of Hearings and the Authority of Claims Personnel › Section 31-279-1 - Claims administration

Current through July 10, 2024
(a) As a condition
			 of procuring a certificate of self-insurance or a license to write workers'
			 compensation insurance, each self-insurer or carrier shall maintain a staff of
			 claims adjusters or attorneys of sufficient size to attend hearings in the
			 various districts at times convenient to the injured employee and the
			 compensation commissioner.
(b) The
			 employer, and his service company where applicable, shall complete a
			 certification of servicing for self-insurers form and file it with the chairman
			 or his designee.
(c) The chairman
			 or his designee shall be notified immediately of any change of third party
			 administrator.
(d) The claims
			 administrator shall notify the chairman or his designee in writing within
			 fourteen (14) days of a self-insured employer's failure to provide adequate
			 funding for timely payment of benefits.
Connecticut Administrative Code › Title 31 - Labor › 279 - Assignment and Postponement of Hearings and the Authority of Claims Personnel › Section 31-279-3 - Request for continuance

Current through July 10, 2024
Except in cases of unforeseeable emergency, requests for
				continuances shall be made in time to provide adequate notice to all parties,
				and should normally not be made ex parte, but only after communication with
				other parties to the claim.
Connecticut Administrative Code › Title 31 - Labor › 279 - Assignment and Postponement of Hearings and the Authority of Claims Personnel › Section 31-279-4 - Basis for decision

Current through July 10, 2024
Unless prior approval for cause is secured from the
				commissioner, a claim assigned for a formal hearing shall be decided on the
				basis of the evidence adduced by the parties at the time and place designated.
				No party can assume the granting of a continuance to produce witnesses at a
				later date, or for any other reason not regularly recognized in a judicial
				proceeding.
Connecticut Administrative Code › Title 31 - Labor › 279 - Assignment and Postponement of Hearings and the Authority of Claims Personnel › Section 31-279-5 - Voluntary agreements and stipulations

Current through July 10, 2024
Representatives of carriers and self-insurers who appear at
				informal and formal hearings shall be authorized by their principals to enter
				into voluntary agreements and stipulations, at least up to a minimum amount,
				and an agent with full authority for each principal shall be reasonably
				accessible by telephone at the time of hearing.
Connecticut Administrative Code › Title 31 - Labor › 279 - Assignment and Postponement of Hearings and the Authority of Claims Personnel › Section 31-279-6 - Assignment of hearings

Current through July 10, 2024
An assignment should normally be requested of a compensation
				commissioner only when prior consultations between the parties have failed to
				achieve an agreement which can be reduced to writing. It shall therefore be
				considered an impropriety for a hearing to be requested by an employer or
				carrier with no prior discussions between the claimant and the
				respondent.
Connecticut Administrative Code › Title 31 - Labor › 279 - Assignment and Postponement of Hearings and the Authority of Claims Personnel › List of Approved Physicians and Fees for Professional Services › Section 31-279-8 - Fees for professional services

Current through July 10, 2024
Until such time as the board of compensation commissioners
				  shall establish fees for professional services as authorized by section
				  31-279,
				  the pecuniary liability of the employer for medical and surgical services
				  rendered injured employees shall continue to be measured by the standard set
				  out in section
				  31-294;
				  namely a limitation to such charges as prevail in the same community or similar
				  communities for similar treatment of injured persons of a like standard of
				  living when such treatment is paid for by the injured
				  persons.
Connecticut Administrative Code › Title 31 - Labor › 279 - Assignment and Postponement of Hearings and the Authority of Claims Personnel › List of Approved Physicians and Fees for Professional Services › Section 31-279-9 - Obligations of attending physician

Current through July 10, 2024
Persons who supply professional services to injured employees
				  entitled to medical care by virtue of chapter 568 of the general statutes shall
				  be presumed to agree to the following conditions:
(a) The employer or its insurance carrier
				will receive an early original report of injury, and such regular subsequent
				progress reports from the attending physician as may be reasonably required in
				each case.
(b) No fee will be
				charged by the attending physician for the completion of any of the forms
				approved by the board of compensation commissioners or for routine progress
				reports submitted to the employer or carrier. Where detailed reports are
				requested or indicated, requiring a significant expenditure of time by the
				attending physician, a reasonable additional charge for such time will be
				appropriate.
(c) It shall be the
				duty of the attending physician, without specific request, to keep the employer
				or insurance carrier advised of any significant development in the course of
				his treatment, such as the attainment of maximum medical improvement, a
				hospital, admission, a surgical procedure, a failure to accept indicated
				treatment or to keep scheduled appointments, or an ability to return to gainful
				employment.
(d) Upon reasonable
				notice, an attending physician will make himself available as a witness in
				hearings before a compensation commissioner, for which appearance he will be
				entitled to be paid a reasonable fee by the party requesting his attendance,
				subject to the pertinent provisions of law.
(e) All charges for medical, surgical,
				hospital and nursing services, except those for expert testimony, shall be
				solely the responsibility of the employer or carrier, and no claim will be made
				against the injured employee for all or part of a fee.
(f) It will be considered professionally
				reprehensible for a physician to refuse to send out his patient's medical
				report to a party properly entitled because his medical bill for services
				rendered has not been paid up to that time.
(g) Violation of these regulations shall
				constitute sufficient cause for a removal from the approved list of physicians
				maintained by the board of compensation commissioners.
Connecticut Administrative Code › Title 31 - Labor › 279 - Assignment and Postponement of Hearings and the Authority of Claims Personnel › List of Approved Physicians and Fees for Professional Services › Section 31-279-10 - Medical care plans

Current through July 10, 2024
(a) All medical
				care plans submitted pursuant to Section
				31-279
				of the Connecticut General Statutes by any employer or, on behalf of one or
				more employers, by any insurer, mutual employer association, self-insurance
				service organization or other sponsoring organization to arrange for the
				provision of medical and health care services, including medical and surgical
				aid or hospital and nursing service and medical rehabilitation services, shall
				include the following in addition to the information required by said section:
(1) The identity of any company or
				organization which will participate in the operation of the medical care plan,
				a description of such participation and, where applicable, the following:
(A) a certificate from the Secretary of the
				State and/or the Insurance Commissioner regarding the company or organization's
				good standing to do business in the State of Connecticut;
(B) a copy of the company or organization's
				balance sheet at the end of its most recently concluded fiscal year, along with
				the name and address of any public accounting firm or internal accountant which
				prepared or assisted in the preparation of such balance sheet;
(C) a list of the names, business addresses
				and official positions of members of the company or organization's board of
				directors or other policymaking body and of those executive officers who are
				responsible for the company or organization's activities with respect to the
				medical care plan;
(D) a list of
				the company or organization's principal owners;
(E) in the case of an out-of-state company or
				organization, a certificate that such company or organization is in good
				standing in its state of organization;
(F) the identity, address and current
				relationship of any related or predecessor company or organization; "related"
				for this purpose means that a substantial number of the board or policymaking
				body members, executive officers or principal owners of both companies are the
				same; and
(G) in the case of a
				Connecticut or out-of-state company or organization, a report of the details of
				any suspension, sanction or other disciplinary action relating to such company
				or organization in this state or in any other state.
Connecticut Administrative Code › Title 31 - Labor › 279(b) - Availability of Workmen's Compensation › Section 31-279(b)-1 - Statutory notice to employees

Current through July 10, 2024
The notice to employees required by Public Act 75-223 shall be
				substantially in the following form:
STATE OF CONNECTICUT
NOTICE TO EMPLOYEES
WORKMEN'S COMPENSATION ACT
Click here to view
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Connecticut Administrative Code › Title 31 - Labor › 279(b) - Availability of Workmen's Compensation › Section 31-279(b)-4 - Policy revisions

Current through July 10, 2024
The information in such notice shall be kept current by each
				employer to whom a certificate of solvency has been issued, and shall be
				revised by each insured employer each time a new policy of workmen's
				compensation insurance is issued to it.
Connecticut Administrative Code › Title 31 - Labor › 280 - Approved Physicians and Other Practitioners › Section 31-280-1 - List of approved physicians, surgeons, podiatrists, optometrists and dentists; standards for approval and removal from the list

Current through July 10, 2024
(a) The list of approved practicing
			 physicians, surgeons, podiatrists, optometrists and dentists from which an
			 injured employee shall choose for examination and treatment under the
			 provisions of Chapter 568, including but not limited to specialists, shall
			 include all such practitioners who hold a current and valid license in their
			 field in the State of Connecticut and who meet the following standards:
(1) continuation of a current and valid
			 license in the State without revocation, suspension or limitation of such
			 license in any way;
(2) possession
			 of a valid federal Drug Enforcement Administration registration certificate in
			 the case of practitioners whose license permits them to prescribe controlled
			 drugs;
(3) compliance with the
			 Medicare anti-kickback regulations promulgated by the United States Department
			 of Health and Human Services;
(4)
			 possession of admitting/active staff privileges at a general hospital
			 accredited by the Joint Commission on Accreditation of Hospitals, if such
			 privileges are required in order to provide satisfactory professional services
			 within the practitioner's area of practice;
(5) compliance with the administrative
			 obligations of attending physicians and other practitioners under Section
			 31-279-9
			 of the Regulations of Connecticut State Agencies;
(6) forbearance from requiring in advance a
			 payment for providing an opinion or report, either written or oral, or for
			 presenting testimony as a witness at a hearing or a deposition;
(7) completion of a course of training,
			 approved by the Chairman, which course shall include a session describing the
			 general responsibilities and obligations of physicians under the provisions of
			 Connecticut General Statutes Chapter 568, along with training in the
			 recognition and reporting of certain occupational and other diseases under
			 sections
			 31-40a
			 and
			 19a-110
			 of the Connecticut General Statutes; and
(8) forbearance from referring workers'
			 compensation patients for physical therapy or diagnostic testing to a facility
			 in which such practitioner has an ownership or investment interest other than
			 ownership of investment securities purchased by the practitioner on terms
			 available to the general public and which are publicly traded.
Connecticut Administrative Code › Title 31 - Labor › 280 - Approved Physicians and Other Practitioners › Practitioner Fee Schedule › Section 31-280-2 - Practitioner fee schedule

Current through July 10, 2024
(a)
				Definitions
(b) Practitioner Fee
				Schedule
(c) Medical Advisory
				Board
(d) Practitioner Billing and
				Payment Guidelines
(e) Dispute
				Resolution
Connecticut Administrative Code › Title 31 - Labor › 280 - Approved Physicians and Other Practitioners › Practitioner Fee Schedule › Section 31-280-3 - Practitioner fee schedule

Current through July 10, 2024
(a)
Definitions
For purposes of section 31-280-3 governing practitioner fee
				  schedule, the following definitions apply:
(1) "Chairman" means the Chairman of the
				Workers' Compensation Commission.
(2) "CPT Code" means the descriptive terms
				and identifying codes used in reporting services and procedures performed by
				Practitioners as listed in the American Medical Association's Physician's
				Current Procedural Terminology (CPT).
(3) "Dispute Resolution Panels" means the
				three-member panels appointed by the Chairman pursuant to subsection (e) (2) of
				these regulations to consider and resolve disputes regarding CPT Code
				assignment or other claims and payment issues.
(4) "Employer" means any employer subject to
				the requirements of the Workers' Compensation system as further defined in
				Conn. Gen. Stat. 31-275 (10).
(5)
				"Annual Increase" means the annual percentage increase in the consumer price
				index for all urban workers which according to Public Act 93-228 shall be
				applied to the Practitioner Fee Schedule as a limit on the annual growth in
				total medical fees.
(6) "Payor"
				means any person, corporation, firm, partnership, other entity, or the State of
				Connecticut and any public corporation within the State that, based on
				statutory obligation or contract, makes payment to Practitioners for services
				provided to employees under the Workers' Compensation system, including but not
				limited to insurance companies, self-insured employers, and mutual insurance
				associations or trusts.
(7)
				"Practitioner" means any health care practitioner authorized by the Workers'
				Compensation Commission to provide services to eligible employees under the
				Workers' Compensation Act.
(8)
				"Practitioner Billing and Payment Guidelines" means the manual prepared and
				published by the Chairman in accordance with Public Act 93-228 to set
				guidelines for the billing, claims payment review, and payment process for
				Practitioners, Payors and Reviewers.
(9) "Practitioner Fee Schedule" means the
				schedule of payments to Practitioners which is established, published, and
				updated annually by the Chairman in accordance with these
				regulations.
(10) "Reviewer" means
				any person, corporation, firm, partnership or other entity, which may be a
				Payor or a third-party entity acting on behalf of a Payor, that reviews,
				examines, evaluates or makes recommendations for payment of any bills, claims
				or fees submitted by a Practitioner to a Payor under the Workers' Compensation
				system. The term "Reviewer" shall not apply to individual employees of a
				Reviewer company providing claims payment review services.
Connecticut Administrative Code › Title 31 - Labor › 283a - Structure and Operation of Workers' Rehabilitation Programs › Section 31-283a-1 - Definitions

Current through July 10, 2024
As used in sections 31-283a-1 through
				31-283a-6,
				inclusive:
(1) "Chairman" means the
			 Chairman of the Connecticut Workers' Compensation Commission, selected by the
			 Governor pursuant to Section
			 31-276,
			 whose powers are enumerated in Sec
			 31-280(b);
			 or his designee.
(2) "Commissioner"
			 means one of the sixteen (16) Workers' Compensation Commissioners as defined in
			 Section
			 31-275(3).
(3) "Rehabilitation Programs" means the
			 following vocational rehabilitation services provided by the Workers'
			 Compensation Commission, with available supporting benefits, to employees who
			 have suffered disabling injuries within the provisions of the Connecticut
			 Workers' Compensation Act:
(A)
			 Outreach
(B) Testing and
			 evaluation
(C) Counseling
(D) Training
(E) Job placement
(F) Post-placement follow-up
Connecticut Administrative Code › Title 31 - Labor › 283a - Structure and Operation of Workers' Rehabilitation Programs › Section 31-283a-2 - Vocational rehabilitation benefit eligibility

Current through July 10, 2024
As provided in Section
				31-283a
				of the general statutes, a disabled employee may be eligible for vocational
				rehabilitation benefits, provided the Chairman or his designee finds
				that:
(1) The employee, employer,
			 insurance carrier, physician, Commissioner, or other interested party has
			 requested vocational rehabilitation services by completing and filing an
			 application signed by the applicant for vocational rehabilitation benefits with
			 the Chairman or his designee.
(2)
			 There exists a permanent impairment which substantially disables the employee
			 for a significant period of time from performing the worker's most recent or
			 customary type of work and that such permanent impairment is a direct result of
			 an injury found to be compensable under Chapter 568 of the general statutes by
			 a Commissioner, a voluntary agreement, an award; or in lieu of those, a
			 stipulation approved by a Commissioner.
Connecticut Administrative Code › Title 31 - Labor › 283a - Structure and Operation of Workers' Rehabilitation Programs › Section 31-283a-3 - Vocational rehabilitation programs and benefits provided to eligible employees

Current through July 10, 2024
(a)
Vocational evaluation.
Each employee may be evaluated to determine
			 the need and/or type of rehabilitation services which may be provided. This
			 evaluation may include a summary of physical, psychological, intellectual
			 capabilities and limitations, a work accommodation analysis, work history,
			 education, inventories of transferable skills and vocational interests, and all
			 other data pertinent to the individual's vocational capabilities.
(b)
Employment capabilities
			 determination.
Following vocational evaluation, the Chairman or his
			 designee shall determine whether:
(1) The
			 employee has the capacity to return to his or her customary or most recent
			 work. In this case all services will be terminated.
(2) The employee has the capacity to return
			 to his or her customary or most recent work provided job modifications are
			 effected. In this case the Commission will assist the employee in obtaining
			 suitably modified employment.
(3)
			 The employee possesses adequate vocational skills to obtain other employment.
			 In this case the Commission will assist the employee in obtaining suitable
			 employment.
(4) The employee's
			 current medically documented residual capacities and vocational status is so
			 unstable or unclear that no meaningful rehabilitation effort is practicable. In
			 this case the Chairman or his designee will defer further determination until a
			 change in circumstances warrants reconsideration.
(5) The employee's medically documented
			 residual capacities present a reasonable expectation of successful completion
			 of a program of vocational rehabilitation including but not limited to
			 reemployment by the same employer in a different capacity, on-the-job training,
			 or vocational education for a new occupation. In this case the Chairman or his
			 designee will provide an appropriate program.
(6) The employee lacks sufficient
			 transferable skills to function adequately within the labor market to which the
			 employee is most likely to be exposed. In this case the Chairman or his
			 designee will provide an appropriate program.
(7) Accommodation of the employee's
			 vocational goals would not require modification of the policies, practices and
			 procedures of the rehabilitation program such that it would cause a fundamental
			 alteration of the nature of the services offered thereunder.
Connecticut Administrative Code › Title 31 - Labor › 283a - Structure and Operation of Workers' Rehabilitation Programs › Section 31-283a-4 - Rehabilitation allowance payments

Current through July 10, 2024
(a)
Eligibility.
The Chairman or his designee may provide to each
			 person for whom a vocational rehabilitation plan has been approved, timely
			 allowances for basic living expenses of the employee while engaged in a
			 full-time vocational training program under the rehabilitation program's
			 sponsorship, provided:
(1) The employee is
			 not receiving or eligible to receive any benefits provided by Chapter 568 of
			 the general statutes, is not receiving or eligible to receive other benefits
			 such as, but not limited to, unemployment compensation or social security
			 disability benefits.
(2) The
			 employee is engaged in a training program described by a vocational
			 rehabilitation plan requiring the trainee to be present at the place of
			 instruction at least 25 scheduled hours, or at a college level program
			 consisting of a course load of no less than 12 credit hours required and earned
			 per semester, or no less than six credit hours required and earned during the
			 summer.
(3) The trainee is adhering
			 to the specific terms of the plan and trainee manual and is providing timely
			 and accurate information as to training progress, performance, and attendance,
			 as required by the Chairman or his designee.
Connecticut Administrative Code › Title 31 - Labor › 283a - Structure and Operation of Workers' Rehabilitation Programs › Section 31-283a-5 - Discontinuance of benefits

Current through July 10, 2024
(a)
Maintenance of benefits.
The trainee shall complete each approved
			 vocational rehabilitation plan unless the Chairman or his designee shall find
			 one or more of the following conditions to exist:
(1) Absences from training exceed ten percent
			 (10%) of the scheduled instruction time for a period; being one semester or one
			 module (a single course or unit of instruction as defined by the training
			 school's course description).
(2)
			 Performance is determined to be substandard, as evidenced by a grade report,
			 transcript, or training progress report form received from the training
			 provider.
(3) The Commission is
			 informed by written statement from the training provider that the trainee's
			 conduct at the training site fails to meet minimum standards as established by
			 the training site's written policy.
(4) Trainee has willfully submitted false
			 claims, reports or statements to the Workers' Compensation
			 Commission.
(5) Any combination of
			 the preceding conditions as a result of which the program no longer offers a
			 reasonable expectation of successful conclusion.
Connecticut Administrative Code › Title 31 - Labor › 283a - Structure and Operation of Workers' Rehabilitation Programs › Section 31-283a-6 - Contested vocational rehabilitation cases. Appeal process

Current through July 10, 2024
(a)
Notice of appeal.
Any person
			 having made application for vocational rehabilitation benefits and aggrieved by
			 action of the Workers' Compensation Commission in withholding or providing
			 benefits, and having been unable to effect resolution through informal
			 discussion, shall be afforded an opportunity for hearing upon submission of a
			 written notice of appeal to the Chairman or his designee. This notice shall
			 include but not necessarily be limited to the following:
(1) The specific nature of the
			 grievance;
(2) The remedy
			 sought;
(3) Acceptable alternative
			 remedies, if any.
Connecticut Administrative Code › Title 31 - Labor › 284 - Self-Insurance Certification › Section 31-284-1 - Definitions

Current through July 10, 2024
As used in Sections 31-284-1 through
				31-284-20,
				inclusive:
(1) "Act" means the State
			 of Connecticut Workers' Compensation Act, Chapter 568, as amended; Sections
			 37-3a,
			 38a-470,
			 51-85,
			 52-149a,
			 and
			 52-174;
			 and Administrative Regulations 31-40v-1 through 31-40v-11, 31-279-1 through
			 31-279-10, and 31-280-1 through 31-280-3.
(2) "Commission" means the State of
			 Connecticut Workers' Compensation Commission.
(3) "Chairman or his designee" means the
			 governor-appointed chairperson of the State of Connecticut Workers'
			 Compensation Commission pursuant to Section
			 31-276
			 whose powers are enumerated in Sec
			 31-280,
			 or his designee.
(4) "Liabilities"
			 means the amount of compensation for medical and indemnity benefits and related
			 expenses incurred.
(5) "Outstanding
			 Liabilities" means the estimated future costs of incurred claims.
Connecticut Administrative Code › Title 31 - Labor › 284 - Self-Insurance Certification › Section 31-284-2 - Application process

Current through July 10, 2024
(a)
Application Filing.
An employer who seeks exemption from insuring
			 its risk under the Workers' Compensation Act shall apply to the Chairman of the
			 commission or his designee for the privilege of becoming an individual
			 self-insurer. An employer who is approved to self-insure agrees to meet by cash
			 payments, all obligations incurred by it under the Act as such become due and
			 payable. An employer who is approved to self-insure is subject to the
			 Commission's rules and regulations as adopted or amended and subject to the
			 Commission's full right and authority to prescribe new and additional rules and
			 regulations. The Commission's authority and its rules and regulations
			 pertaining to self-insurance shall continue to apply to all employers
			 previously self-insured until all liabilities incurred while self-insured have
			 been fully discharged.
(b)
Application Form.
Application shall be made on the Commission's
			 prescribed form and signed by an officer of the corporation, partnership, or
			 the proprietor. All questions shall be answered fully and all required
			 documentation shall be attached.
(c)
Insurance.
Workers'
			 compensation insurance shall be maintained during the application process and
			 until self-insurance authorization is effective. Applications from employers
			 who do not have insurance as required by the Act pursuant to Section
			 31-284
			 of the general statutes shall not be considered.
(d)
Certificate of
			 Self-Insurance.
Employers approved to self-insure are granted a
			 certificate of self-insurance for a one-year period, or the otherwise stated
			 duration on the certificate. The certificate shall be renewed annually, except
			 for municipal employers issued certificates that are continuous until revoked.
			 The Commission may stagger renewal dates of certificates to facilitate its
			 workload. A certificate of self-insurance applies only to the applicant and its
			 affiliated businesses or subsidiaries included in the application. Other
			 affiliates or subsidiaries may be included under a self-insurer's certificate
			 in the future upon the approval of the Chairman or his designee.
Connecticut Administrative Code › Title 31 - Labor › 284 - Self-Insurance Certification › Section 31-284-3 - Partial self-insurance

Current through July 10, 2024
An employer may be approved by the Chairman to self-insure the
				operations of one or more separately incorporated and independently managed
				business units and insure the remainder with an insurance carrier if it can
				show that there will be a clear distinction between the insured and
				self-insured portions of the employer's liabilities. The separation of
				operations and payroll shall be clear. The insured portions shall be identified
				by name, locations, carrier, policy number, and coverage dates. If a dispute
				arises as to responsibility for payment, the employer shall assume full
				financial responsibility to immediately render all payments to the injured
				employee without waiting for the dispute to be settled.
Connecticut Administrative Code › Title 31 - Labor › 284 - Self-Insurance Certification › Section 31-284-5 - Decisions of the commission

Current through July 10, 2024
The Chairman or his designee may deny an application, or move
				to revoke a certificate of self-insurance if the employer does not have
				sufficient assets, net worth, or liquidity to meet its obligations, or any
				component of a proposed or existing self-insurance program does not meet the
				standards set by the Chairman or his designee.
Connecticut Administrative Code › Title 31 - Labor › 284 - Self-Insurance Certification › Section 31-284-6 - Evaluation factors

Current through July 10, 2024
Self-insurance is a privilege and shall only be granted to
				those employers capable of demonstrating the following:
(1) Financial strength and stability
			 sufficient to permit payment of all workers' compensation benefits and
			 assessments required under the Act. Particular emphasis shall be placed upon:
(A) Sufficient working capital and cash flow
			 to meet current and future obligations;
(B) Acceptable levels of long term debt;
			 and
(C) Established record of
			 financial stability and solvency.
Connecticut Administrative Code › Title 31 - Labor › 284 - Self-Insurance Certification › Section 31-284-7 - Reconsideration

Current through July 10, 2024
An employer whose initial or renewal application for
				self-insurance has been denied, or a self-insurer who takes exception to excess
				insurance or reserve requirements made upon it, may request a reconsideration
				by the Chairman or his designee. The request for reconsideration shall be
				submitted in writing and be received by the Chairman or his designee no later
				than 30 days after the notice of the Commission's
				determination.
Connecticut Administrative Code › Title 31 - Labor › 284 - Self-Insurance Certification › Section 31-284-8 - Security requirements

Current through July 10, 2024
As a condition of self-insurance, employers shall post and
				maintain a security deposit for the certificate period in a form and amount
				approved by the Chairman or his designee, unless waived by the Chairman or his
				designee. All self-insurers shall execute a security deposit agreement as part
				of the application process. If approved, an applicant shall post a security
				deposit in accordance with the security deposit agreement. Security shall be
				provided in the form of a surety bond, an irrevocable funded trust, an
				irrevocable letter of credit, or cash deposit.
(1) Surety bonds shall be issued on the
			 prescribed form. Bonds shall not be released until either a new bond is
			 executed which fully replaces and assumes the liabilities of the previous bond
			 or until all obligations have been fully discharged under a terminated
			 self-insurance program.
(2)
			 Irrevocable funded trusts may be used as a security deposit. The fund's trustee
			 is required to report the fund's assets, market value, and investment activity
			 on a periodic basis. Interest or dividends shall accumulate to the trust. Trust
			 assets may not be transferred or reverted back to the employer unless amounts
			 in excess of sufficient funding needs are approved by the Chairman or his
			 designee.
(3) Irrevocable letters
			 of credit and/or cash deposits may be accepted only at the discretion and
			 approval of the Chairman or his designee. Letters of credit shall renew
			 automatically, have a minimum sixty (60) day cancellation by certified mail,
			 and not be subject to any conditions by the bank or contingent upon
			 reimbursement. Letters shall be issued on the prescribed forms and issued by an
			 acceptable bank with a branch office or confirming bank in Connecticut. Any
			 outstanding liabilities under a letter shall be secured with a surety bond at
			 least ten (10) days before any cancellation takes effect or the letter will be
			 drawn on and the monies deposited to an account under the State's control. Cash
			 deposits shall be made to a custodial account with the State or an approved
			 depository institution. The account shall be assigned to the State by the
			 employer to secure the payment of the employer's obligations under the
			 Act.
(4) Funds held by the State as
			 security shall be accompanied by appropriate legal instruments which designate
			 their use solely for payment of workers' compensation obligations, and
			 effectively assign right, title, and interest in such funds to the State. No
			 judgment creditors, other than claimants entitled to benefits under the Act,
			 have a right to levy upon any of a self-insurer's security deposits made under
			 this regulation.
Connecticut Administrative Code › Title 31 - Labor › 284 - Self-Insurance Certification › Section 31-284-9 - Guarantee of liabilities

Current through July 10, 2024
Each subsidiary or affiliate company shall provide a guarantee
				by the parent corporation for payment of benefits under the Act with an
				accompanying authorization resolution. The form and substance of such guarantee
				shall be approved by the Chairman or his designee. Separate legal entities may
				be self-insured under one certificate only if they are majority-owned
				subsidiaries or if the same person or group of persons owns a majority interest
				in such entities. An agreement jointly and severally binding each entity for
				the liability created under the approval shall be executed in a form acceptable
				to the Chairman or his designee. Execution of a Guarantee of Liabilities shall
				not reduce the amount of required security.