DON’T DELAY TO FILE A CLAIM

You should file a claim as soon as possible after you experience an event. In general, you have thirty (30) days after your qualifying event to request benefits for all of your dates of leave, including dates in the past. If you wait too long and file more than 30 days after your event, you will only be allowed to request benefits for leave you intend to take in the future. In some situations, an exception may apply to you. For more information on “exigent circumstances,” see pages 17 and 18 of the Employee Handbook.

Before You Apply

In order to submit a Paid Family Leave claim, you must:

• Have experienced a qualifying event
• Know the days on which you intend to take leave
• Have documentation proving the occurrence of your qualifying event
• Be currently employed by a covered employer in DC

Documents You Will Need

For Parental Leave: Proof of a birth or placement showing:

• The date of the birth or placement and
• Information to establish parental relationship, which may include the claimant’s name, the child’s name, or the spouse’s name depending on the circumstances

For Family Leave:

• The Family Leave Medical Certification Form (PFL-FMC)
• Proof of Familial Relationship
  • The Certification of Family Relationship Form (PFL-FR)

For Medical Leave:

• The Medical Leave Medical Certification Form (PFL-MMC)

For Prenatal Leave:

• The Prenatal Leave Medical Certification Form (PFL-PMC)

Tell Your Employer

As long as you have reason to believe that you will need time off for a qualifying event, the law requires you to tell your employer that you will be taking time off at least 10 days before you need the leave. It is best to do this in writing so that there is a record that you gave notice. When you tell your employer that you will be on leave, you must include the following in what you tell your employer:

• The type of Paid Family Leave benefits you will be applying for.
• How long you expect to be out on leave.
• The expected start and end dates of the leave.
• Your leave schedule.

Choose an Authorized Representative

An authorized representative is someone who is allowed to submit and manage Paid Family Leave claims on your behalf. You are not required to choose an authorized representative, but you may do so, if you want. For more information on authorized representatives, see page 16 of the Employee Handbook. If you choose to elect an authorized representative, you must complete the Power of Attorney form (PFL-POA).

Gather Documents

Filing for Parental Leave

You must provide proof that a qualifying event has occurred. This proof can be one of the following:

• A birth certificate
• A hospital admission form given to you when you gave birth
• A document from a medical provider who provided care to the newborn child
• A court document showing custody of a child and the date on which you took custody of the child
• A document from an adoption or foster care agency involved in the placement of your child that confirms the placement with you and the date of the placement

Your documents must show the following 2 things:

• The date of the birth or placement and
• Information to establish parental relationship, which may include the claimant’s name, the child’s name, or the spouse’s name depending on the circumstances

Filing for Family Leave

• Have your healthcare provider complete the Family Medical Certification Form (PFL-FMC)
• Submit the Family Certification of Family Relationship Form (PFL-FR) or other documentation that establishes the familial relationship

Filing for Medical Leave

• Have your healthcare provider complete the Medical Certification Form (PFL-MMC)

Visit the How to Apply for Benefits page for instructions on how to file for Paid Family Leave benefits.