WORKERS' COMPENSATION
A repository for MPTN Workers' Compensation Commission Regulations and Forms.
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Forms
Provider List
Third Party Insurance Administrator (ESIS)
Contact
Primary References
MPTN WCC Code
WCC Information Booklet
Network Provider List
Important Links
Mashantucket Pequot Tribal Laws
Connecticut Workers' Comp
Disability Carrier (UNUM)
Third Party Insurance Administrator (ESIS)
MPTN Government Holidays
January 1, 2021 - New Year's Day
January 18, 2021 - Martin Luther King Day
February 15, 2021 - President's Day
May 26, 2021 - Pequot Massacre Anniversary
May 31, 2021 - Memorial Day
July 4, 2021 - Independence Day
September 6, 2021 - Labor Day
November 11, 2021 - Veterans' Day
November 25, 2021 - Thanksgiving Day
November 26, 2021 - Native American Day
December 24, 2021 - Christmas Eve Day
December 25, 2021 - Christmas Day
WCC Common Forms
WCC Information Booklet
Authorization for Release of Medical Records
Filing Status and Exemption Form
Hearing Request
Notice of Claim Form
Notification of Appearance
Physician's Permanent Impairment Evaluation Form
Record of Employment Contacts