Paid Family Leave Eligibility

Eligibility

Employees covered by State Disability Insurance (SDI) are also covered by Paid Family Leave (PFL) insurance. If a Voluntary Plan Insurer provides your company’s disability insurance coverage, then it must also provide Paid Family Leave insurance coverage.

Requirements

  • You must be unable to do your regular or customary work for at least eight days due to the need to provide care or to bond with a new child.
    • To care for a seriously ill child, spouse, parent, or registered domestic partner;
    • To bond with the employee’s new child or the new child of the employee's spouse or registered domestic partner; or
    • To bond with a child in connection with the adoption or foster care placement of the child with the employee or the employee’s spouse or registered domestic partner.
  • You must be employed or actively looking for work at the time your family leave begins.
  • You must have lost wages because you were caring for a seriously ill family member or bonding with a new child or, if unemployed, you must have been actively looking for work.
  • You must have earned at least $300 from which SDI deductions were withheld during a previous period.
  • You must complete and mail a claim form within 49 days of the first day of your family leave or you may lose benefits.

A serious health condition means an illness, injury, impairment, or physical or mental condition of a patient that involves inpatient care in a hospital, hospice, or residential medical care facility. This includes any period of incapacity (e.g., inability to work, attend school, or perform other regular daily activities) or any subsequent treatment in connection with such inpatient care; or continuing treatment by a physician or practitioner Unless complications arise, cosmetic treatments, the common cold, influenza, earaches, upset stomach, minor ulcers, and headaches other than migraine, are examples of conditions that do not meet the definition of a serious health condition for purposes of Paid Family Leave. For more information, see frequently asked questions.

Ineligibility

Ineligibility for PFL Benefits

  • Claiming or receiving Unemployment Insurance or Disability Insurance benefits
  • Receiving workers’ compensation benefits at a weekly rate equal to or greater than the PFL rate
  • Failure to have an independent medical examination when requested to do so

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