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Health care provider responsibilities for paid family and medical leave

Health care providers are a critical part of maintaining the integrity of Massachusetts’ paid family and medical leave program.

Table of Contents

Overview

As a health care provider, you play an important role in Massachusetts’ paid family and medical leave application process. We’ll rely on the information you provide to approve or deny paid leave applications. 

Your main responsibility will be to fill out the Certification of a Serious Health Condition form that patients submit as part of their application for paid family or medical leave. The Department of Family and Medical Leave will use the information on this form to approve and deny applications for paid leave.  

An applicant’s Certification of a Serious Health Condition form should contain relevant information about the serious health condition that is causing their need to take leave, including but not limited to: 

  • The nature of the serious health condition 

  • When the serious health condition began 

  • For medical leave applications, whether the serious health condition prevents your patient from working 

  • How long the serious health condition is expected to last 

Your patients should bring a copy of the Certification of a Serious Health Condition form with them for you to fill out during their regularly scheduled appointment if they are planning on applying to take paid family or medical leave. It will be their responsibility to submit the completed form to the Department as a part of their application for paid leave. 

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, 9 a.m. - 4 p.m.

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