Updated Paid Family Leave Request Forms Now Available

Updated Paid Family Leave Request Forms Now Available

The New York State Workers’ Compensation Board (Board) has updated the request forms for Paid Family Leave (PFL). The revised forms are now available on the Paid Family Leave website. PFL insurers should update any of their own PFL forms, accordingly, by January 1, 2023.

All PFL request forms have been updated to include a “Gender X” option, remove unnecessary gender pronouns, and include siblings within Family Care, an expansion in the law that takes effect in 2023 upon employer policy renewal. PFL insurers are encouraged to proactively communicate effective dates with their employer policy holders, so they may tell covered employees when (in 2023) they will be eligible to use PFL to care for a sibling with a serious health condition. The Board has developed a template to assist employers with sharing this information.

Here are direct links to the revised forms:

• Bond with a Newly born, Adopted or Fostered Child (Forms PFL-1 & PFL-2)
• Care for a Family Member with a Serious Health Condition (Forms PFL-1, PFL-3 & PFL-4)
• Assist Families in Connection with a Military Deployment (Forms PFL-1 & PFL-5)
• Request for COVID-19 Quarantine DB/PFL – Self (Forms PFL-1 & SCOVID19)
• Request for COVID-19 Quarantine PFL - Child (Forms PFL-1 & CCOVID19)

More information

For more information and resources related to New York State Paid Family Leave, please visit PaidFamilyLeave.ny.gov.