Eligibility Questionnaire

Do any of the following apply to you?

• I am employed by the federal government.
• I am employed by a non-public elementary or secondary school.
• I am employed by the government of another state or another nation.
• I am a railroad worker.
• I am a resident of another state (not Connecticut) and work in Connecticut in interstate commerce.
• I am the spouse of an active-duty military member and pay taxes in my home state instead of in Connecticut.
• I work for subminimum wage pursuant to a 14C certificate.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility.

Do any of the following apply to you?

• I am employed by the State of Connecticut in a position covered by a collective bargaining agreement.
• I am employed by a municipality.
• I am employed by a local or regional board of education.
• I am employed by a tribal enterprise.

You may be a covered worker if:

• You are employed by a municipality or board of education and the unionized employees have collectively bargained to be included in CT Paid Leave.
• You are a unionized employee of the State of Connecticut, and your union has collectively bargained for participation in CT Paid Leave.
• You are employed by a tribal entity that has entered into an agreement with the Governor to participate in CT Paid Leave.

For general information visit coverage and eligibility. For specific information, talk to your Human Resources Department or union representative to inquire whether your employer is covered under CT Paid Leave.

Have you earned at least $2,325 from a covered employer in one of the first four of the five most recently completed quarters?

This amount is approximately the amount someone with a $9,300 annual salary would make in a quarter.

In order to be eligible for paid leave benefits, a worker has to have earned at least $2,325 from a covered employer (or multiple covered employers) in the highest-earning quarter of the first four of the five most recently completed quarters (the "base period"). More explanation and examples can be found on our coverage and eligibility page.

Wages may include salary or hourly pay, vacation pay, holiday pay, tips, commissions, severance pay and the cash value of any “in‐kind” payments.

Part-time, per diem, and seasonal workers may be eligible for CT Paid Leave as long as they meet the eligibility requirements. An employee does not need to work a specific number of hours to be eligible for benefits under the CT Paid Leave program.

Are you experiencing a qualifying circumstance?

I'm starting or expanding my family

If you are bonding with your newborn or your newly adopted child or newly placed foster child or you are engaged in pre-adoption or preplacement activities, such as court appointments, traveling, etc. Bonding is available for up to 12 months after the date of delivery or placement.

I am experiencing a serious health condition

If you are receiving treatment for or recovering from a serious health condition, including pregnancy, or organ or bone marrow donation.

I need to care for a family member experiencing a serious health condition

If you are caring for a family member who is receiving treatment for or recovering from a serious health condition. A family member means a spouse, parent, spouse's parent, child (of any age), child's spouse, grandparent, spouse's grandparent, sibling, sibling-in-law or an individual related to you by blood or affinity whose close association with you is the equivalent to one of the listed family relationships.

I need to take safe leave

If you are experiencing family violence or sexual assault, you may be eligible to receive up to 12 days of CT Paid Leave benefits to seek medical or psychological care, to seek support from a victim services organization, to relocate, or to participate in any civil or criminal proceeding relating to family violence or sexual assault.

I need to care for a military family member injured during active duty

If you are caring for a spouse, parent, child, or next of kin to care for a covered service member who incurred a serious injury or illness in the line of duty on active duty in the Armed Forces.

I need to take time to address qualifying exigencies associated with overseas active duty

Qualifying exigency leave is leave for one of 9 specific reasons  arising from the deployment of the employee's spouse, son, daughter, or parent on covered active duty with the Armed Forces.

Has the qualifying circumstance already happened, or will it be in the future?

We encourage you to submit your claim as soon as possible. Claims may be submitted up to 45 days after the first date of leave.

SIGN IN to begin the process.

Need to learn more before you apply for benefits? Continue reading about how CT Paid Leave works, coverage and eligibility and benefit claims.

For future requests, we encourage you to apply 30 days in advance of your first date of leave.

SIGN IN to begin the process.

If your leave is more than 30 days in the future or you need to learn more before you apply for benefits, continue reading about how CT Paid Leave works, coverage and eligibility and benefit claims.

You may not be eligible for CT Paid Leave benefits. Learn more about qualifying reasons.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility.

Did you enroll in the CT Paid Leave program?

Did you work for an employer in the State of Connecticut at any time within the last 12 weeks?

Do any of the following apply to you?

• I was employed by the federal government.
• I was employed by a non-public elementary or secondary school.
• I was employed by the government of another state or another nation.
• I was a railroad worker.
• I was a resident of another state (not Connecticut) and worked in Connecticut in interstate commerce.
• I am the spouse of an active-duty military member and continued to pay taxes in my home state instead of in Connecticut.
• I worked for sub-minimum wage pursuant to a 14C certificate.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility.

Do any of the following apply to you?

• I am employed by the State of Connecticut in a position covered by a collective bargaining agreement.
• I am employed by a municipality.
• I am employed by a local or regional board of education.
• I am employed by a tribal enterprise.

You may be a covered worker if:

• You are employed by a municipality or board of education and the unionized employees have collectively bargained to be included in CT Paid Leave.
• You are a unionized employee of the State of Connecticut, and your union has collectively bargained for participation in CT Paid Leave.
• You are employed by a tribal entity that has entered into an agreement with the Governor to participate in CT Paid Leave.

For general information visit coverage and eligibility. For specific information, talk to your Human Resources Department or union representative to inquire whether your employer is covered under CT Paid Leave.

Have you earned at least $2,325 from a covered employer in one of the first four of the five most recently completed quarters?

This amount is approximately the amount someone with a $9,300 annual salary would make in a quarter.

In order to be eligible for paid leave benefits, a worker has to have earned at least $2,325 from a covered employer (or multiple covered employers) in the highest-earning quarter of the first four of the five most recently completed quarters (the "base period"). More explanation and examples can be found on our coverage and eligibility page.

Wages may include salary or hourly pay, vacation pay, holiday pay, tips, commissions, severance pay and the cash value of any “in‐kind” payments.

Part-time, per diem, and seasonal workers may be eligible for CT Paid Leave as long as they meet the eligibility requirements. An employee does not need to work a specific number of hours to be eligible for benefits under the CT Paid Leave program.

Are you experiencing a qualifying circumstance?

I'm starting or expanding my family

If you are bonding with your newborn or your newly adopted child or newly placed foster child or you are engaged in pre-adoption or preplacement activities, such as court appointments, traveling, etc. Bonding is available for up to 12 months after the date of delivery or placement.

I am experiencing a serious health condition

If you are receiving treatment for or recovering from a serious health condition, including pregnancy, or organ or bone marrow donation.

I need to care for a family member experiencing a serious health condition

If you are caring for a family member who is receiving treatment for or recovering from a serious health condition. A family member means a spouse, parent, spouse's parent, child (of any age), child's spouse, grandparent, spouse's grandparent, sibling, sibling-in-law or an individual related to you by blood or affinity whose close association with you is the equivalent to one of the listed family relationships.

I need to take safe leave

If you are experiencing family violence or sexual assault, you may be eligible to receive up to 12 days of CT Paid Leave benefits to seek medical or psychological care, to seek support from a victim services organization, to relocate, or to participate in any civil or criminal proceeding relating to family violence or sexual assault.

I need to care for a military family member injured during active duty

If you are caring for a spouse, parent, child, or next of kin to care for a covered service member who incurred a serious injury or illness in the line of duty on active duty in the Armed Forces.

I need to take time to address qualifying exigencies associated with overseas active duty

Qualifying exigency leave is leave for one of 9 specific reasons  arising from the deployment of the employee's spouse, son, daughter, or parent on covered active duty with the Armed Forces.

Has the qualifying circumstance already happened, or will it be in the future?

We encourage you to submit your claim as soon as possible. Claims may be submitted up to 45 days after the first date of leave.

SIGN IN to begin the process.

Need to learn more before you apply for benefits? Continue reading about how CT Paid Leave works, coverage and eligibility and benefit claims.

For future requests, we encourage you to apply 30 days in advance of your first date of leave.

SIGN IN to begin the process.

If your leave is more than 30 days in the future or you need to learn more before you apply for benefits, continue reading about how CT Paid Leave works, coverage and eligibility and benefit claims.

You may not be eligible for CT Paid Leave benefits. Learn more about qualifying reasons.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility.

Have you earned at least $2,325 from a covered employer in one of the first four of the five most recently completed quarters?

This amount is approximately the amount someone with a $9,300 annual salary would make in a quarter.

In order to be eligible for paid leave benefits, a worker has to have earned at least $2,325 from a covered employer (or multiple covered employers) in the highest-earning quarter of the first four of the five most recently completed quarters (the "base period"). More explanation and examples can be found on our coverage and eligibility page.

Wages may include salary or hourly pay, vacation pay, holiday pay, tips, commissions, severance pay and the cash value of any “in‐kind” payments.

Part-time, per diem, and seasonal workers may be eligible for CT Paid Leave as long as they meet the eligibility requirements. An employee does not need to work a specific number of hours to be eligible for benefits under the CT Paid Leave program.

Are you experiencing a qualifying circumstance?

I'm starting or expanding my family

If you are bonding with your newborn or your newly adopted child or newly placed foster child or you are engaged in pre-adoption or preplacement activities, such as court appointments, traveling, etc. Bonding is available for up to 12 months after the date of delivery or placement.

I am experiencing a serious health condition

If you are receiving treatment for or recovering from a serious health condition, including pregnancy, or organ or bone marrow donation.

I need to care for a family member experiencing a serious health condition

If you are caring for a family member who is receiving treatment for or recovering from a serious health condition. A family member means a spouse, parent, spouse's parent, child (of any age), child's spouse, grandparent, spouse's grandparent, sibling, sibling-in-law or an individual related to you by blood or affinity whose close association with you is the equivalent to one of the listed family relationships.

I need to take safe leave

If you are experiencing family violence or sexual assault, you may be eligible to receive up to 12 days of CT Paid Leave benefits to seek medical or psychological care, to seek support from a victim services organization, to relocate, or to participate in any civil or criminal proceeding relating to family violence or sexual assault.

I need to care for a military family member injured during active duty

If you are caring for a spouse, parent, child, or next of kin to care for a covered service member who incurred a serious injury or illness in the line of duty on active duty in the Armed Forces.

I need to take time to address qualifying exigencies associated with overseas active duty

Qualifying exigency leave is leave for one of 9 specific reasons  arising from the deployment of the employee's spouse, son, daughter, or parent on covered active duty with the Armed Forces.

Has the qualifying circumstance already happened, or will it be in the future?

We encourage you to submit your claim as soon as possible. Claims may be submitted up to 45 days after the first date of leave.

SIGN IN to begin the process.

Need to learn more before you apply for benefits? Continue reading about how CT Paid Leave works, coverage and eligibility and benefit claims.

For future requests, we encourage you to apply 30 days in advance of your first date of leave.

SIGN IN to begin the process.

If your leave is more than 30 days in the future or you need to learn more before you apply for benefits, continue reading about how CT Paid Leave works, coverage and eligibility and benefit claims.

You may not be eligible for CT Paid Leave benefits. Learn more about qualifying reasons.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility .

Did you work for an employer in the State of Connecticut at any time within the last 12 weeks?

Do any of the following apply to you?

• I was employed by the federal government.
• I was employed by a non-public elementary or secondary school.
• I was employed by the government of another state or another nation.
• I was a railroad worker.
• I was a resident of another state (not Connecticut) and worked in Connecticut in interstate commerce.
• I am the spouse of an active-duty military member and continued to pay taxes in my home state instead of in Connecticut.
• I worked for sub-minimum wage pursuant to a 14C certificate.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility.

Do any of the following apply to you?

• I am employed by the State of Connecticut in a position covered by a collective bargaining agreement.
• I am employed by a municipality.
• I am employed by a local or regional board of education.
• I am employed by a tribal enterprise.

You may be a covered worker if:

• You are employed by a municipality or board of education and the unionized employees have collectively bargained to be included in CT Paid Leave.
• You are a unionized employee of the State of Connecticut, and your union has collectively bargained for participation in CT Paid Leave.
• You are employed by a tribal entity that has entered into an agreement with the Governor to participate in CT Paid Leave.

For general information visit coverage and eligibility. For specific information, talk to your Human Resources Department or union representative to inquire whether your employer is covered under CT Paid Leave.

Have you earned at least $2,325 from a covered employer in one of the first four of the five most recently completed quarters?

This amount is approximately the amount someone with a $9,300 annual salary would make in a quarter.

In order to be eligible for paid leave benefits, a worker has to have earned at least $2,325 from a covered employer (or multiple covered employers) in the highest-earning quarter of the first four of the five most recently completed quarters (the "base period"). More explanation and examples can be found on our coverage and eligibility page.

Wages may include salary or hourly pay, vacation pay, holiday pay, tips, commissions, severance pay and the cash value of any “in‐kind” payments.

Part-time, per diem, and seasonal workers may be eligible for CT Paid Leave as long as they meet the eligibility requirements. An employee does not need to work a specific number of hours to be eligible for benefits under the CT Paid Leave program.

Are you experiencing a qualifying circumstance?

I'm starting or expanding my family

If you are bonding with your newborn or your newly adopted child or newly placed foster child or you are engaged in pre-adoption or preplacement activities, such as court appointments, traveling, etc. Bonding is available for up to 12 months after the date of delivery or placement.

I am experiencing a serious health condition

If you are receiving treatment for or recovering from a serious health condition, including pregnancy, or organ or bone marrow donation.

I need to care for a family member experiencing a serious health condition

If you are caring for a family member who is receiving treatment for or recovering from a serious health condition. A family member means a spouse, parent, spouse's parent, child (of any age), child's spouse, grandparent, spouse's grandparent, sibling, sibling-in-law or an individual related to you by blood or affinity whose close association with you is the equivalent to one of the listed family relationships.

I need to take safe leave

If you are experiencing family violence or sexual assault, you may be eligible to receive up to 12 days of CT Paid Leave benefits to seek medical or psychological care, to seek support from a victim services organization, to relocate, or to participate in any civil or criminal proceeding relating to family violence or sexual assault.

I need to care for a military family member injured during active duty

If you are caring for a spouse, parent, child, or next of kin to care for a covered service member who incurred a serious injury or illness in the line of duty on active duty in the Armed Forces.

I need to take time to address qualifying exigencies associated with overseas active duty

Qualifying exigency leave is leave for one of 9 specific reasons  arising from the deployment of the employee's spouse, son, daughter, or parent on covered active duty with the Armed Forces.

Has the qualifying circumstance already happened, or will it be in the future?

We encourage you to submit your claim as soon as possible. Claims may be submitted up to 45 days after the first date of leave.

SIGN IN to begin the process.

Need to learn more before you apply for benefits? Continue reading about how CT Paid Leave works, coverage and eligibility and benefit claims.

For future requests, we encourage you to apply 30 days in advance of your first date of leave.

SIGN IN to begin the process.

If your leave is more than 30 days in the future or you need to learn more before you apply for benefits, continue reading about how CT Paid Leave works, coverage and eligibility and benefit claims.

You may not be eligible for CT Paid Leave benefits. Learn more about qualifying reasons.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility.

You may not be a covered worker under CT Paid Leave. Learn more about coverage and eligibility.