Health care provider responsibilities for Paid Family and Medical Leave

Health care providers are a critical part of maintaining the integrity of Commonwealth's Paid Family and Medical Leave (PFML) program.

Overview

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

Download a Health Care Provider Toolkit to learn more about PFML and your role.

You may need to fill out:

• The Certification of your Serious Health Condition form when your patient needs medical leave due to the patient’s serious health condition
• The Certification of your Family Member's Serious Health Condition form when your patient’s family member needs to take leave to care for your patient

Additional Resources

Health Care Provider Toolkit for Paid Family and Medical Leave

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Who is a health care provider?

A health care provider is licensed and practices medicine, surgery, dentistry, chiropractic, podiatry, midwifery, or osteopathy.  

This includes podiatrists, dentists, clinical psychologists, optometrists, chiropractors, nurse practitioners, nurse midwives, clinical social workers, physician assistants, and Christian Science Practitioners listed with the First Church of Christ, Scientists in Boston. 

What is a serious health condition?

A serious health condition is a physical or mental condition caused by a medical incapacity that prevents an employee or family member from doing their job for more than 3 consecutive days, and requires ONE of the following: 

• Overnight stay in a medical facility 
• Two or more treatments by a health care provider within 30 days of whatever prevented the patient from doing their job 
• At least 1 treatment by a health care provider within 30 days of whatever prevented the patient from doing their job, with plans for continued treatment, including prescriptions 

Serious health conditions include: 

• Chronic conditions, like asthma or diabetes, that stop the patient from working periodically and require going to the doctor more than twice a year 
• Permanent or long-term conditions, like Alzheimer's disease, stroke, or cancer, that will need ongoing attention but will not necessarily require active treatment by a certified health care provider 
• Conditions requiring multiple treatments, like chemotherapy, kidney dialysis, or physical therapy 
• Complications related to a diagnosis of COVID-19 that prevent a patient from working, as certified by a health care provider 
• Substance Use Disorder may be considered a serious condition if the patient is receiving treatment from a certified health care provider 
• Conditions due to pregnancy or post-birth recovery that prevent you from working, as certified by a health care provider
• Conditions due to miscarriage, stillbirth or perinatal depression that prevent you from working, as certified by a health care provider
  • Unfortunately, some pregnancies end in miscarriage or stillbirth. DFML recognizes that the pregnant individual may need to recover both physically and mentally after either of these difficult outcomes. Medical leave can be taken for this recovery if it is certified as a serious health condition by the individual's medical provider. 
  • Since perinatal depression can impact both the pregnant individual and their partner, medical leave may be available to either person for that condition if it is certified as a serious health condition by the individual's medical provider. Partners may also be eligible for family leave to care for the pregnant individual during their recovery.

Serious health conditions do not include: 

• Cosmetic surgery is not considered a serious condition and is not covered by family or medical leave, except when inpatient care is required or complications develop. 

Medical leave applications

The Certification of Your Serious Health Condition form is required for your patient’s application for medical leave for their own serious health condition. The Department of Family and Medical Leave (DFML) will use the information on this form to approve or deny applications for paid medical leave benefits. Learn more about filling out the form. 

The form should contain relevant information about the serious health condition that prevents your patient from doing their job. It should include but not be limited to:  

• A statement that your patient has a serious health condition preventing them from doing their job and any other relevant details about your patient's condition (Questions 7-12). This is the reason for your patient’s leave so make sure to discuss their condition with them. 
• The probable duration of your patient’s serious health condition (Questions 13-15). 

Your patient should bring a copy of the form with them for you to fill out during their regularly scheduled appointment. It is the patient’s responsibility to submit the completed form to DFML as a part of their application.  

Family leave applications

Employees submit the Certification of your Family Member's Serious Health Condition form as part of their application for family leave to care for a family member with a serious health condition. You will receive this form when your patient has a serious health condition that requires care from a family member, and that family member needs time off work to provide that care.  

The family member may not be your patient, but they will need the certification from you to show their need for leave to care for your patient. DFML will use the information on this form to approve or deny applications for paid family leave benefits. Learn more about filling out the form. 

The form should contain relevant information about your patient’s serious health condition that requires the family member to take paid family leave to care for them. It should include but not be limited to: 

• A statement that your patient, the employee’s family member, has a serious health condition and any other relevant details about your patient's condition (Questions 14, 16) This is the reason for an employee to take leave to care for your patient.
• That your patient needs care from their family member and what kinds of care might be needed (Question 17-18).
• Information about how often and how long your patient needs the family member to care for them (Questions 19-21).

Your patient's family member should bring a copy of the form with them for you to fill out. It is the family member’s responsibility to submit the completed form to DFML as a part of their application.