6. Getting the right certification

DFML accepts medical certifications signed by: Podiatrists, dentists, clinical psychologists, optometrists, and chiropractors (limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by X-ray to exist) authorized to practice in a state and within the scope of their practice as defined under the law of that state; Nurse practitioners, nurse-midwives, clinical social workers and physician assistants who are authorized to practice under State law and who are within the scope of their practice as defined under the law of that state; Christian Science Practitioners listed with the First Church of Christ, Scientist in Boston, Massachusetts; and equivalent health care providers in foreign countries. If a worker needs medical treatment in another country, or they are caring for a family member in another country, they can receive PFML benefits. 

Advocate with the worker’s medical providers to obtain the time off work that they need. A serious health condition can include: mental health, elective or cosmetic surgery, migraines, back pain, medical treatment, or time to recover following medical treatment. Especially for maternity leave, the recovery time is historically subjective: many doctors are willing to certify 8, 10, 12, or 14 weeks to allow the new mother time to fully recover, address complications from the birth, or address new health issues that arise while caring for the baby, like mastitis or post-partum depression.  

The most common use of PFML is “continuous leave,” where the worker cannot work at all for one or more weeks in a row. This would apply to surgery, hospitalization, car or workplace accidents, bonding leave with a new child, and more. 

Reduced schedule leave may be appropriate when a worker has a chronic condition that doesn’t let them work as much as you used to. For example, a worker with back pain may be able to work 24 hours a week, and then take PFML for 16 hours a week. In this case, the medical leave can last up to 50 weeks because the worker is only using 40% of a “PFML week” each week. Or, a worker who attends physical therapy or chemotherapy each Friday may work the other four days and take PFML for just one day a week. Another example is a worker who normally works 50 to 60 hours a week may get a medical certification limiting him to 40 hours a week, and then receive PFML benefits for 15 hours a week. Reduced schedule leave can be used after a continuous leave to ease the worker back into their job. In this way, reduced schedule PFML is similar to a disability accommodation at work, but it has much stronger job protection than disability law because there is no employer defense of undue hardship. 

Intermittent leave is for time off in uneven amounts or at unpredictable times. Common examples are: migraines, asthma, fibromyalgia, depression, and chronic pain. A medical provider can certify the condition for up to 12 months at a time.  Parents can use intermittent leave to care for their children with complex medical issues or disabilities that require many medical appointments. Intermittent leave is sometimes called episodic leave.