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Massachusetts COVID-19 Emergency Paid Sick Leave Request Form and Employer Reimbursement Process

On July 8, 2021, the Executive Office for Administration and Finance (“EOAF”) made available a sample form for employees to request COVID-19 sick leave under the COVID-19 Temporary Emergency Paid Sick Leave Act (the Act). The Act, which has been in effect since May 28, 2021, permits employees with a primary place of employment in Massachusetts to take up to 40 hours of COVID-19 sick leave if they are unable to work for specified COVID-19-related reasons. To receive reimbursement from the Commonwealth for the costs of providing COVID-19 sick leave, employers must require their employees to submit written requests that include certain information. While employers were initially advised to prescribe their own request forms, all the information that must be collected is now addressed in the sample form that is available on that state’s COVID-19 Temporary Emergency Paid Sick Leave Program webpage under the “Additional Resources” section.

For additional information on the details of the COVID-19 Sick Leave Law, refer to HR Works’ prior communication regarding this law.

HR Works, headquartered in Upstate New York, is a human resource management outsourcing and consulting firm serving clients throughout the United States for over thirty years. HR Works provides scalable strategic human resource management and consulting services, including: affirmative action programs; benefits administration outsourcing; HRIS self-service technology; full-time, part-time and interim on-site HR managers; HR audits; legally reviewed employee handbooks and supervisor manuals; talent management and recruiting services; and training of managers and HR professionals.