Connecticut jurors who cannot serve because of a physical or mental disability can ask Jury Administration to disqualify them using JD-JA-47, under C.G.S. 51-217. A licensed health care provider gives the opinion in Part II that the patient cannot do a sedentary job requiring close attention for six hours a day over at least three consecutive business days, for one year or permanently.
The juror completes Part I with name, address, ten-digit Connecticut Juror ID and date of birth. A licensed health care provider completes Part II, choosing one-year or permanent disqualification and signing with title and business contact details.
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Request for Medical Disqualification from Jury Service
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State law requires a licensed physician (MD or DO), a physician assistant or an advanced practice registered nurse to complete Part II for a permanent disqualification. For a one-year disqualification, any licensed health care provider can complete Part II of JD-JA-47.
Whether, because of a physical or mental disability, the patient cannot perform a sedentary job requiring close attention for six hours a day, with short breaks in the morning and afternoon, for at least three consecutive business days. The provider then selects one year or permanent disqualification.
No. The form says not to take it to court. The juror faxes it, scans and emails it, or mails it to Connecticut Jury Administration, which notifies the juror of its decision by mail. Approved jurors are not required to appear.