Processing Cases with Paid Family and Medical Leave Income

 

Paid Family and Medical Leave

Paid Family and Medical Leave (PFML) is a state benefit that provides some individuals who work in Massachusetts with up to 26 weeks of paid leave for medical or family reasons. The Department of Family and Medical Leave (DFML) administers the program. The program provides temporary income replacement to eligible workers who are welcoming a new child into their family, are struck by a serious illness or injury, need to take care of an ill or ailing relative, and for certain military considerations. Not all workers are eligible for PFML.

PFML is countable unearned income for TAFDC, EAEDC and SNAP.

Information about benefits and eligibility can be found at the website: www.mass.gov/orgs/department-of-family-and-medical-leave or by calling 833-344-7365.

 

Which TAFDC Applicants Must Apply for PFML

Some TAFDC applicants must apply for PFML if they have not already done so. They must apply if:

Other clients do not have to apply for PFML.

You must explain to clients that the PFML benefit will likely be greater than the cash assistance amount. You must offer to help the client apply by placing a 3-way call to DFML to initiate an application for PFML. You must do this during the application interview or place a separate call to the client if necessary. If the client declines, you must give them the website and phone number to apply. Write a detailed narrative to explain how you assisted the client.

If you cannot place the 3-way call, or the client declines, you must send a VC-1 for application for PFML benefits. You must create a User-entered VC-1 for Additional Verification. Enter Application for Other Benefits in the Details field and enter “You have stopped working due to caring for a relative or the birth, foster care placement or adoption of a child, or you have stopped working due to your own health condition. You must apply for Paid Family and Medical Leave. Call the Department of Family and Medical Leave at 833-344-7365 or apply online. You must give DTA proof that you applied for Paid Family and Medical Leave. Tell your case manager if you need help to apply for PFML.”  

If you place a 3-way call with the client to DFML to initiate the PFML application, this counts as proof that the client initiated the PFML application and the TAFDC application must be approved immediately if otherwise eligible.

If the client applies for PFML online without your assistance, they must submit a screenshot of their PFML account or an email confirming their application to prove that they initiated the PFML application.  

If the client applies for PFML by phone without your assistance, they may not have anything to prove that they initiated their application. In this case, you must accept a telephonic self-declaration.

If the client fails to apply for PFML and you have assisted the client in connecting with DFML, you must document your efforts in a narrative. The case must be denied for Fail to apply for other benefit(s) under Noncooperation. You must not deny the case for failure to apply for PFML unless you have offered the client assistance in applying for PFML. If you did not assist the client to initiate an application for PFML you must approve the application and then assist the client in connecting with DFML.

You must inform clients that if they start receiving PFML, they must tell the Department within 10 days. If a TAFDC client reports that they are receiving PFML, enter the income type Paid Family and Medical Leave on the Other Income page. This will populate a mandatory verification for Paid Family and Medical Leave on the Verification tab. If the client reports that they are receiving PFML and does not submit verification of PMFL benefits, the case must be closed for Fail to submit the required verifications under Noncooperation.

When an ongoing TAFDC client reports that they:

You must create a User-entered VC-1 for Additional Verification. Enter Application for Other Benefits in the Details field and enter “You have stopped working due to caring for a relative or the birth, foster care placement or adoption of a child, or you have stopped working due to your own health condition. You must apply for Paid Family and Medical Leave. Call the Department of Family and Medical Leave at 833-344-7365 or apply online. You must give DTA proof that you applied for Paid Family and Medical Leave. Tell your case manager if you need help to apply for PFML.”

You must inform clients that if they start receiving PFML, they must tell the Department within 10 days.

If the client fails to apply for PFML and you have assisted the client in connecting with DFML, you must document your efforts in a narrative. The case must be closed for Fail to apply for other benefit(s) under Noncooperation. You must not close the case for failure to apply for PFML unless you have offered the client assistance in applying for PFML. If you did not assist the client to initiate an application for PFML you cannot close the case and must assist the client in connecting with DFML.

 

Which EAEDC Applicants Must Apply for PFML

Some EAEDC applicants must apply for PFML if they have not already done so. They must apply if:

Other clients do not have to apply for PFML.

You must explain to clients that the PFML benefit will likely be greater than the cash assistance amount. You must offer to help the client apply by placing a 3-way call to DFML to initiate an application for PFML. You must do this during the application interview or place a separate call to the client if necessary. If the client declines, you must give them the website and phone number to apply. Write a detailed narrative to explain how you assisted the client.

If you cannot place the 3-way call, or the client declines, you must send a VC-1 for application for PFML benefits. You must create a User-entered VC-1 for Additional Verification. Enter Application for Other Benefits in the Details field and enter “You have stopped working due to caring for a relative or you have stopped working due to your own health condition. You must apply for Paid Family and Medical Leave. Call the Department of Family and Medical Leave at 833-344-7365 or apply online. You must give DTA proof that you applied for Paid Family and Medical Leave. Tell your case manager if you need help to apply for PFML.”

If you place a three-way call with the client to DFML to initiate the PFML application, this counts as proof that the client initiated the PFML application and the EAEDC application must be approved immediately if otherwise eligible.

If the client applies for PFML online without your assistance, they must submit a screenshot of their PFML account or an email confirming their application to prove that they initiated the PFML application.  

If the client applies for PFML by phone without your assistance, they may not have anything to prove that they initiated their application. In this case, you must accept a telephonic self-declaration.

If the client fails to apply for PFML and you have assisted the client in connecting with DFML, you must document your efforts in a narrative. The case must be denied for Fail to apply for other benefit(s) under Noncooperation. You must not deny the case for failure to apply for PFML unless you offered the client assistance in applying for PFML. If you did not assist the client to initiate an application for PFML you must approve the application and then assist the client in connecting with DFML.

You must inform clients that if they start receiving PFML, they must tell the Department within 10 days. If a EAEDC client reports that they are receiving PFML, enter the income type Paid Family and Medical Leave on the Other Income page. This will populate a mandatory verification for Paid Family and Medical Leave on the Verification tab. If the client reports that they are receiving PFML and does not submit verification of PMFL benefits, the case must be closed for Fail to submit the required verifications under Noncooperation.

 

When an ongoing EAEDC client reports that they:

they must apply for Paid Family and Medical Leave.

 

You must create a User-entered VC-1 for Additional Verification. Enter Application for Other Benefits in the Details field and enter “You have stopped working due to caring for a relative or the birth, foster care placement or adoption of a child, or you have stopped working due to your own health condition. You must apply for Paid Family and Medical Leave. Call the Department of Family and Medical Leave at 833-344-7365 or apply online. You must give DTA proof that you applied for Paid Family and Medical Leave. Tell your case manager if you need help to apply for PFML.”

You must inform clients that if they start receiving PFML, they must tell the Department within 10 days.

If the client fails to apply for PFML and you have assisted the client in connecting with DFML, you must document your efforts in a narrative. The case must be closed for Fail to apply for other benefit(s) under Noncooperation. You must not deny the case for failure to apply for PFML unless you have offered the client assistance in applying for PFML. If you did not assist the client to initiate an application for PFML you cannot close the case and must assist the client in connecting with DFML.

 

SNAP Households

Application

If a client is receiving PFML at application, the only income type the client can select to best fit this income type on the online web application is Other. When a case manager receives the action to process the web application, the case manager will not know what type of income the client is receiving. Three cold call attempts must be made to reach the applicant to clarify the income type. If contact is made, you must confirm if the client is receiving PFML, enter in the information on the Other Income Status page, and a mandatory VC-1 must be issued upon confirmation. If the cold call attempts are unsuccessful, you must issue an appointment letter.

If the client completes a Telephonic SNAP application or paper SNAP application, the client has the option to write or declare that they are specifically receiving PFML.  If you are able to determine that the client is specifically receiving PFML, you must enter the information on the Other Income Status page and send an appointment letter.

If the client fails to submit the required verification by the VC-1 due date, the application will be denied.

 

Recertifications Submitted Online

If a client reports that they are receiving PFML at their COVID-19 recertification, the only income type the client can select to best fit this income type on their online recertification is Other.  When a case manager receives the Action to process the recertification, the case manager will not know what type of income the client is receiving.  Since contact with the client is not required at COVID-19 recertification you must issue a mandatory, User-entered VC-1 for Additional Verification entering in the Details field: Other Income. In the Document(s) of evidence field enter:

“You have indicated you are receiving “Other” income. Please provide verification of the income type and the gross monthly amount you are receiving.”

An appointment letter must not be sent at COVID-19 recertification, even when you are sending a mandatory VC-1.

If verification is not provided at recertification, the case will automatically close on the release date.

 

Case Maintenance

If a client reports that they have terminated their employment, the case manager must end the employment record. 

Job termination may be verbally self-declared. If a client reports that they are not terminated, but currently have no hours/pay, the income source must be zeroed out. If it is unclear whether they are still employed, and cold call attempts to the client are unsuccessful, the source must be ended in BEACON. A verbal self-declaration that a client is no longer working must be accepted.

You must inquire if the client receives PFML when the client states they have ended a job or have taken a leave. If the client reports that they are not receiving PFML, no additional action is required. If the client reports that they are receiving PFML, and the case is certified as Simplified Reporting, you must determine if the amount of PFML income when added to the case will place the client over the gross income limit for their household size. If the reported income would not place the client over the gross income limit, no verification is required, and no income is to be entered into BEACON. The case manager must detail this information in the narrative to be reviewed at the next Recertification.

If the reported income will place the client over the gross income limit, the case manager must send a mandatory VC-1 for PFML income. If the client fails to submit the required verification by the VC-1 due date, BEACON will generate a Verifications Due action. The case manager must close the case for Noncooperation with a reason of Fail to provide the required verifications.

 

Entering Paid Family and Medical Leave in BEACON

A new PFML drop-down section has been created on the Other Income Status page under Type in BEACON. All PFML payments must be entered using the new drop-down selection as unearned income for TAFDC, EAEDC and SNAP.  For more information regarding entering unearned income in BEACON, please click here.

 

 

  Last Update: May 26, 2022