| Party Type | Name | Address Line 1 | Address Line 2 | City | State | Zip Code | Phone | Fax |
| Claimant | Rushawn Carroll | | | | | | | |
| . . . Claimant's Rep | . . . Mancini Law | 777 Echo Lake Rd Ste G | | Watertown | CT | 06795-6618 | (860) 215-8969 | (860) 470-8205 |
| Employer | New England Gypsum Floors | 111 Prestige Park Road | | East Hartford | CT | 06108- | (860) 289-4117 | ( ) - |
| . . . Insurer Contact | . . . Gallagher Bassett Services, Incorporated | PO Box 2934 | | Clinton | IA | 52733-2934 | (800) 307-5256 | (781) 849-8558 |
| . . . . . . Hrg Ins Contact | . . . . . . Gallagher Bassett Services, Incorporated | Attn: Hearing Notices (Non State) | PO Box 2934 | Clinton | IA | 52733- | (860) 509-3480 | (860) 291-9875 |
| . . . . . . . . . Hrg Contact Rep | . . . . . . . . . Natale & Wolinetz | 116 Oak St. | | Glastonbury | CT | 06033- | (860) 430-1802 | (860) 430-1809 |