Stephanie Haber
/ Categories: Claims

Why You Shouldn’t Submit Your PFL Claim Forms Before Your Leave

March 13, 2018

PFL planning

It may be tempting to get all your paperwork for Paid Family Leave submitted early and out of the way, especially when preparing for a big, life changing event like the birth of a new baby.  But, there are some pretty important reasons why you shouldn’t submit your claims forms too early.

While you have to notify your employer at least 30 days in advance (more on that later), your insurance carrier doesn’t need to know in advance at all.  You might think that by submitting your forms ahead of time, it saves you time and will help you get paid quicker once you are out on leave, but it actually has the opposite effect!  Here’s why:

Your insurance carrier can’t give you a determination on your claim until your leave actually starts - even if you provide everything necessary and your forms are filled out perfectly.  There are many factors that go into making a determination on your claim, and it’s possible that some of these factors could change if you submit your forms too early.  A few of these important factors are:

  • your wages (PFL benefits are based on your wages 8 weeks prior to the date your leave begins)
  • the actual date your leave starts
  • the duration of leave, and whether you take it weekly or daily
  • whether you are using full days of Sick/Vacation/PTO during the requested leave period
  • your employment status at your same job (including whether you have worked the necessary length of time to be eligible for benefits - 26 weeks or 175 days)
     

 “Life happens” and plans may change.  So, the more time you have in between when your claim form is submitted and when your leave actually starts, the greater the likeliness that things may not go as anticipated.

For example, let’s say Elly is preparing for the birth of her new baby who is due on June 1.  She knows she is going to take PFL after the baby is born, so she fills out all her necessary PFL paperwork and submits it to her carrier in March .  After receiving her claim, Elly’s carrier then sends her a letter letting her know that it’s too early to submit her claim, and to please fill out a new form with updated information and submit that new form once her leave actually starts.  She’s now spending more time, doing double work by filling out the forms and sending them in twice, plus the added back-and-forth between Elly and her carrier may even delay her benefit payment.

Another thing to keep in mind is, Bonding Leave cannot begin until after the baby is already born. We all know babies are rarely born right on their due dates, thus changing the date on which the Paid Family Leave would actually start.  This being an additional reason why it would be counterproductive to send your forms in too early. 
 

PFL Expert Tip:
You can’t take DBL and PFL at the same time.  So, if you’re taking Paid Family Leave directly following a DBL claim, make sure the dates of leave are not the same on the respective claim forms you submit!

 

How to Prepare For Your Leave Without Submitting Forms Too Early
Our best advice for those who want to prepare for their leave is to download and print out all the forms you need ahead of time.  There’s a handy chart on this page to see which forms you’ll need when filing your claim. You can even fill out the basic information that’s not going to change, like your name, address etc.  But then hold off until you actually start your leave to fill in the leave specific information and submit it to your carrier - keeping in mind that claims must be submitted to your insurance carrier within 30 days after your first day of leave taken.

And don’t forget, before you go out on PFL and can fill out a claim form, you must provide a 30-day notice to your employer for any foreseeable leave.  If the leave is not foreseeable, you must give notice to your employer as soon as ”practicable,” typically within a day or two. This notice should be in writing and identify which of the 3 qualifying events you will be taking leave for and the anticipated timing and duration.

Have questions about PFL claim forms, or anything else Paid Family Leave?  Email our experts anytime at pfl@shelterpoint.com.

 

 


This blog post is for informational purposes only and is not intended to provide legal counsel. Please consult with an appropriate professional for legal and compliance advice. Any PFL information is as of the blog post’s date stamp; it is based on the applicable statutes and regulation,  and may change as regulations evolve or NY State issues guidance regarding Paid Family Leave regulations. Have more questions? Email us at pflquestions@shelterpoint.com
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