WORKERS' COMPENSATION

A repository for MPTN Workers' Compensation Commission Regulations and Forms.

  • Home
  • Benefits
  • 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

Home | Benefits | Forms | Provider List | ESIS | Contact

Copyright © Mashantucket Pequot Tribal Nation | design from css3templates.co.uk