June 22, 2004 Paid Family Leave Benefits Available to Employees Starting July 1

In 2002, the California legislature passed legislation providing Paid Family Leave (“PFL”) benefits to qualifying employees covered by the State Disability Insurance program or by a Voluntary Plan for State Disability Insurance, which together cover approximately 13 million California employees. The purpose of this legislation is to provide a temporary wage replacement benefit to employees to help cover the economic burden of providing family care. California employees began contributing to the PFL program through payroll deductions on January 1, 2004. Beginning July 1, 2004, employees may begin filing claims and receiving PFL benefits.

As a service to our clients and friends, we have prepared this brief guide to coverage and eligibility issues that employers should be aware of as employees begin to file claims for PFL benefits.

PFL Coverage

An employee may file a claim and receive PFL benefits for any of the following qualifying reasons:

  • To provide care for a seriously ill child, spouse, parent, or domestic partner. A serious health condition under PFL includes any illness, injury, impairment, or physical or mental condition that involves inpatient care or continuing treatment or supervision by a health care provider. In general, illnesses such as the common cold, influenza, earaches, upset stomach, minor ulcers, and headaches other than migraine will not meet the definition of a serious health condition under the PFL law; or
  • To bond with a newborn child or a minor child in connection with the adoption or foster care placement of that child within the first year after the birth, adoption or placement.

Eligibility Requirements And Limitations

To receive PFL benefits, an employee must file a written claim for benefits with the California Employment Development Department (“EDD”), which is responsible for administering PFL claims, within 42 days from the first day for which the employee may be paid benefits. Claim forms are available through the EDD. Along with a claim form, an employee must provide a medical certification that attests to the serious health condition of the patient and the need for a family member to provide care. “Baby bonding” claims do not require a medical certification; however, the employee must provide documents establishing his or her eligibility for the bonding leave (such as a birth certificate or proof of adoption).

An employee’s right to receive PFL benefits is also subject to the following limitations:

  • An employee must wait seven days before receiving any benefits. Thus, an employee cannot receive PFL benefits until his or her eighth day of absence due to a PFL qualifying reason.
  • An employee may receive PFL benefits for no more than six weeks in a twelve month period to provide care to any single care recipient.
  • An employee cannot receive PFL benefits while he or she is receiving State Disability Insurance, Unemployment Insurance, or Workers' Compensation Insurance benefits.
  • An employee who is entitled to leave under the California Family Rights Act ("CFRA") or the federal Family and Medical Leave Act ("FMLA") must take Paid Family Leave concurrently with leave under those laws.
  • An employer can require the employee to use up to two weeks of earned but unused vacation prior to receiving PFL benefits.

Employer Responsibilities

Although the EDD is responsible for the administration and payment of PFL claims, employers are responsible for providing information to their employees regarding the availability of PFL benefits. Specifically, employers must do the following:

  • Provide the PFL informational brochure to employees hired after January 1, 2004, and to employees who request leave to care for a seriously ill family member or to bond with a child after July 1, 2004; and
  • Post the EDD’s required notice to employees regarding PFL benefits in the workplace of employees who are covered by State Disability Insurance.

The PFL brochure and required postings are available through the EDD’s website: www.edd.ca.gov.

As a final note, it is important to underscore that the PFL law does not require employers to grant time off or to return an employee who receives PFL to their job at the end of their leave. An employee’s right to time off of work is governed by employer policy and/or other laws, most commonly the CFRA and the FMLA and in certain cases, time off may be required as a “reasonable accommodation” under the Americans with Disabilities Act or its state counterpart, the California Fair Employment & Housing Act.

If you have any questions about this or any other topic, please contact Fred Plevin or Mike Minguet at (619) 237-5200 at Paul, Plevin, Sullivan & Connaughton.