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Documents needed to complete your paid family and medical leave (PFML) application

When you apply for PFML, you will be asked to provide documents to verify the information included in your application.

When you apply for medical and family leave, you’ll need to provide some information about your situation so we can verify the details of your application. Here is a list of specific documents, forms, and other materials you will be asked to provide copies of as part of your paid family or medical leave application.

Please provide color copies of identity verification documents. Please do not send the Department original documents - they will not be returned to you.

Only PDF and image files (.jpg, .jpeg, .png) are accepted. Files must be smaller than 4.5 MB.

Learn more about document requirements and formatting for upload

Table of Contents

For All Applications: Documents to prove your identity

No matter what type of leave you apply for, you will need to prove your identity. The easiest way to do that will be to provide a color copy of a Massachusetts Driver’s License or ID card, but there are other options available.

A few requirements to keep in mind when you apply for paid family and medical leave:

  1. You must include both the FRONT and BACK of the document for it to be accepted.

  2. Document copies must be IN COLOR and ONLY PDF or .jpg, .jpeg, .png IMAGE FILES are accepted. We are not able to accept .heic (the default image file for iphones) at this time.

  3. Color documents must be uploaded or mailed as we cannot accept color faxes at this time.

  4. Files must be smaller than 4.5 MB.

Learn more about document requirements and formatting for upload

To provide proof of identity, you will need a color copy (front and back) of ONE of the following documents for ID proofing:

  • A valid, unexpired U.S. State or Territory Real-ID License or ID card

  • A valid, unexpired U.S. State or Territory Standard License (also called a Standard Driver’s License) or ID card

  • A valid, unexpired U.S. Junior Operating License

  • A valid, unexpired Massachusetts Commercial Driver’s License

  • A valid, unexpired Massachusetts Limited Term License

  • A valid, unexpired Massachusetts Not for Federal Use license

  • A valid, unexpired Massachusetts Tribal ID card

  • A valid, unexpired U.S. passport or passport card (the copy should include both the page with identifying information AND the signature page)

  • A valid, unexpired Permanent Resident Card (Form I-551) issued by the U.S. Department of Homeland Security (DHS) or the U.S. Immigration and Naturalization Service

  • An employment Authorization Document (EAD) issued by DHS, Form I-766, or Form I-688B

  • A valid, unexpired foreign passport AND a work visa as defined by the U.S. Department of State

If you don’t have any of the options above, you will need to provide color copies of TWO documents:

One to prove your legal ability to live and work in the U.S., and one to prove your social security number (SSN) or if you are self-employed, your Individual Tax Identification Number (ITIN).

To demonstrate your legal ability to live and work in the U.S., you can use a color copy of any one of these documents:

  • A certified copy of your birth certificate filed with a State Office of Vital Statistics or equivalent agency in your state of birth. (A Puerto Rican birth certificate will only be accepted if it was issued on or after July 1, 2010. For more information on the Puerto Rican birth certificate law, visit the Puerto Rico Federal Affairs Administration.)

  • A certificate of Citizenship, Form N-560, or Form N-561, issued by DHS

  • A certificate of Naturalization (Form N-550 or N-570)

You can then provide proof of your 9-digit SSN or your ITIN using a copy of one of the following documents:

  • An SSN Card

  • A W-2 Form

  • An SSA-1099 Form

  • A Non-SSA-1099 Form

  • A pay stub with your full name and SSN on it

  • An authorization letter from the IRS displaying your 9-digit individual tax identification number

Remember, no matter which option or options you choose to use, document copies must include both the front and back, be in color, and be saved as a PDF or image file (.jpg, .jpeg, .png) to be accepted. Files must be smaller than 4.5 MB.

Color documents must be mailed or uploaded as we cannot accept color faxes at this time.

For Medical Leave Applications

Continuous leave for your own serious health condition

If you are taking continuous leave, you must provide DFML with a Certification of your Serious Health Condition form filled out by you and your health care provider. This is a new version of this form. If you are already using the old form, you can submit that as part of your application.

It is important that your health care provider fill out the form as completely as possible, especially:

  • A statement that you have a serious health condition (Questions 8-10). This is the reason for your leave so make sure to discuss your medical condition with your health care provider. If this section is not filled out properly and completely, it could delay your leave approval.

  • The date on which your serious health condition started (Form Question 11). 

  • The probable duration of your serious health condition (Form Questions 14-16, Part 3A).

  • A certification that you can’t work due to your serious health condition (Form Question 23).

Reduced or intermittent leave for your own serious health condition

If you are taking intermittent or reduced paid leave in addition to continuous or instead of continuous leave, your health care provider should also include the items listed below:

  • The probable duration of your serious health condition (Form Questions 17-19 and/or 20-22, Part 3B and C)

For Family Leave Applications

Family leave to bond with a child

Family leave can be taken by a parent or legal guardian to bond with a child during the first 12 months after the child’s birth, adoption, or foster care placement. In order to be approved to take family leave, you will need to send in one of these documents:

  • The child's government-issued birth certificate, or 

  • A statement from the child's health care provider stating the child's birth date, or 

  • A statement from the health care provider of the person who gave birth stating the child's birth date, or 

  • A statement or Birth Record from the hospital where the child was born indicating the child’s birth date and signed by the Birth Registrar, or

  • A certificate from the child's health care provider confirming both the placement of the child AND date of placement, or

  • A certification from an adoption or foster care agency involved in the placement confirming both the placement of the child AND date of placement, or

  • A certificate from the Department of Children and Families confirming both the placement of the child AND the date of the placement

Family leave to care for a family member with a serious health condition

In addition to proving your identity, to be approved for family leave to care for a family member, we will need to confirm your relationship to your family member and their serious health condition. To do this, you’ll need a Certification of your Family Member's Serious Health Condition form filled out by your family member’s health care provider. It is important that your family member’s health care provider fill out the form as completely as possible, especially:

  • A statement that your family member has a serious health condition and any other relevant details about your family member’s condition (Form Questions 14-15, 18)  This is the reason for your leave so make sure to have your family member discuss their medical condition with their health care provider. If this section is not filled out properly and completely, it could delay your leave approval.

  • When your family member’s condition began (Form Question 16) 

  • That you, the employee, are needed to care for the family member and what kinds of care might be needed (Form Question 19-20)

  • Information about how often and how long your family member needs you to care for them (Form Questions 21-29)

  • The name and address of your family member and their relationship to you (Form Questions 8-11) 

Family leave to care for a family member who is a covered service member

Currently, applications for military-related paid family leave can only be made by calling the Department’s Contact Center at (833) 344-7365.

In order to apply for military-related paid family leave, a Contact Center Agent will guide you through the application. You can make the process quicker by gathering your required verification documents before calling the Contact Center.

In addition to proving your identity, to be approved for family leave to care for a family member who is a covered service member, we’ll need to confirm your relationship to your family member and their serious health condition. To do this, you’ll need a Certification of your Family Member's Serious Health Condition form filled out by your family member’s health care provider. It is important that your family member’s health care provider fill out the form as completely as possible, especially:

  • Attestation by the service member's health care provider that the health condition is connected to the service member's military service (Form Question 17) This is the whole reason for your leave so make sure your family member’s health care provider is aware of this on the form.

  • The date on which the covered service member's serious health condition began (Form Question 16)

  • That you, the employee, are needed to care for the covered service member and what kinds of care might be needed (Form Question 19-20)

  • Information about how often and how long the covered service member needs you to care for them (Form Questions 21-29)

  • Your familial relationship with the covered service member (Form Question 8)

  • The name and address of the covered service member (Form Questions 9-11) 

Family leave to manage affairs while a covered servicemember is or will be deployed

Currently, applications for military-related paid family leave can only be made by calling the Department’s Contact Center at (833) 344-7365.

In order to apply for military-related paid family leave, a Contact Center Agent will guide you through the application. You can make the process quicker by gathering your required verification documents before calling the Contact Center.

In addition to proving your identity, when applying to manage affairs when a family member who is a covered service member is or will be deployed, you should include copies of documents that prove the following:

  • The dates or period of time for which your leave is required  

  • The underlying reason for your leave 

  • Your familial relationship with the service member

  • The name and address of the family member being cared for 

  • Information as required by Department proving identity of family member who is or will be deployed

And a copy of one of the following certification documents: 

  • A copy of the family member's active duty orders 

  • A letter of Impending Activation from the family member's Commanding Officer 

  • FMLA WH-384 form

Contact

Phone

For questions about benefits and eligibility: (833) 344-7365

Department of Family and Medical Leave - Hours of operation: Monday-Friday, 8 a.m - 5 p.m.

Fraud Reporting Hotline: (857) 366-7201

Department of Family and Medical Leave - Hours of operation: Monday-Friday, 8 a.m - 5 p.m.

For questions about contributions and exemptions: (617) 466-3950

Department of Revenue - Hours of operation: Monday-Friday, 8:30 a.m. - 4:30 p.m.

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