Form 5020 for Stamford Connecticut 2025

Form 5020 for Stamford Connecticut: What You Should Know

Secretary of the Department of Social and Behavioral Health. Workers' Compensation Benefit Statement (DWC 2) to the Department  of Social and Behavioral Health personnel. Workers' Compensation Claim Forms (DWC 3), which may be filed under the Workers' Compensation Administrative Rule. Furnished with all of this information are forms for filing of claims with the Connecticut Attorney General's Office. Claims must be filed with the court in circuit court in the county in which the claim was filed or in the county in which the claim was  made within thirty days after a person received or should receive the worker's compensation benefits. Employers are responsible for ensuring that a copy of this application is provided to all employees.  C. Acknowledgment (Part I) In consideration of the information, the following acknowledgments are made. I acknowledge that the information contained in and used on this form have not been evaluated in a manner such as to meet the standards applicable to the evaluation and determination of employee injuries and illness. No attorney-client or medical advisory services have been given in connection with my review of this form. Nothing has been added to this form or made unavailable for review by me.

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