12 CRR-NY 380-4.2NY-CRR
STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 12. DEPARTMENT OF LABOR
CHAPTER V. WORKERS' COMPENSATION
SUBCHAPTER H. DISABILITY BENEFITS
ARTICLE 2. RULES UNDER DISABILITY BENEFITS LAW
PART 380. PAID FAMILY LEAVE
SUBPART 380-4. REQUEST FOR PAID FAMILY LEAVE, MEDICAL CERTIFICATION AND HIPAA AUTHORIZATION
12 CRR-NY 380-4.2
12 CRR-NY 380-4.2
380-4.2 Content of medical certification taken because of the serious health condition of a family member.
(a) Required information.
When leave is taken because of the serious health condition of a family member, the employee must obtain a medical certification from a health care provider that sets forth the following information:
(1) name, address, telephone number, email address (if available), license number and state of license of the health care provider, and the type of medical practice/specialization;
(2) approximate date on which the serious health condition commenced, and its probable duration;
(3) certification regarding the patient’s health condition for which PFL is requested. The certification must be sufficient to support the need for leave; and
(4) an estimate of the frequency and duration of the leave required to care for the family member, including whether the need for care is continuing or on an intermittent basis.
(b) A health care provider may refuse to supply a certification for family leave when the employee requesting the leave is the perpetrator of domestic violence or child abuse against the care recipient.
(c) In all instances in which certification is required, it is the employee’s responsibility to provide the carrier with a complete and sufficient certification, and failure to do so may result in the denial of family leave. The authorization, release, or waiver executed by the care recipient shall be subject to the authorization rules and exceptions thereto of the HIPAA Privacy Rule (45 C.F.R. parts 160 and 164 [2005]).
12 CRR-NY 380-4.2
Current through August 31, 2021
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IMPORTANT NOTE REGARDING CONTENT CURRENCY: The "Current through" date indicated immediately above is the date of the most recently produced official NYCRR supplement covering this rule section. For later updates to this section, if any, please: consult editions of the NYS Register published after this date; or contact the NYS Department of State Division of Administrative Rules at [email protected]. See Help for additional information on the currency of this unofficial version of NYS Rules.