Washington Family and Medical Leave Request Form
Description
How to fill out Family And Medical Leave Request Form?
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FAQ
How to File a Paid Family Leave (PFL) Claim by MailVisit Online Forms and Publications and order a form online. A form will be mailed to you.Obtain the form from your physician/practitioner or employer.Visit an SDI Office.Call 1-877-238-4373. California Relay Service (711) Provide the PFL number (1-877-238-4373)
How do I apply for leave? You can apply online or with a paper application. To request the paper application contact us at (833) 717-2273.
After you notify your employer and gather the documents needed, start your application process:Create your account. See the help center for instructions on creating a Paid Leave benefit account.Fill out the online application that applies to you: medical leave or family leave.Upload documents.
PFML and FMLA are separate entitlements and should be treated differently. PFML is a statewide insurance program that provides wage replacement, along with job protections, similar to FMLA (if eligible). FMLA is a federal entitlement providing job protections and insurance maintenance for employees who qualify.
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.
Nearly every Washington worker can qualify for Paid Family and Medical Leave as long as they worked a minimum of 820 hours (about 16 hours a week) in Washington over the last year. Full-time, part-time, temporary and seasonal work counts.
Processing times: Our goal is to process complete applications within three weeks.
Once your application is approved, you can expect weekly payments to begin 2-4 weeks after your leave begins.
For all leaves except baby bonding, there is a seven-day waiting period before an employee is eligible for PFML benefits. But note, the waiting period may not always be seven days2026. If ESD approves the application, ESD pays the benefit directly to the employee.
Washington's Family and Medical Leave ProgramMost workers are eligible for up to 12 weeks of paid leave a year, with some eligible for up to 16 weeks. Employees in Washington who take paid leave can receive as much as 90 percent of their weekly wages, with a cap of $1,000 a week.
