Organization name? *

Please provide the name of your organization.

What type of PFML issue are you experiencing? *

Please select all that apply in your experience with the PFML program. 

Eligibility Confusion

Claim Approval or Denial Concern

Intermittent Leave Issue

Full-Day Increment Requirement

Medical Certification or Documentation Burden

General Technical or Payment Submission Issue

Third-Party Administrator or Private Plan Issue

Interaction with Short-Term DIsability or Other Benefits

Staffing or Service Disruption

Cost or Administrative Burden

Statutory or Regulatory Loophole

Other

Please describe the issue in detail. *

Please include what happened, when it happened, who handled the issue, and how the PFML process affected the employee, employer, clients, services, or organization.

What type of leave claim was involved? *

For example: employee’s own medical leave; family caregiving leave; parental/bonding leave; qualifying exigency leave; intermittent leave; reduced schedule leave; or another type of leave.

Was the issue related to eligibility, documentation, or claim approval standards? *

If yes, please explain: *

The relevant facts such as hire date, hours worked, tenure, employee count, family relationship involved, serious health condition certification, medical verification, or whether the employee was approved or denied.

Did the issue involve any of the following? *

If any option applies, please select. 

Intermittent Leave

Reduced Schedule Leave

The One-Full-Workday Minimum Increment

If yes, please describe the intermittent or reduced leave arrangement and its impact. *

Please include the schedule requested, how much time was actually needed, how much PFML time was required or approved, and any resulting staffing, operational, or service-delivery impact.

What was the outcome or current status of the claim or process? *

Please describe how or if the issue was resolved.

Did this issue involve any of the listed entities? *

Please select any option that applies. 

State System

Third-Party Administrator

Private Plan

Short-Term Disability Carrier

Payroll Provider

Outside Vendor

Other

If yes, please describe. *

How did its process, requirements, decision, or technology contributed to the issue?

Did your organization have implementation challenges or need support from the Office of Paid Leave? *

Please describe any challenges with guidance, communication, responsiveness, training, technical assistance, employer portal use, payment submission, claim administration, or other support needs.

What impact has this issue had on your organization? *

For example: administrative burden, staff time, duplicate paperwork, employee or employer costs, delayed payments, staffing gaps, overtime, office closures, program disruptions, client impacts, or other consequences.

May DANA follow up with you and potentially use this example in advocacy or policy discussions? *