Filing a Paid Family Leave Claim: Which Forms Will You Need?

November 27, 2017
Filing a claim for New York Paid Family Leave is a simple and straightforward process.

Filing a claim for New York Paid Family Leave is a simple and straightforward process. When filing a claim, employees must fill out one to three forms and provide supporting documentation. Let's take a step-by-step look at the forms employees need to submit for each type of leave.

The Right Forms for Each Type of Leave

Employees may file a PFL claim for bonding, caregiving or military family leave. Click on the links to download forms and instructions for each type of leave.

Bonding With a Newborn, Adopted or Fostered Child

Required Forms

Form PFL-1: Request for Paid Family Leave
Form PFL-2: Bonding Certification

Supporting Documentation

For the birth mother:

  • Birth certificate or documentation of pregnancy or birth from a health-care provider, including mother's name and due date or birth date

For foster care:

  • A letter of placement from a county or city social services department or voluntary agency

For adoption:

  • Legal evidence of adoption process

Care of a Family Member

Required Forms

PFL-1: Request for Paid Family Leave

PFL-3: Release of Personal Health Information Under the Paid Family Leave Law

  • Note: This form will be provided to the health-care provider, not PFL carrier.

PFL-4: Health Care Provider Certification for Care of Family Member With Serious Health Condition

Supporting Documentation

  • Any other necessary certification from the family member's health-care provider

Military Family Leave

Required Forms

PFL-1: Request for Paid Family Leave
PFL-5: Military Qualifying Event

Supporting Documentation

  • U.S. Department of Labor Military Family Leave Certification (federal Military Leave form)
  • Copy of military duty papers
  • Other documentation supporting the reason for the leave

 

Leave TypeForms Required
 PFL-1PFL-2PFL-3PFL-4PFL-5Supporting Documentation

Bonding

 

 

 

Caregiving

 

 

Military

 

 

 

 

To find out more about PFL and other regulations that affect employees, follow The Standard on Facebook, LinkedIn and Twitter with the hashtag #PaidFamilyLeave, and subscribe to this blog's RSS feed to receive updated content as new information becomes available.

For more details about New York Paid Family Leave, visit: ny.gov/programs/new-york-state-paid-family-leave.