When an injured worker in Connecticut receives a letter denying their workers’ compensation claim, it can feel like a second injury — one that strikes financially and emotionally. After weeks of pain, lost wages, and uncertainty, learning that your employer’s insurance company has refused to cover your medical care or wage replacement can leave you wondering what to do next. Fortunately, under Connecticut law, you have the right to challenge that decision through a structured appeals process designed to ensure fairness and accountability.
Understanding Why Connecticut Workers’ Comp Claims Are Denied
Workers’ compensation in Connecticut is governed by the Connecticut Workers’ Compensation Act (Connecticut General Statutes §31-275 through §31-355). This law requires most employers to carry insurance that covers employees who suffer injuries or illnesses in the course of employment. Despite these protections, insurance companies routinely deny valid claims.
Common reasons for denial include:
- Disputes about whether the injury occurred at work.
- Missing deadlines or incomplete paperwork.
- Lack of sufficient medical evidence linking the injury to job duties.
- Allegations of pre-existing conditions.
- Claims that the worker was not acting within the “scope of employment.”
For instance, if a warehouse worker injures their back lifting boxes but delays reporting the injury, the insurer may argue it happened outside of work or that it’s unrelated to the job. This type of reasoning is common — and often unfair.
Step One: Review the Denial Letter Carefully
When your claim is denied, the insurance company must provide a written explanation. This denial letter should outline specific reasons and reference supporting evidence or missing documentation.
In practice, this document becomes the roadmap for your appeal. Review it closely with an experienced Connecticut workers’ comp attorney to identify what’s missing — whether it’s medical records, witness statements, or clarity in your original report.
Under Connecticut General Statute §31-294c, you generally have one year from the date of injury (or three years for occupational diseases) to file a claim. However, if your claim has already been filed and was denied, your next step is to formally request a hearing before the Workers’ Compensation Commission (WCC).
Filing a Form 30C and Requesting a Hearing
The appeal process in Connecticut begins with filing a Form 30C (Notice of Claim for Compensation). This form alerts your employer and the WCC that you intend to pursue benefits.
Once your claim is on record, you can request a hearing before a Commissioner — an administrative judge who resolves disputes between employees, employers, and insurers. There are three main types of hearings, each increasing in formality and significance:
Informal Hearing: A preliminary discussion between you, the insurer, and the Commissioner to explore settlement or clarify misunderstandings.
Pre-Formal Hearing: If the issue remains unresolved, this step allows both sides to present documentation and narrow down contested facts.
Formal Hearing: This is the equivalent of a trial. Evidence, testimony, and medical records are presented, and the Commissioner issues a binding decision.
Missing deadlines or failing to provide proper documentation can delay or weaken your case. Working with an attorney ensures that your filings comply with the Connecticut Workers’ Compensation Commission’s procedural rules.
Strengthening Your Appeal with Medical Evidence
Medical documentation is often the deciding factor in a denied claim. In many cases, insurers deny benefits by arguing there’s “insufficient proof” that the injury was work-related. Strengthening your case involves gathering:
- Doctor’s notes and diagnostic imaging.
- Independent medical evaluations (IMEs).
- Testimony from treating physicians or specialists.
- Workplace safety reports or witness statements confirming the incident.
Connecticut law allows injured employees to select their own physician after the employer’s initial choice, which can be critical when obtaining unbiased opinions. A consistent medical narrative — showing that your injury directly resulted from your job — significantly increases your chance of success at the hearing.
Legal Standards That Apply in Connecticut Workers’ Comp Appeals
Connecticut workers’ compensation is a no-fault system, meaning employees don’t have to prove employer negligence — only that the injury occurred “arising out of and in the course of employment.” However, that simple phrase becomes the central debate in many appeals.
Under Connecticut General Statute §31-275(1), “arising out of employment” refers to injuries that are caused by work-related risks, while “in the course of employment” refers to injuries occurring during work hours or while performing job duties. Insurers often use narrow interpretations to deny claims — for example, asserting that an injury during a break or while walking to a car after a shift doesn’t qualify. Courts, however, have frequently ruled otherwise when work conditions directly contribute to the incident.
What Happens After the Commissioner’s Decision
If the Commissioner rules against you after the formal hearing, you still have options. You can appeal to the Compensation Review Board (CRB) within 20 days of receiving the written decision.
The CRB reviews the case record for legal or factual errors. While it does not typically re-hear evidence, it can overturn or remand a decision if the Commissioner misapplied the law or ignored key evidence. From there, further appeals can be made to the Connecticut Appellate Court or, in rare cases, the Connecticut Supreme Court.
This multi-level structure ensures that workers are not left without recourse when an administrative decision is flawed or unfair.
Common Mistakes That Lead to Denied Appeals
Many denials stem not from the facts of the case but from procedural or evidentiary issues. To avoid those pitfalls, workers should steer clear of these mistakes:
• Missing statutory deadlines or failing to submit required forms.
• Not following through with medical treatment or ignoring doctor recommendations.
• Failing to provide clear documentation linking the injury to work.
• Relying on verbal communication with insurers rather than written correspondence.
• Attempting to navigate the process without legal representation.
An experienced attorney can help identify weak points early and build a comprehensive appeal strategy that meets both legal and medical standards.
Example: A Denied Shoulder Injury Claim
Consider this example: A Connecticut nurse injures her shoulder while lifting a patient. She reports the incident but receives a denial citing a “pre-existing condition.” With her attorney’s help, she obtains imaging scans and a letter from her orthopedic specialist confirming that the work incident aggravated — not caused — her prior shoulder condition. The lawyer files a formal appeal, presents medical testimony, and secures a favorable ruling at the hearing.
This case highlights how medical clarity and persistence can turn a denial into a successful claim, especially when supported by professional legal guidance.
Key Steps to Take After Receiving a Workers’ Comp Denial in Connecticut
If your claim has been denied, taking organized action immediately can make all the difference. Here’s how to proceed:
- Read the denial letter carefully. Note the specific reason for denial.
- Consult a workers’ compensation attorney. Legal guidance early on can preserve rights and avoid procedural errors.
- File a Form 30C. Officially register your claim with the Connecticut Workers’ Compensation Commission.
- Gather medical documentation. Ensure your doctor explicitly connects your injury to your job duties.
- Attend all hearings. Missing a hearing can result in dismissal or further delay.
- Follow medical treatment. Demonstrating compliance supports your credibility and recovery.
- Keep records. Maintain a file with every letter, report, and medical bill.
Each of these steps strengthens your case and demonstrates your commitment to securing the benefits you deserve.
Why Legal Guidance Matters in Connecticut Workers’ Comp Appeals
The appeals process can be complex, with multiple hearings, forms, and deadlines that vary by case type. A skilled Connecticut workers’ compensation attorney not only manages filings and hearings but also frames your evidence in ways that resonate with the Commissioner’s legal analysis.
In practice, this often means hiring vocational experts, securing corroborating testimony, or challenging insurer medical reports. Attorneys also ensure compliance with procedural requirements outlined by the Connecticut Workers’ Compensation Commission, preventing delays that could otherwise jeopardize benefits.
Need Legal Help? Brandon J. Broderick, Attorney at Law is One Phone Call Away
If your Connecticut workers’ compensation claim has been denied, you don’t have to face the appeals process alone. The experienced legal team at Brandon J. Broderick, Attorney at Law helps injured workers navigate every stage — from filing Form 30C to arguing cases before the Compensation Review Board. Whether your denial was due to insufficient evidence, missed deadlines, or disputed medical opinions, our attorneys understand how to build persuasive appeals that get results. We serve workers across Connecticut who need fair compensation for medical bills, lost wages, and long-term recovery. Don’t wait to protect your rights.