Request for Extension of Training Enrollment Deadline

TRA-856 (Rev. 09/15) Trade Readjustment Allowances (TRA) Request for Extension of Training Enrollment Deadline

IMPORTANTE - TENGA ESTO TRADUCIDO INMEDIATAMENTE

Name SS# Petition # Address

You may not receive TRA after your training enrollment deadline unless, prior to the deadline, you either enrolled in Trade Act-approved training or received a waiver of the training requirement. Extenuating circumstances may justify an extension of your enrollment period for an additional 45 days. Additionally, if you are subject to the 2009, 2011 or 2015 program rules, an extension beyond 45 days may be possible for “good cause.” o “Enrolled in Trade Act-approved training” means the individual has been accepted by a training provider for admittance into a program approved by CTDOL and the training will begin within 30 days.

Important: In order to restore TRA eligibility, individuals subject to 2002 program rules have a limited period of time to not only establish extenuating circumstances but also enroll in Trade Act-approved training or receive a training waiver. If you are covered by a petition number between 50,000 and 69,999; between 80,000 and 80,999 if you elected to be subject to 2002 rules; – contact a Trade Act representative in your local CT Works office immediately to apply for the waiver or enroll in training before the end of the 45-day period that follows your training enrollment deadline.

Instructions: Complete this questionnaire and attach copies of any available supporting evidence. For example, if illness, injury or a family emergency prevented you from complying with the training enrollment requirement, appropriate documentation may include physician’s certification, hospital records, or your airline itinerary. If there were factors outside of your control, be sure to explain the link between those factors and your failure to enroll in training, or receive a waiver, before the deadline. Unless submitting this form through your local CTWorks office, return it by mail or fax to: Connecticut Department of Labor - UI Technical Unit, 200 Folly Brook Blvd., Wethersfield, CT 06109-1114; fax (860) 263-6039.

TRA denial issued on Appeal received on Appeal status if denied TRA: FOR OFFICE USE ONLY:

Complete this section if you have already been denied TRA and receipt of your appeal is not acknowledged above. If you have not yet filed an appeal: If you are unsuccessful in requesting this extension, an appeal would be your only recourse. To be timely, an appeal must be filed within 21 days of the date of the decision denying TRA. If filing your appeal more than 21 days after the decision date, include a statement about your reason for filing the appeal late. I appealed the determination on . Appeal method: Internet in person by mail by fax I did not previously appeal the determination but I wish for my submission of this completed questionnaire to serve as my appeal and application for a hearing. I disagree with the TRA denial, referenced above, for the following reason(s):

1. When and how did you receive information regarding the Trade Act certification of your worker group and your eligibility to apply for benefits?

2. Did you receive any of the notice to attend a scheduled Trade Act orientation session following? (Check all that apply.) determination approving TRA determination denying TRA

3. How long have you been at the address indicated at the top of this page? If your address changed since the Labor Department’s previous mailing of any Trade Act notifications, indicate your prior address and moving date.

Did you advise the Post Office to forward your mail? Yes No 4. Have you experienced any significant mail delivery problems? Were any of the Labor Department’s Trade Act notices delayed in reaching you? Yes No If yes, explain.

5. If you were scheduled to participate in a Trade Act orientation session and failed to attend, what circumstances prevented you from reporting to the Job Center as directed?

6. If you did attend a Trade Act orientation session, explain why you ultimately failed to enroll in training or obtain a training waiver as directed. If any specific personal circumstances prevented you from satisfying the requirements, explain fully. What is or was the nature of these circumstances? When did these circumstances first occur? When were they over? If ongoing, explain.

What actions did you take, if any, to comply in light of these circumstances?

7. If you were unable to either 1) attend your scheduled Trade Act orientation session or 2) actively participate in reemployment activities scheduled by the Job Center (relating to the assessment of your skills or development of your reemployment plan): What efforts did you make, if any, to notify the Job Center regarding your circumstances and inability to attend or participate? When and how did you notify the Job Center?

What resulted from these efforts? If given any specific advice, explain and indicate the name of the contact person, if available. If you did not reschedule or failed to attend any rescheduled appointment(s), explain why.

TRA-856 8. If, as a member of a reserve component of the Armed Forces, you were required to interrupt or postpone employment-related assistance, including Trade Act benefits, indicate whether either statement is true and provide service dates. (Applicable only if you are subject to either the 2009 or 2011 program rules.) I served on active duty in the Armed Forces for a period of more than 30 days under a call or order to active duty of more than 30 days. Dates of service: to . I performed, as a member of the Army National Guard of the United States or Air National Guard of the United States, full-time National Guard duty under 32 U.S.C. 502(f) (regarding required drills and field exercises) for 30 consecutive days or more when authorized by the President or the Secretary of Defense for the purpose of responding to a national emergency declared by the President and supported by Federal funds. Dates of service: to . 9. Did any of the following reasons contribute to your inability to satisfy the training enrollment requirement and deadline? If yes, please explain. Failure of the Connecticut Department of Labor, or any other cooperating state agency, to carry out its responsibilities. Failure of your employer to comply with verification or other notification requirements relating to your trade- impacted employment following issuance of the Trade Act certification under which you are covered. Coercion or intimidation which prevented the prompt filing of a claim.

CERTIFICATION I certify that this information is true and correct, knowing the law provides penalties for false statements or the withholding of facts. If appealing the TRA denial referenced on page one, I certify that I am instructed to continue to file claims for weeks of unemployment pending a decision by the referee on my appeal. I understand that if I fail to file each week, as directed, no benefits can be paid for those weeks, irrespective of the decision of the referee. If my claim for Trade Readjustment Allowances (TRA) is approved, I understand that the decision could be reversed by a higher authority, and I agree to repay any amounts to which it is determined I am not eligible.

Worker’s Signature Date Telephone #

FOR OFFICE USE ONLY – WHEN SUBMITTING THROUGH A CTWORKS TRADE ACT REPRESENTATIVE TAA BRI was/will be given on Other scheduled appointments JS-52/training proposal submitted on Training start date Approval date A training program is under consideration for approval, but the TRA deadline will occur, (or occurred), before the worker is/was able to enroll in TAA approved training or obtain a waiver of training requirement. Explain below the status of the training program under consideration, and approximately what date the JS-52/training proposal will be submitted to the TAA Unit, if not already submitted.

o “Equitable tolling” is a doctrine that permits the suspension of a deadline date where equity demands, and may only apply in egregious circumstances where an individual acted with due diligence to meet the deadline. Example: where an individual was not notified of the deadline until after the deadline expired; or, where an individual was notified of TAA benefits and deadlines and did everything necessary to enroll in training by the deadline, but was unable to do so because the state did not approve the training in time. o If enrollment in approved training or issuance of a waiver is not possible within the 45-day period allowed for extenuating circumstances, should the “equitable tolling” doctrine be applied? Yes No Explain why or why not.

Authorized Signature Date Local Office

Print Name Title TRA-856