How do I apply for FMLA?

To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.

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Massachusetts
Family and Medical Leave Request Form

Massachusetts Family and Medical Leave Request Form

Q: Do I qualify for Ma paid family leave?

You&#039;re eligible for PFML coverage if you are:A full-time, part-time, or seasonal employee in Massachusetts. A 1099-MISC contractor who works for a business that issues 1099-MISC tax forms to more than 50% of its employees. Unemployed for 26 weeks or fewer.

Q: How much does Ma Family and Medical Leave Pay?

MA Paid Family &amp; Medical Leave Benefit Amounts 80% of the portion of the employee&#039;s average weekly wage that is equal to or less than 50% of the State average weekly wage (SAWW); Plus 50% of the portion of the employee&#039;s average weekly wage that is more than 50% of the SAWW; Capped at the Maximum Weekly Benefit.

Category:

Employment - Leave - Family and Medical Leave Act (FMLA)

State:

Multi-State

Control #:

US-266EM

Format:

Instant download

Description

An employee may use this form to request leave under the FMLA.

Massachusetts Request for Family or Medical Leave

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Massachusetts Application for Family Medical Leave of Absence

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Massachusetts Employee Application for FMLA

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Massachusetts FMLA Certification of Physician

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Massachusetts File Form for Family and Medical Leave

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How to fill out Family And Medical Leave Request Form?

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FAQ

If you are applying for military-related paid family leave benefits, or if you are currently self-employed or unemployed, please call the Department's Contact Center at (833) 344-7365 to begin your application.

You can take your leave 3 ways: continuous, intermittent, or reduced. If you are applying for military-related paid family leave benefits, or if you are currently self-employed or unemployed, please call the Department's Contact Center at (833) 344-7365 to begin your application.

To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.

Your benefits payment is based on your individual average weekly wage, the state average weekly wage for Massachusetts workers, and the type of leave you are taking. The maximum weekly benefit is $1,084.31.

In most circumstances, FMLA and PFML will run concurrently if the employee is eligible for both types of leave. The leave can be taken intermittently for up to 12 weeks per benefit year.. While on leave, employees will have their health insurance maintained at the same level as if they had not been on leave.

Qualifying reasons for which an employee can take FMLA or PFML leave include:Birth, adoption, or placement of a foster child.For a serious health condition that makes the employee unable to perform the essential functions of their job.To care for a family member with a serious health condition.More items...

You're eligible for PFML coverage if you are:A full-time, part-time, or seasonal employee in Massachusetts. A 1099-MISC contractor who works for a business that issues 1099-MISC tax forms to more than 50% of its employees. Unemployed for 26 weeks or fewer.

FMLA provides up to 12 weeks of job-protected, unpaid leave in a calendar year for family or medical reasons, or up to 26 weeks of job-protected, unpaid leave in a calendar year to care for a family member in the armed services. Employers are not required to pay employees taking FMLA leave.

FMLA v. PFML: As stated, PFML provides paid leave to all eligible Massachusetts employees while FMLA provides unpaid job protected leave only for employers with 50 or more employees or smaller employers that choose to participate.

MA Paid Family & Medical Leave Benefit Amounts 80% of the portion of the employee's average weekly wage that is equal to or less than 50% of the State average weekly wage (SAWW); Plus 50% of the portion of the employee's average weekly wage that is more than 50% of the SAWW; Capped at the Maximum Weekly Benefit.