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House Bill No. 5506

Public Act No. 22-118 303 of 739

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 [July 20, 2022] 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 [July 20, 2022] 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.