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Employer role in the paid family and medical leave review process

Leave administrators play a critical role in the paid family and medical leave approval and appeals process.

As representative for your employer to manage requests for paid leave, you’ll play an important role in the paid family and medical leave process. The Department of Family and Medical Leave will rely on you to provide important details about applications that list your employer, in order to verify the accuracy of these claims. Here’s how that process will work.

Table of Contents

Reviewing an application

You will receive an email letting you know that an employee at the company you represent has submitted an application for paid family or medical leave. You will be able to view the details of the employee’s application by clicking on a link provided in the email.

When you receive this email notification, you will have 10 business days to review and respond to the information. If we don’t hear from you or any other verified leaved administrator from your organization in that time, we will proceed with the application using only the information the employee provided. 

The first thing to determine is if you are the correct person to be evaluating this particular employee’s application. If you are not the correct person, check with your team – there should be someone else on your company’s staff that would be more appropriate. If you are the correct person to review, you will be ask to verify that the information you will provide during your assessment is true. 

Here is a list of information you may be asked to confirm or provide, as well as why we ask for this information. 

Other instances of paid and unpaid leave that the worker has taken in the past benefit year 

Most Massachusetts workers are eligible for up to 26 weeks of combined family and medical leave per benefit year. This combined leave may include: 

  • Up to 20 weeks of paid medical leave per benefit year to manage a personal serious health condition 

  • Up to 12 weeks of paid family leave per benefit year to care for a family member or to bond with a child, or 

  • Up to 26 weeks of paid family leave per benefit year to care for a family member who is a member of the armed forces. 

Paid family and medical leave is a Massachusetts-offered program. It works alongside federal programs like the Family and Medical Leave Act, and any independent leave programs offered by your employer. 

We ask if the worker has taken any other types of leave in the previous benefit year in order to confirm that they have not used more time than they are eligible for. 

The worker’s time with the company 

A worker’s history with the company and their wages play an important part in reaching a decision on their paid leave application. To be eligible for paid family and medical leave, a worker must have earned at least $5,400 and at least 30 times their calculated weekly paid leave benefit amount in the last 4 completed quarters. Former workers are eligible to take paid family and medical leave for up to 26 weeks after they have separated from their employer. 

Work patterns and hours 

While most paid leave will be taken all at once, workers may also apply for paid leave on an intermittent or reduced schedule. If they choose this option, they should have confirmed their leave schedule with you before beginning their application for paid leave. 

Reporting potential fraud 

You will be asked if any of the information provided appears to be fraudulent. The Department takes fraud allegations seriously. Any application where the paid leave administrator has indicated that fraud might be taking place will be flagged for further review. 

Would you approve? 

After your review of the information that the employee provided in their application, you will be asked if you are approving or denying their application based on the law and your company’s existing policies. 

You will not actually be approving or denying their application with this question – the Department will ultimately decide this – but your recommendation will be taken into consideration when the Department makes that decision. Note that if the employee is legally eligible to take paid family or medical leave, and if all aspects of the employee’s application are truthful and correct,  the application will be approved, even if it is inconvenient for the employer. 

If you have flagged the application for potential fraud, the system will automatically deny the application. 

Additional Resources

Reaching a decision

When a decision has been made on a specific application that you reviewed, you will receive an email with a link to a PDF containing details of the decision.

If a worker appeals a decision

Workers may appeal any aspect of a paid family or medical leave determination, including: 

  • Denial of benefits 

  • Leave modifications

  • Weekly benefit amounts

  • The duration of their leave

Employer Documentation Requirements

Employers must generally maintain records and documents relating to medical information, medical certifications, recertifications, or medical histories of employees in separate files/records from the usual personnel files and in accordance with any applicable laws and regulations.

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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