Eligibility Questionnaire

Have you worked for an employer in the State of Connecticut in the past 12 weeks?

The first requirement for CT Paid Leave eligibility is that you work for a covered employer in Connecticut at the time that you need to take leave from work or that you did work for a covered employer within the 12 weeks immediately before your need for benefits begins.

Are you self‐employed or a sole proprietor?

Sole proprietors and self-employed individuals have the option to enroll in the program. For the purpose of CT Paid Leave, you are considered a sole proprietor or self-employed individual if you earn self-employment income as defined by the IRS at 26 USC 1402(b).

Did you enroll in the CT Paid Leave Program?

Sole proprietors and self-employed individuals have the option to enroll in the program.

Does one of the following apply to you?

• Are you employed by the federal government?
• Are you employed by the State of CT and are a member of a collective bargaining unit?
• Are you employed by a municipality?
• Are you employed by a local or regional board of education?
• Are you employed by non‐public elementary or secondary schools?
• Are you employed by the government of another state?
• Are you a railroad worker?
• Are you a resident of another state (not Connecticut) and work in Connecticut in interstate commerce?
• Are you employed by a sovereign nation?