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Massachusetts Department of Family and Medical Leave Informed Consent Agreement

When you apply for Paid Family and Medical Leave benefits, the Department of Family and Medical Leave (DFML) will use information about you to administer your application and benefits. This agreement spells out how we will use that information.

Table of Contents

How we use your data

The information you provide to DFML will be used to administer Paid Family and Medical Leave benefits.  In order to process your claim application, and determine your eligibility and benefit amount, DFML will share your data with your employer and other entities as part of the application process, DFML may need to provide and/or retrieve your information from designated state agencies (“DFML State Partners”). We need this information to confirm your eligibility for coverage, determine your benefit amount, and give you the best service possible.

DFML State Partners may include but not limited to:

  • Department of Revenue 
  • Department of Unemployment Assistance 
  • Department of Industrial Accidents 
  • Office of the Comptroller 
  • Massachusetts Parole Board 
  • Department of Corrections 
  • Department of Public Health 
  • Department of Transitional Assistance 
  • Center for Health Information Analytics 
  • Registry of Motor Vehicles 
  • Department of Children and Families 
  • Office of the State Treasurer 
  • Executive Office of Technology Services and Security 
  • Any other “DFML State Partner” that DFML deems necessary to verify eligibility 

DFML takes its responsibilities regarding personal information seriously. Utilizing secure channels, DFML will verify your personal information such as your Social Security number, date of birth or driver’s license number by matching it against DFML State Partner data. For example, your information might be shared with the Department of Unemployment Assistance or the Department of Revenue to conduct data matches to track wages. Using data in this manner allows us to know we are providing the correct benefit amount to the correct, eligible person. 

DFML will share your certification of a serious health condition form with your current or former employer and DFML State Partners, to validate the information you’ve provided. In addition, we will share information about your claim with your current or former employer such as: 

  • Your name and date of birth 
  • When you start, submit, or update your claim 
  • The dates of leave you are requesting 
  • The type of leave you are requesting 
  • Whether your claim is approved or denied 
  • Legal notices 

To verify your identity and the authenticity of certification of serious health condition forms, we may also share this information with your health care provider.  

The DFML also uses information about participants to administer the program, to meet its reporting requirements, and to determine how the program is working and whether it is meeting its goals.

Your rights to confidentiality

The DFML takes the protection of personal information seriously.  The information you provide to the DFML will be kept confidential to the extent required by law and by your agreement to these terms.    

Participant’s authorization for DFML to release information 

Before completing an application, you must attest that you have read and understand this agreement and give the DFML permission to collect, share and use your information consistent with the terms of this agreement.

Participant’s attestation to the truthfulness of all statements to DFML

Before starting an application, you must also attest to giving true answers to all questions.  

If the DFML finds that an individual received benefits on the basis of a false statement or representation or willfully withheld material facts in order to obtain benefits, DFML may deny the application for benefits and/or require the individual to repay to the Trust Fund any benefits received. DFML needs true answers to every question so that we can manage this program the way the law requires. Providing false answers will forfeit your right to receive and keep paid leave benefits and job protections and may result in other penalties under the law.  

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