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Both employer “licenses” available under Connecticut’s workers’ compensation laws are administered by the State of Connecticut Workers’ Compensation Commission. Each license’s application package contains the required forms and documentation described on the Connecticut Licensing Info Center website, and is directly accessible from this page.
The Commission’s two online application packages are only available in PDF format and require Adobe’s FREE ACROBAT 5 READER for basic use:
Free ACROBAT READER (version 5)
Help using our PDF Licensing Applications with ACROBAT
To view, print, save, and fill in our online PDF application forms, you must first upgrade to the free VERSION 5 Acrobat Reader from Adobe Software. Version 4 and earlier Readers will not work with our online PDF forms.
Click here for the FREE Acrobat 5 Reader from Adobe Software.
NOTE: Although you can save a blank form with the free ACROBAT 5 READER, to save your information as well, you must use either the Adobe ACROBAT APPROVAL 5 program (list price $39) or the “full” Adobe ACROBAT 5 program (list price $249).
Click here to learn more about Adobe ACROBAT software products available for your use.
Employer Medical Care Plan Application Package
(PDF File: 18 pages; 180K; Last revised December 20, 2001)
Information package for employers wishing to apply for approval to provide medical care and treatment for their injured employees by means of a medical care plan under the Workers’ Compensation Act, along with the required forms and documents.
Employer Self-Insurance Application Package
(PDF File: 25 pages; 275K; Last revised October 15, 2002)
Information package for employers wishing to self-insure their workers’ compensation liabilities, along with the required forms and documents.
Go to the Connecticut Licensing Info Center (CT-CLIC) - the official State website for all state licensing and permitting activities in Connecticut.
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