Connecticut General Statutes 31-900 – Connecticut Essential Workers COVID-19 Assistance Program. Account. Claims. Calculation of payment. Reconsideration. Penalty. Report
(a) As used in this section and section 31-290a:
Terms Used In Connecticut General Statutes 31-900
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
(1) “Affected person” means an essential employee who died or was unable to work as a result of contracting COVID-19, or due to symptoms that were later diagnosed as COVID-19, at any time between March 10, 2020, and July 20, 2021, provided: (A) The contraction of COVID-19 by such employee is confirmed by a positive laboratory test or, if a laboratory test was not available for the employee, as diagnosed and documented by the employee’s licensed physician, licensed physician assistant or licensed advanced practice registered nurse, based on the employee’s symptoms; (B) a copy of the positive laboratory test or the written documentation of the physician’s, physician assistant’s or advanced practice registered nurse’s diagnosis is provided to the administrator; and (C) such employee, during the fourteen consecutive days immediately preceding the date the employee died or was unable to work due to contracting COVID-19, (i) was not employed in a capacity where the employee worked solely from home and did not have physical interaction with other employees, or (ii) was the recipient of a written offer or directive from such employee’s employer to work solely from home but otherwise chose to work at a work site of the employer. “Affected person” does not include a federal employee who qualifies for benefits under the COVID-19 workers’ compensation presumption included in the American Rescue Plan Act of 2021;
(2) “Essential employee” means any person employed in a category recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices as of February 20, 2021, to receive a COVID-19 vaccination in phase 1a, 1b or 1c of the COVID-19 vaccination program;
(3) “Administrator” means an employee of the Office of the Comptroller, or a third-party administrator;
(4) “Assistance” means moneys payable by the Comptroller from the Connecticut Essential Workers COVID-19 Assistance Fund, established pursuant to subsection (c) of this section, to assist affected persons pursuant to this section;
(5) “Uncompensated leave” means the wages or salary lost by (A) an affected person unable to work as a result of contracting COVID-19, or due to symptoms that were later diagnosed as COVID-19, at any time during the public health and civil preparedness emergencies declared by the Governor on March 10, 2020, or any extension of such declarations; and
(6) “COVID-19” means the respiratory disease designated by the World Health Organization on February 11, 2020, as coronavirus 2019, and any related mutation thereof recognized by the World Health Organization as a communicable respiratory disease.
(b) There is established the Connecticut Essential Workers COVID-19 Assistance Program. The program shall offer assistance, within available funds and on a first-come, first-served basis, to affected persons eligible for assistance under this section, pending verification of eligibility, provided no assistance shall be paid to any affected person after June 30, 2024. The program shall be administered by the administrator. The administrator shall accept applications for assistance on or after October 1, 2021. For the purposes of this section, the administrator shall be authorized to (1) determine whether an affected person meets the requirements for eligibility for assistance under this section and the amount of assistance that should be provided; (2) summon and examine under oath such witnesses that may provide information relevant to the eligibility of an affected person, and direct the production of, and examine or cause to be produced or examined, such books, records, vouchers, memoranda, documents, letters, contracts or other papers in relation to any matter at issue as the administrator may find proper; and (3) take or cause to be taken affidavits or depositions within or without the state.
(c) There is established an account to be known as the “Connecticut Essential Workers COVID-19 Assistance Fund” which shall be a separate, nonlapsing account within the General Fund. The account shall contain any moneys required by law to be deposited in the account. Moneys in the account shall be expended by the Comptroller at the discretion of the administrator for the purposes of (1) assistance offered under the Connecticut Essential Workers COVID-19 Assistance Program, and (2) costs and expenses of operating the program, including the hiring of necessary employees and the expense of public outreach and education regarding the program and fund, provided not more than five per cent of the total moneys received by the fund shall be used for any administrative costs, including hiring temporary or durational staff or contracting with a third-party administrator, or other costs and expenses incurred by the administrator or Comptroller in connection with carrying out the provisions of this section and subsection (a) of section 31-306. The administrator shall make all reasonable efforts to limit the costs and expenses of operating the program without compromising affected persons’ access to the program.
(d) To apply for assistance from the Connecticut Essential Workers COVID-19 Assistance Fund, an affected person with a pending workers’ compensation claim under chapter 568, related to COVID-19, or an affected person who does not have such pending workers’ compensation claim, shall submit a claim to the administrator, in such form as required by the administrator, not later than December 31, 2022. An affected person who does not have a pending workers’ compensation claim related to COVID-19 shall submit a claim to the administrator, in such form as required by the administrator, not later than one year after the date such person was initially unable to work as a result of contracting COVID-19 or due to symptoms that were later diagnosed as COVID-19 or December 31, 2022, whichever is later. Any such claim shall include: (1) A certificate issued by a licensed medical professional documenting the laboratory test or diagnosis that such affected person contracted COVID-19 (A) requiring such person to isolate and quarantine from others, (B) preventing such affected person from performing such affected person’s employment duties, or (C) requiring in-patient or outpatient medical treatment; (2) for the purposes of requesting assistance for uncompensated leave, evidence of (A) such affected person’s weekly earnings during the eight calendar weeks immediately preceding the time of diagnosis, except in the case of an employee who has not yet worked for that employer for an eight-week period, for the time period such employee was employed, and (B) uncompensated leave due to the contraction of COVID-19 or symptoms that were later diagnosed as COVID-19; (3) for the purposes of requesting assistance for out-of-pocket costs for medical and surgical aid or hospital or nursing service, evidence of such affected person’s costs; and (4) any additional information as requested or required by the administrator.
(e) The level of assistance offered to an affected person shall be calculated as follows, subject to available funds, and payable on a retroactive basis from the date such person was initially unable to work as a result of contracting COVID-19 or due to symptoms that were later diagnosed as COVID-19, but not earlier than March 10, 2020, and not later than July 20, 2021: (1) Weekly assistance for all uncompensated leave, calculated as seventy-five per cent of such affected person’s average weekly earnings during the eight calendar weeks immediately preceding the date such person was initially unable to work as a result of contracting COVID-19, or due to symptoms that were later diagnosed as COVID-19, except in the case of an employee who has not yet worked for that employer for an eight-week period, seventy-five per cent of such affected person’s average weekly earnings for the time period such employee was employed, and after such earnings have been reduced by any deduction for: (A) Federal or state taxes, or both; (B) the federal Insurance Contributions Act, provided such assistance shall not exceed the average weekly earnings of all workers in the state as calculated by the Labor Commissioner, pursuant to section 31-309; and (C) any benefits received for total or partial unemployment as provided in chapter 567, any amount of temporary total or temporary partial disability benefits under chapter 568, and any amounts provided through a paid leave plan provided by an employer or pursuant to any state or federal law, for the same days of such claimed assistance; (2) all documented out-of-pocket COVID-19 related costs for medical and surgical aid or hospital and nursing service incurred directly as a result of such affected person contracting COVID-19, including, but not limited to, medical rehabilitation services, mental health therapy services and prescription drugs; and (3) burial expenses in the amount of three thousand dollars in any case in which an employee died due to contracting COVID-19 during (A) the public health and civil preparedness emergencies declared by the Governor on March 10, 2020, or any extension of such declarations, or (B) any new public health and civil preparedness emergencies declared by the Governor as a result of a COVID-19 outbreak in this state.
(f) The administrator shall promptly review all claims submitted pursuant to this section. The administrator shall evaluate each claim and determine, on the basis of information provided by the affected person, or additional information provided at the request of the administrator, whether or not such claim should be approved and, if approved, the amount of assistance offered. The administrator shall provide such determination, in writing, to such affected person not later than sixty business days after having received the notice of claim, or, if the administrator requested additional information, not later than ten business days after receiving such additional information, and shall direct the Comptroller to pay any such assistance offered to such affected person in the amount and for the duration determined by the administrator, if applicable. If the administrator determines more information is needed from the affected person for the purpose of requesting assistance for uncompensated leave, out-of-pocket costs for medical and surgical aid or hospital or nursing service or burial expenses, the administrator may pay such affected person for the completed parts of their claim while the remainder of the claim is pending.
(g) For purposes of this section, a pending workers’ compensation claim submitted by an affected person shall not prevent the administrator from approving such person’s claim for assistance under this section, provided any workers’ compensation benefits such affected person receives for the workers’ compensation claim shall be offset by the amount of assistance such affected person receives for uncompensated leave under this section, as deemed appropriate by the presiding workers’ compensation commissioner. Any assistance available under this section shall be offset by any workers’ compensation benefits already paid to the affected person for the uncompensated leave or out-of-pocket medical costs, including payments made without prejudice. It shall be the responsibility of the administrator of the fund to notify the Workers’ Compensation Commission of an available offset.
(h) For purposes of this section, a disability or unemployment claim submitted by an affected person or affected employee shall not prevent the administrator from approving such person’s claim for assistance under this section, provided any assistance available under this section shall be offset by any disability or unemployment benefits already paid to the affected person for the uncompensated leave, including payments made without prejudice. If an affected person or affected employee received unemployment benefits pursuant to chapter 567, nothing in this section shall be construed to require such person to be currently employed with a previous employer in order to qualify for assistance from the fund.
(i) An affected person may request that a determination made pursuant to subsection (f) of this section be reconsidered by the administrator’s designee by filing a request with the administrator, on a form prescribed by the administrator, not later than twenty business days after the mailing of the notice of such determination. The administrator, not later than three business days after receipt of such request for reconsideration, shall designate an individual to conduct such reconsideration and shall submit to such designated individual all documents relating to such affected person’s claim. The administrator’s designee shall conduct any reconsideration requested by an affected person, which shall consist of a de novo review of all relevant evidence, not later than twenty business days after such individual’s designation. Such administrator’s designee shall issue such designee’s decision affirming, modifying or reversing the decision of the administrator not later than twenty business days after the designee’s reconsideration of the determination and shall submit such decision in writing to the administrator and the affected person. The decision shall include a short statement of findings that shall specify any assistance to be paid to the affected person in accordance with subsection (f) of this section.
(j) Any statement, document, information or matter may be considered by the administrator or, on reconsideration, by the administrator’s designee, if in the opinion of the administrator or designee, it contributes to a determination of the claim, whether or not the same would be admissible in a court of law.
(k) There shall be no right of appeal by any affected person or affected employee claiming assistance under this section following the final decision of the administrator’s designee issued pursuant to subsection (i) of this section.
(l) Any assistance provided to an affected person under this section shall not be considered income for the purpose of the state’s personal income tax law, corporation tax or any other tax laws.
(m) If a claim is paid to an affected person erroneously or as a result of wilful misrepresentation by such affected person, the administrator may seek repayment of benefits from the affected person having received such compensation and may also, in the case of wilful misrepresentation, seek payment of a penalty in the amount of fifty per cent of the benefits paid as a result of such misrepresentation.
(n) On or before January 1, 2022, and monthly thereafter, and any other time at the request of the administrator, the Comptroller shall submit a report to the administrator indicating the value of the Connecticut Essential Workers COVID-19 Assistance Fund at the time of the report.
(o) On or before January 1, 2022, and at least quarterly thereafter, the administrator shall submit to the joint standing committee of the General Assembly having cognizance of matters relating to labor, in accordance with section 11-4a, a report on the financial condition of the Connecticut Essential Workers COVID-19 Assistance Fund. Such report shall include (1) an estimate of the fund’s value as of the date of the report; (2) the effect of scheduled payments on the fund’s value; (3) an estimate of the monthly administrative costs necessary to operate the program and the fund; and (4) any recommendations for legislation to improve the operation or administration of the program and the fund.
(p) On or after May 7, 2022, the administrator shall review any previously denied, or currently pending, claim for assistance from the program and make a new determination of eligibility.