Conn. Gen. Stat. § 31-296
(c) The employer's or insurer's notice of intention to discontinue or reduce payments shall (1) identify the claimant, the claimant's attorney or other representative, the employer, the insurer, and the injury, including the date of the injury, the city or town in which the injury occurred and the nature of the injury, (2) include medical documentation that (A) establishes the basis for the discontinuance or reduction of payments, and (B) identifies the claimant's attending physician, physician assistant or advanced practice registered nurse, and (3) be in substantially the following form:
IMPORTANT
STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION
YOU ARE HEREBY NOTIFIED THAT THE EMPLOYER OR INSURER INTENDS TO REDUCE OR DISCONTINUE YOUR COMPENSATION PAYMENTS ON .... (date) FOR THE FOLLOWING REASONS:
If you object to the reduction or discontinuance of benefits as stated in this notice, YOU MUST REQUEST A HEARING NOT LATER THAN 15 DAYS after your receipt of this notice, or this notice will automatically be approved.
To request an Informal Hearing, call the Workers' Compensation Commission District Office in which your case is pending.
Be prepared to provide medical and other documentation to support your objection. For your protection, note the date when you received this notice.
(1949 Rev., S. 7444; 1953, S. 3047d; 1958 Rev., S. 31-170; 1961, P.A. 491, S. 18; 1971, P.A. 510, S. 1; P.A. 79-376, S. 44; P.A. 83-114, S. 1; P.A. 84-180, S. 1; P.A. 88-106, S. 1; P.A. 90-116, S. 6; P.A. 07-80, S. 1; P.A. 11-44, S. 48; June 12 Sp. Sess. P.A. 12-1, S. 85; P.A. 19-98, S. 6; 19-157, S. 84; P.A. 21-18, S. 1; 21-196, S. 58; P.A. 22-89, S. 3.)
History: 1961 act entirely replaced previous provisions; 1971 act changed point at which discontinuance is effective from time notices are sent to commissioner to time when specifically approved in writing by commissioner; P.A. 79-376 replaced “workmen's compensation” with “workers' compensation”; P.A. 83-114 provided that the commissioner's statement of approval of a voluntary agreement shall inform the individual as to his rights for an annual cost-of-living adjustment under this chapter; P.A. 84-180 provided that the commissioner's statement of approval inform the employee of his rights to participate in a rehabilitation program; P.A. 88-106 authorized reduction of benefits; P.A. 90-116 provided that notices of discontinuance and reduction shall be made by certified mail, provided for priority hearing on discontinuances and reductions and provided for interest and attorney's fees against the employer in cases of wrongful discontinuance or reduction (Revisor's note: In 2001 the references in this section to the date “19..” were changed editorially by the Revisors to “20..” to reflect the new millennium); P.A. 07-80 divided section into Subsecs. (a), (b) and (c), made technical changes, in Subsec. (b), required notice to specify reasons for proposed discontinuance or reduction of benefits and changed from 10 days to 15 days the time for employee to request hearing and, in Subsec. (c), required specified information in notice and revised form; P.A. 11-44 amended Subsec. (a) by adding provision re rehabilitation program administered by Bureau of Rehabilitative Services, effective July 1, 2011; June 12 Sp. Sess. P.A. 12-1 amended Subsec. (a) by replacing “Bureau of Rehabilitative Services” with “Department of Rehabilitation Services”, effective July 1, 2012; P.A. 19-98 amended Subsec. (c)(2)(B) by adding “or advanced practice registered nurse”; P.A. 19-157 amended Subsec. (a) by replacing “Department of Rehabilitation Services” with “Department of Aging and Disability Services”; pursuant to P.A. 21-18, “commissioner” and “commissioner's” were changed editorially by the Revisors to “administrative law judge” and “administrative law judge's” respectively in Subsecs. (a) and (b), effective October 1, 2021; P.A. 21-196 amended Subsec. (c) by adding reference to physician assistants; P.A. 22-89 amended Subsec. (b) to delete “by certified mail” and add reference to Sec. 31-321, effective May 24, 2022.