What are the benefits and requirements under California's Paid Family Leave program?

The Paid Family Leave (PFL) program is a component of California's State Disability Insurance (SDI) program. For California workers covered by SDI (or a voluntary plan for SDI), PFL insurance provides up to eight weeks of benefits for individuals who take time off for the following reasons:

• To care for a seriously ill family member.
• To bond with a new child.
• To participate in a qualifying event because of a family member's military deployment.

For bonding, PFL is limited to the first year after the birth, adoption or foster care placement of a child.

Employees are not eligible for PFL if a) they are claiming or receiving unemployment insurance or disability insurance benefits, b) they are receiving workers' compensation benefits at a weekly rate equal to or greater than the PFL rate, or c) they fail to have an independent medical examination when requested to do so. Additionally, an individual is not eligible for PFL benefits for any day that another family member is able and available for the same period of time that the individual is providing the required care.

Note: There is no service requirement for eligibility for the California PFL. In addition, the PFL provides no job protection. It is a wage replacement program to care for a family member or to bond with a new child.

Definition of Serious Health Condition

A "serious health condition" is defined as 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), 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 PFL.

Certification

A medical certificate is required when a PFL claim is filed to provide care for a seriously ill family member. The certificate must include a diagnosis and International Classification of Diseases code, the beginning date of the disability, the probable duration and the estimated time that care will be needed. The certificate must also state that the serious health condition warrants the participation of the employee to provide care, including psychological comfort and arranging third-party care.

A separate certification must be completed for leave associated with the birth, adoption or foster care placement of a child.

The certification process may be completed online by the employee, the physician and the employer.

The employee is responsible for obtaining a physician/practitioner certification for his or her disability. The employee's claim will be returned if the physician/practitioner certification is not received within 30 days. The employee provides the receipt number to his or her physician/practitioner after the employee has filed the claim. The employer will be notified that an employee has submitted a disability insurance (DI) or PFL claim. However, the employee's detailed claim information is confidential and will not be shared with the employer.

Benefits

The benefits of the program are paid through the state Employment Development Department (EDD). In addition, the employer may require the employee to use up to two weeks of vacation leave or paid time off (PTO) prior to receiving benefits and an employee may also use his or her legally accrued sick pay.

No more than eight weeks of PFL benefits may be paid within any 12-month period. PFL benefits are subject to federal income tax but are not subject to California income tax.

Employer Notice Requirements

Employers must provide the Paid Family Leave (DE 2511) brochure to new employees and employees who request leave to care for a seriously ill family member or to bond with a new child. Employers are not required to provide the PFL insurance claim forms to their employees.

Interaction with the Family and Medical Leave Act and the California Family Rights Act

The Family and Medical Leave Act (FMLA) and the California Family Rights Act (CFRA) are federal and state leave laws, respectively, that allow an employee to take up to 12 work weeks of unpaid leave from his or her job in a 12-month period to care for themselves or family members who are ill, or for children who are unable to take care of themselves. PFL does not change either law in any way and is completely separate from them. PFL merely provides up to six weeks of paid benefits to an employee who suffers a wage loss when taking time off work to care for others.

Job Protection

PFL does not protect an employee's job. It simply provides partial wage replacement when an employee cannot work due to the need to care for a child, parent, spouse or registered domestic partner, or to bond with a new child. An employee may have his or her job protected under other laws, such as the FMLA or the CFRA.