| Party Type | Name | Address Line 1 | Address Line 2 | City | State | Zip Code | Phone | Fax |
| Claimant | Marcus Rodriguez | | | | | | | |
| . . . Claimant's Rep | . . . Dombrowski Law Group, LLC | 360 Bloomfield Avenue, Suite 200 | | Windsor | CT | 06095- | (860) 219-0779 | (860) 219-0773 |
| Employer | Quality Lumping Service | 33 Harvest Court | | Newington | CT | 06111- | ( ) - | |
| . . . Insurer Contact | . . . Central Mutual Insurance Company | Workers' Comp Claims Manager | 800 South Washington Street | Van Wert | OH | 45891-2381 | (800) 736-7000 | (800) 736-7026 |
| . . . . . . Hrg Ins Contact | . . . . . . Central Mutual Insurance Company | ATTN:WC Manager/Hearing Notices | 800 South Washington Street | Van Wert | OH | 45891-2381 | (866) 808-5205 | (800) 736-7026 |
| . . . Policy Ins | . . . Central Mutual Insurance Company | Workers' Comp Claims Manager | 800 South Washington Street | Van Wert | OH | 45891-2381 | (800) 736-7000 | (800) 736-7026 |
| . . . . . . Hrg Ins Contact | . . . . . . Central Mutual Insurance Company | ATTN:WC Manager/Hearing Notices | 800 South Washington Street | Van Wert | OH | 45891-2381 | (866) 808-5205 | (800) 736-7026 |
| . . . . . . . . . Hrg Contact Rep | . . . . . . . . . Goldberg Segalla, LLP | PO Box 967 | | Buffalo | NY | 14201- | (860) 760-3300 | (860) 760-3301 |