BASIC ELIGIBILITY. PFL benefits can be paid only after you
meet all of the following requirements:
• You must be unable to do your regular or customary work
due to the need to provide care, to bond with a new child,
or to participate in a qualifying event.
• You must be employed or actively looking for work at the
time your family leave begins.
• If working, you must have lost wages because you were
caring for a seriously ill family member, bonding with a new
child, or participating in a qualifying event.
• You must have earned at least $300 from which State
Disability Insurance (SDI) deductions were withheld during
a previous period. (See “YOUR BENEFIT AMOUNTS” in the
next column.)
• You must complete and mail a claim form within 41 days
after the first day your family leave begins or you may lose
benefits.
In addition, the following requirements must be met only if your
PFL claim is to care for a seriously ill family member:
• The care recipient must be your child, parent, spouse,
registered domestic partner, grandparent, grandchild, sibling,
or parent-in-law.
• The care recipient must be under the continuing treatment
or supervision of a licensed physician/practitioner or
accredited religious practitioner while you are receiving
benefits.
• The care recipient’s physician/practitioner must complete
the certification that he/she requires care. If the care
recipient is under the care of a religious practitioner, request
a Practitioner’s Certification for Paid Family Leave (PFL)
Benefits (DE 2502F) from the PFL office. Certification by a
religious practitioner is acceptable only if the practitioner has
been accredited by the EDD.
The following requirements must also be met only if your PFL
claim is to bond with a new child:
• Your leave must take place within 12 months of the birth,
adoption, or foster care placement of the child.
• The new child must be either your or your registered
domestic partner’s biological child, adopted child, or foster
child.
The following requirements must also be met only if your PFL
claim is to assist a military family member:
• Provide proof of covered active duty or call to covered active
duty documentation of the family member.
• Provide the qualifying event for leave and any supporting
documentation. For example taking the leave to make
financial or child care arrangements, or to attend an event
sponsored by the military. A document supporting the reason
for leave may be required.
INELIGIBILITY. You may apply for benefits even if you are not
sure you are eligible. If you are found to be ineligible for all or
part of a period claimed, you will be notified of the ineligible
period and the reason. You may not be eligible for PFL benefits if:
• You are claiming or receiving Unemployment Insurance (UI)
or Disability Insurance (DI) benefits.
• You are receiving workers’ compensation benefits at a
weekly rate equal to or greater than the PFL rate.
• You are in jail, prison, or any other facility.
FRAUD. Under sections 1143, 2101, 2116, 2122, and 3305 of
the California Unemployment Insurance Code, it is a violation
to willfully make a false statement or knowingly conceal a
material fact in order to obtain the payment of any benefits.
Such violation is punishable by imprisonment, and/or by a fine
not exceeding $20,000, or both. To detect and discourage fraud,
the EDD continually monitors claims, vigorously investigates
suspicious activity, and will seek restitution and conviction
through prosecution.
YOUR RESPONSIBILITIES
• File your claim and other forms completely, accurately, and
in a timely manner. If a form is late, include with the form a
written explanation of the reason(s).
• Carefully read the instructions on this and all other forms
you receive from PFL. If you are not sure what is required,
contact the PFL office.
• Call or report in writing to the PFL office any:
o Change of address or telephone number.
o Return to part-time or full-time work.
o Need for care or bonding to stop.
o Income you receive.
• Include your name and Social Security number on all
correspondence.
YOUR RIGHTS. Information about your claim will be kept
confidential, except for the purposes allowed by law. California
Civil Code, section 1798.34, gives you the right to inspect any
personal records maintained about you by the EDD. Section
1798.35 permits you to request that the record be corrected if you
believe it is not accurate, relevant, timely, or complete. Certain
types of information that would generally be considered personal
are exempt from disclosure to you: medical or psychological
records where knowledge of the contents might be harmful to the
subject (Civil Code, section 1798.40); records of active criminal,
civil, or administrative investigations (Civil Code, section 1798.40).
Additionally, the EDD will not disclose or provide copies of care
recipients’ medical information to care providers. If you are denied
access to records which you believe you have a right to inspect
or if your request to amend your records is refused, you may file
an appeal with the PFL office. You may request a copy of your
file by calling the telephone number shown on your Notice of
Computation (DE 429D).
You also have the right to appeal any disqualification,
overpayment, or penalty. Specific instructions on how to appeal
will be provided on any appealable document you receive.
YOUR BENEFIT AMOUNTS. Your claim begins on the date your
family leave began. The EDD calculates your weekly benefit
amount using your base period. The date your family leave began
determines your base period. You may not change the beginning
date of your claim or adjust your base period after you have
established a valid claim.
This base period covers 12 months and is divided into four
consecutive quarters. Your base period includes wages subject to
SDI tax that you were paid approximately 5 to 18 months before
your PFL claim begins. Your base period does not include wages
being paid at the time family leave begins. For a PFL claim to be
valid, you must have earned at least $300 in wages in the base
period. Using the following, you may determine the base period.
• If your claim begins in January, February, or March, your base
period is the 12 months ending last September 30.
• If your claim begins in April, May, or June, your base period is
the 12 months ending last December 31.
• If your claim begins in July, August, or September, your base
period is the 12 months ending last March 31.
• If your claim begins in October, November, or December, your
base period is the 12 months ending last June 30.
The quarter of your base period in which you were paid the highest
wages determines your weekly benefit amount.
• For more information about your benefit amount visit
edd.ca.gov/Disability/Calculating_PFL_Benefit_Payment_
Amounts.htm.
Contact the PFL office to inquire about benefits and to provide
additional information if your situation fits any of these
circumstances:
• If you do not have sufficient base period wages, you may be
able to establish a valid claim by using a later beginning date.
• If you do not have enough base period wages and you were
actively seeking work for 60 days or more in any quarter of the
base period, you may be able to substitute wages paid in prior
quarters.
• If during your base period you served in the military, received
workers’ compensation benefits, or did not work because of a
labor dispute.
DE 2501F Rev. 5 (12-20) (INTERNET) Instruction & Information
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