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Required documents for your Paid Family and Medical Leave (PFML) application

When you apply for PFML benefits, you will be asked to provide documents to verify the information included in your application.

Table of Contents

For all applications: Documents to prove your identity

No matter what type of benefits you apply for, you will need to prove your identity. The easiest way to do that is to provide a color copy of a Massachusetts driver’s license or ID card, but there are other options available.

Here's a downloadable version of the data on the page.

To provide proof of identity, you will need a valid, unexpired color copy (front and back) of ONE of the following documents:

  • A state driver's license or state ID card

  • A Junior Operator License (learner's permit)

  • A  Massachusetts Commercial Driver’s License

  • A Massachusetts Limited Term License

  • A Massachusetts Not for Federal Use license

  • A Massachusetts Tribal ID card

  • A U.S. passport or passport card (include both the page with identifying information AND the signature page)

  • A Permanent Resident Card (Form I-551) issued by the U.S. Department of Homeland Security (DHS) or the U.S. Immigration and Naturalization Service

  • An Employment Authorization Document (EAD) issued by DHS, Form I-766, or Form I-688B

  • A foreign passport

If you don’t have any of the options above, you will need to provide valid, unexpired copies of TWO documents from the following categories:

You will need a color copy of any one of these documents:

  • A certified copy of your birth certificate filed with a State Office of Vital Statistics or equivalent agency in your state of birth. (A Puerto Rican birth certificate will only be accepted if it was issued on or after July 1, 2010. For more information on the Puerto Rican birth certificate law, visit the Puerto Rico Federal Affairs Administration.)

  • A certificate of citizenship, Form N-560, or Form N-561, issued by DHS

  • A certificate of naturalization (Form N-550 or N-570)

And you will need to provide a black and white or color copy of one of these documents:

  • An SSN Card

  • A W-2 Form

  • An SSA-1099 Form

  • A Non-SSA-1099 Form

  • A pay stub with your full name and SSN on it

  • An authorization letter from the IRS displaying your 9-digit individual tax identification number

Document copies must include both the front and back, be in color, if indicated, and be saved as a PDF or image file (.jpg, .jpeg, .png). Files must be smaller than 4.5 MB.

Color documents must be mailed or uploaded as we cannot accept color faxes.

Additional Resources

For medical leave applications

Leave for your own serious health condition

If you are taking medical leave, you must provide a Certification of your Serious Health Condition form filled out by you and your health care provider. 

It is important that your health care provider fill out the form as completely as possible, especially:

  • A statement that you have a serious health condition and any other relevant details about your condition. This is the reason for your leave so make sure to discuss your medical condition with your health care provider. If this section is not filled out properly, it could delay your application.

  • The date on which your serious health condition started

  • The probable duration of your serious health condition and what activities you should refrain from doing 

  • An attestation that you can’t work due to your serious health condition

For family leave applications

Family leave to bond with a child

Family leave can be taken by a parent or legal guardian to bond with a child during the first 12 months after the child’s birth, adoption, or foster care placement. To apply for family leave benefits, you will need to provide ONE of these documents:

  • The child's birth certificate 

  • A statement from the child's health care provider with the child's birth date

  • A statement from the health care provider of the person who gave birth with the child's birth date 

  • A statement or birth record from the hospital where the child was born with the child’s birth date and signed by the birth registrar

  • A certificate from the child's health care provider confirming both the placement of the child AND date of placement

  • A certification from an adoption or foster care agency involved in the placement confirming both the placement of the child AND date of placement

  • A certificate from the Department of Children and Families confirming both the placement of the child AND the date of the placement

Family leave to care for a family member with a serious health condition

To apply for family leave to care for a family member, we need to know your relationship to your family member and confirm their serious health condition. You’ll need a Certification of your Family Member's Serious Health Condition form filled out by you, the employee, and your family member’s health care provider.

It is important that your family member’s health care provider fill out the form as completely as possible, especially:

  • A statement that your family member has a serious health condition and any other relevant details about your family member’s condition. This is the reason for your leave so make sure to have your family member discuss their medical condition with their health care provider. If this section is not filled out properly, it could delay your leave application.

  • When your family member’s condition began

  • That you, the employee, are needed to care for the family member and what kinds of care might be needed 

  • Information about how often and how long your family member needs you to care for them

  • The name and address of your family member and their relationship to you

Family leave to care for a family member who is a covered service member with a serious health condition

Applications for military-related paid family leave can only be made by calling the Department’s Contact Center at (833) 344-7365.

A Contact Center Agent will guide you through the application. You can make the process quicker by gathering required documents before calling.

To apply for family leave to care for a family member who is a covered service member, we need to know your relationship to your family member and confirm their serious health condition. You’ll need a Certification of your Family Member's Serious Health Condition form filled out by your family member’s health care provider.

It is important that your family member’s health care provider fill out the form as completely as possible, especially:

  • An attestation by the service member's health care provider that the health condition is connected to the service member's military service. This is the reason for your leave so make sure your family member’s health care provider is aware of this on the form.

  • The date on which the covered service member's serious health condition began

  • That you, the employee, are needed to care for the covered service member and what kinds of care might be needed

  • Information about how often and how long the covered service member needs you to care for them 

  • The covered service member's relationship to you

  • The name and address of the covered service member

Family leave to manage affairs while a covered service member is or will be deployed

Applications for military-related paid family leave can only be made by calling the Department’s Contact Center at (833) 344-7365.

A Contact Center Agent will guide you through the application. You can make the process quicker by gathering required documents before calling.

You should include copies of documents that prove the following:

  • The dates or period of time for which your leave is required  

  • The reason for your leave 

  • The service member's relationship to you

  • The service member's name and address 

  • Information proving the identity of the family member who is or will be deployed

And a copy of one of the following certification documents: 

  • A copy of the family member's active duty orders 

  • A letter of impending activation from the family member's commanding officer 

  • FMLA WH-384 form

Document requirements and formatting

  1. You must include both the FRONT and BACK of your identity document for it to be accepted. For passports or passport cards, the copy should include both the page with identifying information AND the signature page. For forms, make sure to upload all of the pages of the form.

  2. Copies of your identity document must be IN COLOR and ONLY PDF or .jpg, .jpeg, .png IMAGE FILES are accepted. We are not able to accept .heic (default image file for iphones).

  3. Copies of other documents can be in black and white but ONLY PDF or .jpg, .jpeg, .png IMAGE FILES are accepted.

  4. It’s faster to upload your documents online, but you can fax or mail copies of your documents, with the exception of your identity document. We cannot receive color faxes so identity documents need to be uploaded or mailed.

  5. Please provide only copies of identity documents. Do not send original documents - they will not be returned to you.

  6. All files must be smaller than 4.5 MB. If your file is larger than 4.5 MB, try resizing it or splitting it into separate files.

  7. All text and images must be clear and readable.

If your file is not in one of the approved formats, try one of the following:

  • Take a picture of the document and save as a PDF or .jpg, .jpeg, or .png file before uploading.

  • Take a screenshot of the document and save as a PDF or .jpg, or .jpeg, .png file before uploading.

  • Take a picture of each document page and upload the pictures individually as a PDF or .jpg, .jpeg, or .png file.

If your document is attached to an email:

  • Open the file on your computer or phone

  • Save it as a PDF or .jpg, .jpeg, or .png file before uploading.

Uploading, mailing or faxing documents

It’s faster to upload your documents online, but you can fax or mail copies of your documents, with the exception of your identify document since it will need to be in color.

Please write or type your application ID number in the top left corner of each page mailed or faxed to the Department.   

Your application ID is on all notices you receive from the Department or when you log in to your paid leave account

Online

To upload your documents online, log in or create an account.

By mail

Documents can be mailed to:

Department of Family and Medical Leave  
Attn: Claims Processing 
P.O. Box 838  
Lawrence, MA 01842

By fax

Documents can be faxed to (617) 855-6180, unless they are in color. We are unable to accept color faxes.

If you fax your application, please confirm that the application is in the right order with all pages numbered in the top right corner. Supporting forms should come after the main application form, followed by all required attachments. 

Contact

Phone

Get answers to your questions in English, Español, and Português. Translation services for up to 240+ languages are also available. (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.

Last updated: April 28, 2022
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