Workers’ Compensation Claim Kit – Connecticut

Who will handle your claims?

The New Jersey Regional Claim Office will handle your Connecticut claims, located at:

305 Madison Ave
P.O. Box 1973
Morristown, NJ 07962

Phone: (888) 890-1500
Diane Parish, Regional Director

How to Report Workers’ Compensation Claims?

To report via the Internet: Log on to the Crum & Forster website at Use your assigned User ID and Password. If you do not have a current User ID, please contact your local Crum & Forster Claims or Marketing resource.

To report via e-mail:
To report via fax: 1-877-622-6218
To report claims via telephone: 1-800-690-5520

(7 day/24 hour toll free reporting line for all states)

  • In the event of a serious or fatal injury, notify the local claim office immediately by telephone.

What forms and pamphlets does the employer need to be aware of?

Posting Notice:
Review the instructions and prominently display the form where each employee is likely to see the notice on a regular basis. The Connecticut posting notice is available on the Crum & Forster website.

Worker’s Compensation Information Packet:
Review information about Connecticut’s workers’ compensation system, provided in both Spanish and English. The packet includes sample workers’ compensation forms.

CT Info-Packet-English 7.24.20

CT Info-Packet-spanish 7.24.20

Employer’s First Report of Injury form:
If you report the claim via the Internet or by telephone, you do not need to fill out this form. If you report the claim via fax, complete this form, and fax it to Crum & Forster at the fax number provided above.


Employee Notice of Claim for Compensation:

CT-notice of Claim & Compensation- 30C

Employer’s Wage Statement:
Connecticut does not have a wage statement form.

Supplemental Report of Injury & Instructions:
Connecticut does not have a supplemental report.

Waiting Period for Lost Wages in Connecticut
The waiting period is 3 days. If the employee is off for more than 7 days, the first 3 days are paid retroactively.

Choice of Physician Rules in Connecticut
The employee is entitled to the initial choice of physician only if you do not have a managed care program established.

Preferred Provider Organization Network (PPO):
Crum & Forster has a PPO network available. Follow the instructions below to access the PPO Network:

Logon to the website at:

  • Search by Provider Address, Name or Region
  • Select the Distance, Provider Type and Specialty
  • Results can then be exported to a directory or excel.
  • You can obtain a Map List or text message by selecting a specific provider

Where should all medical bills be sent?

Crum & Forster
PO Box 14801
Lexington, KY 40512

Important Websites:

State of Connecticut WC Division-

Multi-State Information-