Applying for Benefits

TOP Applying for Benefits
Filing a Claim
WYSIWYG

Your employer’s insurance carrier will receive and process claims, and make benefit payments. If your employer self-insures, they will receive and process claims, and make benefit payments.  You can find more information about filing a claim by calling the Paid Family Leave toll-free helpline at (844) 337-6303.

You are responsible for notifying your employer if you intend to claim Family Leave Insurance benefits. If your family leave is foreseeable, you must give your employer 30-days advance notice so they can plan for your absence. If the event was not foreseeable, you must notify your employer as quickly as possible.

Note: Paid Family Leave does not go into effect in New York State until January 1, 2018.

0
Required Documentation
Required Documentation
WYSIWYG

You will need to file a Request for Paid Family Leave form and documentation in support of your Paid Family Leave request.

To justify your request for Paid Family Leave, you will be required to present a certification from the health care provider treating your family member or, if the leave is following birth of a child, the health care provider treating the mother of the child. For adoption and foster care, different types of documentation will be needed. If you are taking Paid Family Leave for a qualifying military event, you will need to present copies of Duty Papers or other supporting documentation.

For Birth:

The birth mother will need the following documentation:

  • Birth Certificate, or
  • Documentation of pregnancy or birth from a health care provider (includes mother’s name and due/birth dates)

A second parent will need the following documentation:

  • Birth certificate, or if not available, a voluntary acknowledgment of paternity or court order of filiation; or
  • A copy of documentation of pregnancy or birth from a health care provider (includes mother's name and due/birth dates) and a second document verifying the parent's relationship with the birth mother or child.

For Foster Care:

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

For Adoption:

  • 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 and a second document verifying the relationship to the parent named in the document.

For Serious Medical Condition:

  • Certification from the Care Recipient's Health Care Provider 

For the Military:

  • US Department of Labor Military Family Leave Certification (Federal Military Leave Form)
  • Copy of Military Duty Papers
  • Other documentation supporting the reason for the leave (copy of meeting notice, ceremony details, rest and recuperation orders, etc.)
0
Using Your Paid Family Leave Benefit
Using Your Paid Family Leave Benefit
WYSIWYG

When do I need to file a claim?
If you have a foreseeable situation, you must give your employer 30-days advance notice so they can plan for your absence.

If the event was not foreseeable, you must notify your employer as quickly as possible. If you fail to do so without unusual circumstances justifying the failure, your Paid Family Leave can be delayed or partially denied.

 

Do I have to follow my employer’s policies for leave when requesting Paid Family Leave?
If your employer’s rules about taking time off are less strict than the rules to take Paid Family Leave, your employer may require you to follow them. 

 

How will I be paid?
You will be paid by check, direct deposit or debit card. Not every carrier will offer all three, but the carrier must pay you by check if you request this on your Request for Paid Family Leave.

 

When will I be paid?
Within 18 days of filing a complete claim for benefits, the Paid Family Leave insurance carrier (or your employer if they self-insure) must pay you or deny the claim and provide an explanation of the denial.

 

Will I be able to take Paid Family Leave on an hourly basis?
No, Paid Family Leave is only available in full day increments, but it can be taken intermittently, so you can take only the full days off during the week when you are caring for your relative or bonding with a child.

 

My employer offers benefits that go beyond the state’s program, such as more than 12 weeks leave or higher wage replacement. Can I use both?
If your employer already has a Paid Family Leave program that fulfills or exceeds New York state law, you will receive only those benefits. The provisions of the Paid Family Leave law are a foundation; employers are free to exceed the minimum benefit required by law.

 

If I receive 8 weeks of Paid Family Leave benefits to bond with my newborn and then one of my parents becomes seriously ill later in the year, will I be able to receive Paid Family Leave benefits again since it is for a different reason?
No. An employee is only eligible for the maximum benefit for the year they apply.

 

Can I take both temporary disability and Paid Family Leave?
Your combined total disability leave and Paid Family Leave in any 52 week period may not exceed 26 weeks.

0
Claims Denial and Discrimination
Claims Denial and Discrimination
WYSIWYG

If your claim for Paid Family Leave is denied and you disagree with the denial reason, you may request to have the denial reviewed by an independent arbitrator. Your employer must send you information explaining how to file a request for arbitration of your denial of Paid Family Leave benefits.

For more information, you can check with your Human Resources department.

 

If my employer does not complete or fully complete the Employer section on the Request for Paid Family Leave, can my claim be denied? 
No. Your claim may not be denied because the employer section of the Request for Paid Family Leave is incomplete.

 

What are the protections for employees who take Paid Family Leave?
An employer may not discriminate against employees for taking Paid Family Leave.

Employees are guaranteed job protection, with the same or a comparable job, upon return from Paid Family Leave. Employees are also guaranteed continuation of health insurance while out on Paid Family Leave.

Note:  An employee who contributes to the cost of health insurance must continue to pay his or her portion of premium cost while out on Paid Family Leave.

 

Can my employer take any action against me for taking Paid Family Leave?
No. Your employer may not retaliate or discriminate against you because you have taken Paid Family Leave. If your employer does not return you to your same or a comparable job, you must formally request reinstatement. 

0
Contact Us
Contact Us

For more information, call the Paid Family Leave toll-free helpline Monday-Friday, 8:30am – 4:30pm ET.

(844) 337-6303