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Paid Family Leave Qualifying Events: Caregiving

When a close family member becomes seriously ill or injured, the stress of caring for them can greatly impact your job — as well as your life. Finding time to schedule doctor’s appointments, managing medication schedules, and ensuring that your loved one is comfortable and taken care of can be challenging while also maintaining a full-time job. Yet, taking dedicated time to care for a loved one is important to the wellbeing of everyone involved. This is were Paid Family Leave (PFL) can help.

At ShelterPoint, we understand how difficult this time can be, and we are here to assist during those times with PFL’s caregiver benefits. On this page, you will find some of the most important details about the benefit, eligibility, and process of Paid Family Leave, specifically for caregiving.


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Learn more about other qualifying events:
Bonding  
Military Exigencies  


Want more details on how much you can get for Paid Family Leave?

Visit this NY Paid Family Leave Benefits page for everything you need to know about calculating the maximum benefit amount and duration.

 

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To get an idea of your
potential PFL benefit amount, use our easy

Paid Family Leave
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How Does Caregiver Leave Work?

Being sidelined by the common cold doesn’t qualify for Paid Family Leave. Your family member must be unable to go to work or school, do regular daily activities, or be otherwise incapacitated for at least 4 consecutive days by a serious medical condition. This includes:

  • at least 2 doctor treatments,
  • or 1 doctor treatment with a doctor-supervised regimen thereafter.
Paid Family Leave can be taken in increments as small as 1 day. So, if your mom has chemotherapy every Monday or your dad has to go to dialysis every Thursday, and you need to be there with them, you can take that day routinely under Paid Family Leave without having to use up your paid time off such as sick time or vacation days (unless your FMLA policy requires it – learn more about PFL vs. FMLA here). If you choose to use those PTO days and receive your full paycheck instead, that is entirely up to you.

If you and a family member both work for the same company and need to take time off to care for your seriously ill family member, you are both entitled to use your full PFL time to do so. It will be up to the employer, however, if you can be out at the same time, or if you need to stagger your time out.

 



Who Is Considered A “Family Member”?

While in many ways similar to caregiver leave under FMLA, the definitions of qualifying family members differ between the two (check out our handy infographic comparing PFL to FMLA). NY Paid Family Leave can only be taken to care for:

  • Spouse/domestic partner
  • Child (including step-child, biological, foster, adoptive, or child under legal guardianship)
  • Parent (including step-parents, in-laws, biological, foster, adoptive, or legal guardian)
  • Grandparent
  • Grandchild
  • Sibling (for leaves that begin on or after 1/1/23)
Any other relationships (such as cousins, aunts/uncles) do not qualify.

 

What Is Considered A “Serious Health Condition” For PFL Purposes?

Paid Family Leave regulations have very specific definitions of what is recognized as a serious health condition, such as:

  • An illness, injury, impairment, or physical or mental condition that involves specialized care.
  • Any of the above that requires inpatient care in a hospital, hospice, or residential health care facility.
  • Any of the above that requires continuing treatment or supervision by a healthcare provider.
  • A serious chronic health condition that requires frequent doctor visits over time (including asthma, diabetes, or epilepsy).
  • Long-term illnesses, injuries, etc., for which treatment may not be effective and supervision is necessary (as with Alzheimer’s, severe strokes, and late-stage cancers).
  • Conditions (like cancer, severe arthritis, or kidney disease) that could incapacitate a patient within 3 days of interrupting treatment (like chemotherapy, physical therapy, or dialysis).
  • Restorative dental or plastic surgery after an injury or removal of cancerous growths.

Qualified caregiving events also include:

  • Picking up medication
  • Physical care
  • Emotional support
  • Visitation
  • Assistance in treatment
  • Transportation
  • Assistance with daily living matters
  • Personal attendant services

What Does NOT Qualify As A Serious Health Condition Under Paid Family Leave?

While Paid Family Leave aims to cover a wide variety of medical-related needs for time off, there are some things that you will not be able to take paid time off for under PFL, including:

  • Routine examinations which are not considered treatment.
  • A regimen or treatment that can be, and is, initiated without a visit to a healthcare provider, including taking over-the-counter medication (aspirin, antihistamines, salves, etc.), bed-rest, drinking fluids, exercise, and so on.
  • The common cold, flu, ear aches, upset stomach, minor ulcers, headaches (other than medically diagnosed migraines), routine dental or orthodontic problems, periodontal disease, etc. unless complications arise.
  • Cosmetic treatments, such as most treatments for acne or plastic surgery.

 




Notification Of Employer

As with all qualifying events for Paid Family Leave, at least a 30-day notice is required to take leave; however, in situations where your family member’s serious condition happens unexpectedly, you need to provide notice “as soon as practicable” (generally considered to be the very next day, or the next business day). The notice should also include the reason for leave, and the anticipated length of the leave, if foreseeable.

 

 


Need Help With Your Paid Family Leave Claim For Caregiving?

Visit our claims help page for everything you need to file your claim.

Read more

Young girl caring for an old lady

Father work at home with daughter

Caring For A Family Member Due To COVID-19?

Visit our dedicated guide for COVID-19-related claims

Read more


Paid Family Leave
In Person Stories

See the personal side of Paid Family Leave and how it is making a difference for New Yorkers as part of our “PFL in Person” series. Read through our library of real stories, from real people who have used NY’s Paid Family Leave here.

Discover real life stories of PFL  
Faces of New Yorkers who took Paid Family Leaves

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NY Paid Family Leave FAQs For Caregiving

 

Can employees take recurring time off throughout the year to care for a seriously ill family member? For example, can they take time every Monday for this purpose?

Yes, employees can take recurring time off throughout the year. PFL benefits can be taken in daily increments in intermittent intervals, such as every Monday to, for example, take your mom to her chemotherapy sessions. You can take that day routinely under Paid Family Leave without having to use up your sick time or vacation days (unless your employer’s FMLA policy requires it).

It’s important to understand that Paid Family Leave does not allow you to take leave in hourly or partial-day increments. For example, if you just need a couple hours for those chemotherapy appointments, you’d have to take the entire day from a Paid Family Leave standpoint.

If a qualifying event stretches over more than 52 consecutive weeks (1 full year), a new request must be submitted before the next 52-week period begins. So, if your family member’s condition lasts longer than one year, you’ll need to make another request for PFL for the second year.

To qualify for paid caregiver leave, does the employee have to actually take care of the relative?
What if the family member is receiving full care in the hospital or a "Residential Health Care Facility"?
Can the employee use PFL to visit the family member?

Yes, Paid Family Leave allows employees to visit family members. PFL does not require the employee to perform the actual care in order to qualify for benefits. In addition to physical care, Paid Family Leave covers these other forms of care:
  • Emotional support
  • Visitation
  • Transportation
  • Arranging for change in care
  • Travel to pick up medication
  • Assistance in treatment
  • Assistance with essential daily living matters
  • Personal attendant services
So, you don’t need to take care of your family member in the direct sense. As shown above, you can provide emotional support or visit them when they are in a hospital or residential health care facility. You can also provide transportation, pick up their medication and more under PFL.

An employee has a grandparent in a nursing home. Can that employee use PFL to take their grandparent to a routine doctor appointment?

Maybe. In this case, the grandparent being in a nursing home isn’t – on its own – sufficient reason to qualify for Paid Family Leave because the grandparent can reside in a nursing home without having a serious illness.

But if the grandparent has been diagnosed with a serious illness, such as Alzheimer’s disease or other related dementias, cancer, or a disability resulting from the natural aging process (like severe arthritis), you may qualify for PFL. This would cover things like transportation to doctor visits (whether or not those are directly related to the diagnosed qualifying condition, i.e. a routine doctor’s visit) and other activities, like spending time with the grandparent to provide emotional support, or making a run to the pharmacy to pick up their medication.

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The ShelterPoint family of companies operates under the “ShelterPoint” name strictly as a marketing name, and no legal significance is expressed or implied. The ShelterPoint family of companies consists of ShelterPoint Life Insurance Company, a NY-domiciled carrier, and its wholly-owned subsidiary ShelterPoint Insurance Company, a FL-domiciled carrier, depending on the state. ShelterPoint is a registered service mark.

Underwritten by:
ShelterPoint Life Insurance Company (principal office in Garden City, NY) in: NY
ShelterPoint only offers Paid Family Leave in form of a rider to DBL.
Policy Form# SPL DB0922 F

This page is for informational purposes only and is not intended to provide legal counsel. Please consult with an appropriate professional for legal and compliance advice. Any Paid Family Leave information is based on the applicable statutes and may change if guidance is issued by the State of New York.

 

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