ct form victim
First Report of Injury WC 207
The Supervisor must complete this form with the injured worker and then forward it along with the balance of the claim package to the Workers Compensation
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personal injury application - Connecticut Judicial Branch
We are here to help. If you have any questions about filling out this application or the Victim Compensation Program, please call OVS at 1-888-286-7347.
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Form CA-16 - Authorization for Examination / Medical
Description of Injury or Disease: 6. You are authorized to provide medical care for the employee for a period of up to sixty days from the date shown in item 11
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