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12 CRR-NY 380-4.4NY-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 380-4.4

380-4.4 Proof of eligibility for leave taken to bond with a child.

(a) A birth mother’s claim for paid family leave to bond with a child must be supported by documentation in the form of:

(1) if available, a birth certificate; or

(2) if a birth certificate is unavailable, documentation of pregnancy or birth from a health care provider that includes the mother’s name and the child’s due or birth date.

(b) A parent’s (other than a birth mother) claim for paid family leave to bond with a child must be supported by documentation in the form of:

(1) if available, a birth certificate;

(2) if no birth certificate is available, a voluntary acknowledgment of paternity or court order of filiation;

(3) if the documents in paragraphs (1) and (2) of this subdivision are not available, then the employee must provide:

(i) a copy of documentation of pregnancy or birth from a health care provider that includes the mother’s name and the child’s due or birth date (see paragraph [a][2] of this section); and

(ii) a second document verifying the parent’s relationship with the birth mother or child (i.e., marriage certificate, civil union documents, or domestic partner documents);

(4) if the documents in subparagraph (3)(iii) of this subdivision are not available, a parent may submit other documentary evidence of parental relationship for evaluation on a case-by-case basis. The chair may update the list of acceptable documentation.

(c) An adoptive parent’s claim for paid family leave to bond with a child must be supported by documentation in the form of:

(1) a court document indicating that an adoption is in process or is being finalized; or

(2) when leave is taken prior to completion of the adoption, a document evidencing that the adoption process is underway, including but not limited to, a signed statement from an attorney, adoption agency, or adoption-related social service provider that the employee is in the process of adopting a child;

(3) if the second parent is not named in the document(s) in paragraph (1) or (2) of this subdivision, the employee must provide:

(i) a copy of the document evidencing the adoption; and

(ii) a second document verifying the relationship to the parent named in the document (i.e., marriage certificate, civil union documents, or domestic partnership documents).

(d) A foster parent’s claim for paid family leave to bond with a child must be supported by documentation in the form of:

(1) a letter of placement issued by the county or city department of social services or local volunteer agency;

(2) if the employee is not named in the placement document, submit:

(i) a copy of the document evidencing the placement; and

(ii) a second document verifying the relationship to the parent named in the document (i.e., marriage certificate, civil union documents, or domestic partnership documents).

12 CRR-NY 380-4.4

Current through August 31, 2021

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