You have reached the original website of the
   Connecticut Workers' Compensation Commission.

   Forms, publications, statutes, and most other
   information is now located at our NEW site:
   PORTAL.CT.GOV/WCC

WCC MEMORANDUMS
 
ARE STILL LOCATED AT THIS SITE WHILE IN THE
PROCESS OF BEING MIGRATED TO OUR NEW SITE.

Click to read WCC MEMORANDUMS.

WCC Revised Voluntary Agreement Form Memorandum - July 22, 1999

MEMORANDUM NO. 99-13

TO: Commissioners, District Administrators, Self-Insureds, Insurance Carriers, Attorneys, Unions, Medical Practitioners, and Advisory Board Members
FROM: Jesse M. Frankl, Chairman
DATE: July 22, 1999
RE: VOLUNTARY AGREEMENT FORM REVISED 7/20/99

We are pleased to announce a revision of the Voluntary Agreement (Form WCC-1).

The enclosed BLUE form, effective July 20, 1999, reflects a change in the method of calculating concurrent employment for all injuries occurring on or after July 1, 1995.

PLEASE NOTE THAT THIS FORM WILL BE ACCEPTED ON BLUE STOCK ONLY.

With this revision, the Workers’ Compensation Commission will now be accepting the following voluntary agreement forms:

This form is available from our website or any district office.

 

   You have reached the original website of the
   Connecticut Workers' Compensation Commission.

   Forms, publications, statutes, and most other
   information is now located at our NEW site:
   PORTAL.CT.GOV/WCC

WCC MEMORANDUMS
 
ARE STILL LOCATED AT THIS SITE WHILE IN THE
PROCESS OF BEING MIGRATED TO OUR NEW SITE.

Click to read WCC MEMORANDUMS.