How can Paid Family Leave Help you this Holiday Season?

How can Paid Family Leave Help you this Holiday Season?

How can Paid Family Leave Help you this Holiday Season?
Need Paid Family Leave Help?

PFL Can Help You This Holiday Season

As of January, 2018, most employees who work for private employers are eligible to take paid family leave. If you work for an public entity, your employer may choose to offer paid family leave.

Paid Family Leave (PFL) provides job-protected, paid off time so you can:

  • Bond with adopted/fostered child or a newly born
  • Care for a close relative with a serious health condition
  • Assist loved ones when a family member is deployed abroad on active military service

How long do I have to work for eligibility?

  • Full-time employees -who work 20 or more hours per week, are eligible for Paid Family Leave after 26 consecutive weeks of employment.
  • Part-time employees – who work less than 20 hours per week, are eligible after working 175 days, which do not need to be consecutive.

How do I apply?

Four basic steps for an employee to request Paid Family Leave:

  1. First, you must notify your employer at least 30 days before your leave will start. If this is not done, it’s foreseeable. Otherwise, notify your employer as soon as possible.
  2. Second, obtain the request form package for the specific type of leave you need to take (from your employer, your employer’s insurance carrier or directly from the website.) Complete the request form for Paid Family Leave (Form PFL-1), following the instructions on the cover sheet. Make a copy for your records, you submit it to your employer.
  3. Third, the employer must fill out their section of the form and return it to you within 3 business days.
  4. Fourth, you lastly then submit Form PFL-1, the other request forms specific to the leave you are taking, and supporting documentation directly to your employer’s Paid Family Leave insurance carrier. You can then submit your request before or within 30 days after the start of your leave process.

Required Supporting Documentation

When you put in a request for Paid Family Leave, you will need to file a Request for Paid Family Leave form. Documentation will be needed in support of your Paid Family Leave request. The specific documentation required varies based on the specific type of leave you are requesting.

For the Birth of a Child:

  • Birth certificate
  • Documentation of pregnancy or birth form from health care provider

A second parent will need:

  • Birth certificate/ voluntary acknowledgement of paternity
  • Copy of documentation of pregnancy or birth from a health care provider that includes mothers name and due/birth dates.

Foster Care:

  • Letter of placement issued by city department of social services, county, or local voluntary agency
  • If second parent is not named in documentation, a copy of that document verifying relationship to the parent named in the foster care placement will be needed.

Adoption:

  • Provide legal evidence of adoption process
  • If second parent is not named in legal documents, the second parent must provide a copy of the legal evidence of adoption process. As, well as another document verifying the relationship to the parent in the document.

Leave to Care for Serious Medical Condition:

  • Family member with serious health condition will need to have their health care provider complete the Health Care Provider Certification for Care of a Family Member with Serious Health Condition ( Form PFL-4)
  • This form is a required part of your Paid Family Leave request. It must be submitted to your employer’s Paid Family Leave insurance within 30 days of the first date you take Paid Family Leave.

Military-related Leave:

  • US Department Labor Military Family Leave Certification
  • Copy of Military Duty papers
  • Documentation supporting the reason for the leave

Questions during this process:

  • Can I take both short-term/ temporary disability and Paid Family Leave at the same exact time?

Answer: No, not at the exact same time. You can take the short-term disability and then Paid Family Leave or Paid Family Leave and then short-term disability. If you qualify for either. However, you cannot take more than 26 weeks of combined short-term disability and Paid Family Leave in a 52-week period.

  • If I participate in Paid Family Leave, when will I receive payment?  How many days will I have to wait?

Answer: The insurance carrier has 18 days after receipt of a completed request for Paid Family Leave. To either pay or deny the claim. After the initial payment, they’ll pay benefits bi-weekly.

  • Where and who do I send my completed request forms and documentation?

Answer: Your completed request should be sent to your employer’s Paid Family Leave insurance carrier at the address provided in the PFL-1 Form Part B, Question 13 (the section your employer completed), if they are self-insured send it directly. If all the information is not on the form, ask your employer for the carrier’s address. Or contact Paid Family Leave Helpline at 844-337-6303.

Complaints: Benefit/ Denial Disputes

If you happen to get denied or partially denied for Paid Family Leave, your insurance carrier (or employer, if self-insured) must provide you with specific reason for denial and information about requesting arbitration. This is one of the best times to enlist the Social Security Disability Advocates for your case.

The NAM (National Arbitration and Mediation) handles Arbitration. You may also request arbitration for any other PFL claim-related disputes, such as denial or timeliness of the carrier’s payment. Insurers must deny or pay your request within 18 days of receiving your completed request, or your first day of leave, whichever is later.

How to Protect Yourself from Discrimination and Retaliation When taking Paid Family Leave

Your employer cannot discriminate or retaliate against you for requesting or taking PFL. They must reinstate you to the a comparable position when you return from Paid Family Leave. If you make a request or take PFL and your employer:

  • Terminates your employment completely
  • Reduces your pay or benefits in anyway
  • Disciplines you in anyway or matter
  • Does not return you to your comparable job

Which States Enacted Paid Family Leave Programs?

Six current states and the District of Columbia have programs for Paid Family Leave in order to bond with a new child, care for oneself because of a serious health condition, or care for certain ill family members. Most states are considering enacting such policies.

Paid Family Leave benefits can also raise administrative concerns from the employer’s perspective. However, research in early-adopter states showed the value of paid family leave as a “caregiver-friendly” policy, for employers and the economy as a whole. Also, Paid Family Leave lessens the strain of care giving and actually provide family caregivers with greater financial security, help maintain a productive workforce, and lastly increase employee retention.

Majority of employers surveyed in states that have enacted these workplace leave benefits have not experienced any negative impacts on their business trends suggest increasing share of family caregivers will also be in future labor force.

PFL policies are an amazing investment, from both the perspective of America’s working families and employers. Workers should not have to choose between providing care to a seriously ill family member or keeping their jobs.

Questions about Social Security?

We know that Social Security can be confusing to deal with, so contact Social Security Disability Advocates USA for help. Reach us at 24/7 at (602) 952-3200 or you can also chat with us online. Consultations are free, too, so don’t hesitate to contact us.

The information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.

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