APPLICANT MUST MEET ALL THREE PARTS: AND AND WIOA DISLOCATED WORKER DOCUMENTATION GUIDE REFERENCES. and

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Shana Barber
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1 CATEGORY 1 Laid off/terminated (or received notice of layoff/termination), eligible/exhausted unemployment, unlikely to return to previous industry/occupation APPLICANT MUST MEET ALL THREE PARTS: 1. Terminated or laid off or received notice of termination or layoff from employment (15)(A)(i) Applicant s Unemployment Notice (UC-61) or UI Records (MD20 or IBIQ screens) DD-214 with other than dishonorable discharge Layoff letter from the employer or union (If the worker s name does not appear, also make a copy of WR10/IBIQ or paystubs showing wages from said employer). Please note that for some company-specific National Dislocated Worker Grants, the worker s name date of separation must appear on the letter) Rapid Response Early Intervention Self-certification stating that he/she has or will be laid off from company X on X date accompanied by UI Wage records (WR10 or IBIQ) or paystubs from said employer. 2. Is eligible for or exhausted entitlement to Unemployment Compensation (15)(A)(ii)(I) For those who have already filed for Unemployment Compensation: UI Records (MD20, IBIQ, NM01, or BP10); For those who have yet to file: UI Records (WR10 or IBIQ), DD-214 with other than dishonorable discharge, or W-2 or pay stubs if there are no wage records. This must be accompanied by a statement on the WIOA-5 verification field that the worker is able available for full-time work For Exhausted Unemployment Compensation: UI Records (BP10, MD20, or IBIQ)

2 CATEGORY 1 3. is unlikely to return to a previous industry or occupation (15)(A)(iii) MD20 or BP10 showing exhaustion of benefits or last day worked more than 26 weeks ago TAA-854 or TAA-857 (TAA eligibility documents) DD-214 or MD20 showing UCX as the program a discharge date is within the past 48 months MD20, driver s license, passport, hospital record of birth, DD-214, federal, state, or local government ID showing the individual is 55 or older MD30 on most recent unemployment claim where selection under ERS/RESEA is noted CTHires documentation or self-certification form indicating a lack of a High School diploma or its equivalent MD30 (showing the worker s language of preference) or signed statement by DOL staff that the worker is an English language learner Doctor s note or medical records showing the individual s present or past disability or a selfcertification form in which the individual states the nature of the disability Fewer than 10 full-time job postings for the individual s previous occupation in the local labor market area for which the worker is qualified CT DOL LMI or other local/regional business professional information indicating declining occupations or industries

3 CATEGORY 1 3. is unlikely to return to a previous industry or occupation (15)(A)(iii) O*Net Online, My Next Move, My Skills My Future, Occupational Outlook Hbook or other sites which indicate declining job growth for certain occupations Doctor s note stating the individual can no longer perform his/her previous occupation for medical reasons Documentation of limited number of employers in the state in a certain occupation Media reports or Rapid Response Early Intervention/Rapid Response notices indicating multiple layoffs in the same industry Documented Job Search Log (Must have minimum of 3 job contacts on at least two separate dates for each of the past 4 weeks. The log must indicate date of contact, employer name, address, contact (if known), position applied for, method of contact (resume, application), result of the contact (waiting to hear, interview scheduled)

4 CATEGORY 2: Laid off/terminated (or received notice of layoff/termination), worked for a sufficient duration but is not eligible for unemployment due to insufficient wages or employment not covered by UC law, unlikely to return to previous industry/occupation APPLICANT MUST MEET ALL THREE PARTS: 1. Terminated or laid off or received notice of termination or layoff from employment (15)(A)(i) Applicant s Unemployment Notice (UC-61) or Unemployment Compensation Records (MD20 or IBIQ screens) DD-214 with other than dishonorable discharge Layoff letter from the employer or (If the worker s name does not appear, also make a copy of WR10/IBIQ or paystubs showing wages from said employer). Please note that for some companyspecific National Dislocated Worker Grants, the worker s name date of separation must also appear) Rapid Response Early Intervention Self-certification stating that he/she has/will be laid off from company X on X date accompanied by UI Wage records (WR10 / IBIQ) or paystubs from said employer. 2. has been employed for a duration sufficient to demonstrate, to the appropriate entity at a one-stop center, attachment to the workforce, but is not eligible for unemployment compensation due to insufficient earnings or having performed services for an employer that were not covered under a state U.C. law (15)(A)(II) Pay stubs for the past three months Documented Job Search Log (Must have minimum of 3 job contacts on at least two separate dates for each of the past 4 weeks. The log must indicate date of contact, name, address, contact at the employer (if known), kind of work sought, method of contact (resume, application), result of the contact (waiting to hear, interview scheduled) Additionally, anyone certified under this part must have a note in the statement on the WIOA-5 verification field that the worker is able available for full-time work

5 CATEGORY 2: 3. is unlikely to return to a previous industry or occupation (15)(A)(iii) MD20 or BP10 showing exhaustion of benefits or last day worked more than 26 weeks ago TAA-854 or TAA-857 (TAA eligibility documents) DD-214 or MD20 showing UCX as the program a discharge date is within the past 48 months MD20, driver s license, passport, hospital record of birth, DD-214, federal, state, or local government ID showing the individual is 55 or older MD30 on most recent unemployment claim where selection under ERS/RESEA is noted CTHires documentation or self-certification form indicating a lack of a High School diploma or its equivalent MD30 (showing the worker s language of preference) or signed statement by DOL staff that the worker is an English language learner Doctor s note or medical records showing the individual s present or past disability or a selfcertification form in which the individual states the nature of the disability Fewer than 10 full-time job postings for the individual s previous occupation in the local labor market area for which the worker is qualified CT DOL LMI or other local/regional business professional information indicating declining occupations or industries

6 CATEGORY 2: 3. is unlikely to return to a previous industry or occupation (15)(A)(iii) O*Net Online, My Next Move, My Skills My Future, Occupational Outlook Hbook or other sites which indicate declining job growth for certain occupations Doctor s note stating the individual can no longer perform his/her previous occupation for medical reasons Documentation of limited number of employers in the state in a certain occupation Media reports or Rapid Response notices indicating multiple layoffs in the same industry Documented Job Search Log (Must have minimum of 3 job contacts on at least two separate dates for each of the past 4 weeks. The log must indicate date of contact, employer name, address, contact (if known), position applied for, method of contact (resume, application), result of the contact (waiting to hear, interview scheduled) CATEGORY 3: Plant closing/substantial layoff Has been terminated or laid off, or has received notice of termination or layoff, from employment as a result of any permanent closure of, or substantial layoff at, a plant facility or enterprise (15)(B)(i) WARN notice that meets the definition of a closing or substantial layoff at a plant, facility, or enterprise Letter from employer or union that indicates a closing or substantial layoff. Rapid Response Unit Early Intervention Notice or Fact Sheet that indicates a closing or substantial layoff

7 CATEGORY 3: Plant closing/substantial layoff Has been terminated or laid off, or has received notice of termination or layoff, from employment as a result of any permanent closure of, or substantial layoff at, a plant facility or enterprise (15)(B)(i) Unemployment Notice (UC-61) which lists closing as the reason for separation Self-certification where the worker attests that he/she has or will be laid off from X company on X date as a result of a substantial layoff or plant closure accompanied by UI wage records (WR10/IBIQ) or pay stubs from said employer CATEGORY 4: Plant closing - general announcement Is employed at a facility at which the employer has made a general announcement that such facility will close within 180 days OR for purposes of eligibility to receive services other than training services, career services, or supportive services, is employed at a facility at which the employer has made a general announcement that such facility will close. (15)(B)(ii) & (iii) Media announcement in which company officials state that a plant, facility, or enterprise will close within 180 days or more Rapid Response Unit Early Intervention Notice or Fact Sheet that indicates a closing within 180 days or more Self-certification where the worker attests that he/she has or will be laid off from X company on X date as a result of a substantial layoff or plant closure accompanied by UI wage records (WR10/IBIQ) or pay stubs from said employer

8 CATEGORY 5: Previously self-employed but unemployed due to economic conditions or natural disasters Was self-employed (including employment as a farmer, rancher, or fisherman) BUT (15)(C) Business Quarterly or Annual Tax Return State Tax Identification Number Business License/Permit IRS documentation for the business is unemployed as a result of general economic conditions in the community in which the individual resides or because of natural disasters (15)(C) Business ledgers showing expenses exceeding income Chapter 7 or 11 bankruptcy published in newspaper Letter or documentation of the failure of a business supplier or customer Chamber of Commerce data which indicates less than favorable economic conditions Federal/state declaration of disaster Media reports of general economic conditions Self-certification form in which the individual attests that he or she was self-employed but is currently unemployed as a result of economic conditions or because of a natural disaster

9 CATEGORY 6: Displaced Homemaker Is a Displaced Homemaker (15)(D) Must qualify under 1 or 1a meet conditions under 2 The term displaced homemaker means an individual who has been providing unpaid services to family members in the home who: (16) Tax returns (of then married couple or of domiciled family members) Divorce decree/court records Family member s death certificate 1. Has been dependent on the income of another family member but is no longer supported by that income (16)(A)(i) UI records of the displaced homemaker (WR10, IBIQ, MD20) Pay stubs for the last six months Self-certification form in which the individual attests that he/she resided with the family member(s), provided unpaid in-home services to family members, for six months or more was dependent on another family member for more than 50% of the household income but is no longer supported by that income due to death, divorce, etc. OR 1a. Is the dependent spouse of a member of the Armed Forces on active duty (16)(A)(ii) Marriage license or joint tax return Military orders

10 CATEGORY 6: whose family income is significantly reduced because of a deployment, or a call or order to active duty, a permanent change of station, or the service-connected death or disability of the member; (16)(A)(ii) Military orders DD-214 or other documentation certifying a service-connected death or disability Pay stubs of Armed Forces Member spouse (or unemployment wage records) before after deployment, call to duty, change in duty station, or the service-connected death or disability of the member. Pay stubs must show a 20% reduction. 2. Is unemployed or underemployed is experiencing difficulty in obtaining or upgrading employment (16)(B) Self-certification stating the family income has been reduced by 20% due to a deployment, call or order to active duty, permanent change in station, or the service-connected death or disability of the member. UC-61, MD20, BP10, or IBIQ Pay stubs indicating less than full-time employment (<35 hours per week) applicant statement on full-time availability WR10 or MD02 records showing previous wages that are higher than current wages Documentation showing current annualized wage rate, in relation to family size, is not in excess of the higher of either the federal poverty level (FPL) or 70% of the Lower Living Stard Income Level (LLSIL)

11 CATEGORY 6: 2. Is unemployed or underemployed is experiencing difficulty in obtaining or upgrading employment (16)(B) Self-certification stating that the worker is unemployed or underemployed he/she has looked for employment for a minimum of four weeks has been unable to find work or has attempted to gain employment at a higher level but has been unsuccessful CATEGORY 7: Spouse of an active duty armed forces service member who is unemployed due to change in duty station Is the spouse of a member of the Armed Forces on active duty (15)(E)(i) Marriage license or tax returns Military orders Must meet all conditions who has experienced a loss of employment as a direct result of relocation to accommodate a permanent change in duty station of such member Military orders showing change in duty station MD20 or equivalent showing separation from employment Self-certification stating his/her employment loss was due to the change in duty station

12 CATEGORY 8: Unemployed/underemployed spouse of an active duty armed forces experiencing difficulty in obtaining/upgrading employment Is the spouse of a member of the Armed Forces on active duty (15)(E)(ii) Marriage license or tax returns Military orders Must meet all conditions is unemployed or underemployed is experiencing difficulty in obtaining or upgrading employment (16)(B) UC-61, MD20, IBIQ or BP10 Pay stubs indicating less than full-time employment (<35 hours per week) applicant statement on full-time availability WR10 or MD02 records showing previous wages that are higher than current wages Documentation showing current annualized wage rate, in relation to family size, is not in excess of the higher of either the federal poverty level (FPL) or 70% of the Lower Living Stard Income Level (LLSIL) Self-certification stating that the worker is unemployed or underemployed he/she has looked for employment for a minimum of four weeks has been unable to find work or has attempted to gain employment at a higher level but has been unsuccessful

Revision to WIA Eligibility Documentation Guide

MEMO: AP 00-21 Change 5 DATE: May 22, 2007 TO: FROM: SUBJECT: WIB Directors WIB Chairpersons Grant Recipients Carl Buzzelli WIA Program Manager Revision to WIA Eligibility Documentation Guide Background: