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PFML frequently asked questions for health care providers

Find answers to your questions about Paid Family and Medical Leave (PFML).

Table of Contents

General information

Does PFML take the place of FMLA?   

No, PFML and FMLA are separate programs that run at the same time if an employee is eligible for both. FMLA is a federal program that provides unpaid time off and offers certain job protections. PFML is a paid family and medical leave program offered by the Commonwealth of Massachusetts that also offers job protections. Learn how PFML is different than FMLA

Who is considered a health care provider? 

A health care provider is an individual licensed by the state, commonwealth, territory, or country in which the individual 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 types of leave are available? 

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

  • Up to 20 weeks of paid medical leave to manage a serious health condition     
  • Up to 12 weeks of paid family leave to care for a family member   
  • Up to 12 weeks of paid family leave to bond with a child    
  • Up to 26 weeks of paid family leave to care for a family member who is a member of the armed forces  
  • Up to 12 of paid family leave to manage family affairs when a family member is on duty in the armed forces, including the National Guard or Reserves  

Learn more about the different types of leave.

What documents do I need to complete? 

Health care providers need to complete forms for 3 different types of leave: 

Can a physician’s assistant or nurse fill out the forms? 

Yes, a PA or Nurse can fill out the form if you, the health care provider, signs and dates it.   

Can I use a rubber stamp for my signature? 

Yes, you can use a rubber stamp of your signature to sign the form. 

Can the form be completed digitally? 

Your patient can forward a link to the form, but you cannot fill it out online.  Currently, you will need to print it out to complete and sign it. 

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 
  • Conditions due to pregnancy or post-birth recovery that prevent a patient from working, as certified by a health care provider 
  • 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 

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.

Who is considered a family member? 

Family members include: 

  • Spouse or domestic partner 
  • Children, step-children or domestic partner’s children 
  • Parents, step-parents, parent’s domestic partner, or guardian who legally acted as a parent when the patient was a child 
  • Spouse or domestic partner’s parents 
  • Grandchildren, step-grandchildren or domestic partner’s grandchildren 
  • Grandparents, step-grandparents, or grandparent’s domestic partner 
  • Siblings or step-siblings

What kinds of things qualify as activities for family leave to care for a family member with a serious health condition? 

When caring for a family member with a serious health condition, activities can include but are not limited to: 

  • Helping the family member with daily tasks they can’t do themselves, such as helping them get dressed or preparing meals  
  • Providing transportation to the doctor for appointments and treatment  
  • Helping make arrangements for changes in care, such as a transfer to a nursing home 

Filling out the forms

If my patient has a chronic condition like asthma and needs intermittent leave, how do I fill out the start and end dates? Can I fill it out for an entire year? 

The start and end dates should be based on how long you think the condition will last or when it is at its worst.  If it is ongoing, the start and end dates can be for as long an interval as you think makes sense, but your patient is limited to a total of 20 weeks of medical leave.  Consider when the condition will incapacitate a patient from doing work and how often when making your recommendation. A new application is required at the end of a benefit year. 

Can my patient combine medical leave and family leave to bond with a child? 

A patient who is pregnant or has given birth can take medical leave during or after their pregnancy, if they have a serious health condition. You and your patient should fill out the Certification of Your Serious Health Condition form for medical leave. Your patient should apply for medical leave first prior to applying for family leave to bond with a child. They can then go online to paidleave.mass.gov or call the Contact Center at (833) 344-7365 to add an application for bonding leave. Learn more about transitioning from medical leave to family leave to bond with a child

Is there a form for family leave to bond with a child? 

No. There is no form for family leave to bond with a child. A new parent or guardian must provide proof of their identity and proof of the child’s birth or placement to apply. Learn more about family leave to bond with a child

For a pregnancy, when do you say that the serious health condition began? 

You should estimate when the condition affected your patient’s ability to work. 

Can my patient extend their leave and do I need to fill out the form again? 

If your patient plans to extend their leave, they must notify the Department of Family and Medical Leave (DFML) within 30 calendar days of their leave end date and notify their employer at this time. Health care providers can confirm the extension with the same form if it is filed within this time period. If your patient files after 30 calendar days, they may need to start a new application and get a new medical form filled out by you. 

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