7 CCR 1107-3.6 - Applying for Benefits

1. To request paid family and medical leave insurance benefits, the claimant or the claimant's designated representative must apply to the Division for benefits.

2. Applications may be submitted up to thirty (30) days prior to the benefit start date.

3. The claimant must provide any information necessary for the Division or private plan administrator to calculate benefits.

4. The Division will notify the claimant's employer of the application submission within five (5) business days.

5. Applications may be submitted up to thirty (30) days after the leave has begun. If the Division receives an application after thirty (30) days, but before ninety (90) days, the Division will consider the application if it includes evidence establishing good cause for the claimant's failure to submit the application within thirty (30) days.

6. Additional Documentation Requirements

A. For leave necessary to care for a child because of birth, the claimant must submit the following documentation with their application:

1. Proof of birth, which may include a birth certificate, an application for a birth certificate, documentation from a health care provider who provided care during the birth or recovery, or other vital records showing birth;

2. A statement establishing in loco parentis status; and

3. Any other reasonable information or documentation necessary to adjudicate the claim for benefits, as requested by the Division.

B. For leave necessary to care for a child because of adoption, the claimant must submit the following documentation with their application:

1. Proof of adoption placement, which may include documentation from a court or an adoption agency; and

2. Any other reasonable information or documentation necessary to adjudicate the claim for benefits, as requested by the Division.

C. For leave necessary to care for a child because of placement through foster care, the claimant must submit the following documentation with their application:

1. Either:

a. Proof that the claimant is either a licensed or certified foster parent and the child has been placed in their care; or

b. Documentation from a child placement agency as defined in C.R.S. § 26-6-102, the state department of human services, a county department of human services, or a court indicating a kinship or emergency placement was necessary to provide for the immediate care and safety of a minor child, and the person will be standing in loco parentis through a power of attorney or other legal designation; and

2. Any other reasonable information or documentation necessary to adjudicate the claim for benefits, as requested by the Division.

D. For leave necessary to care for a family member with a serious health condition, the claimant must submit the following documentation with their application:

1. A "Serious Health Condition Certification - Family Member Form" completed and signed by the family member's health care provider; and

2. Any other reasonable information or documentation necessary to adjudicate the claim for benefits, as requested by the Division.

E. For leave necessary because of the claimant's own serious health condition, the claimant must submit the following documentation with their application:

1. A "Serious Health Condition Certification - Self Form" completed and signed by the health care provider; and

2. Any other reasonable information or documentation necessary to adjudicate the claim for benefits, as requested by the Division.

F. For leave due to a need for qualifying exigency leave, the claimant must submit the following documentation with their application:

1. A "Military Exigency Leave Attestation Form" completed by the claimant; and

2. Any other reasonable information or documentation necessary to adjudicate the claim for benefits, as requested by the Division.

G. For leave due to a need for safe leave, the claimant must submit the following documentation with their application:

1. A "Safe Leave Attestation Form" completed by the victim or a family member of the victim; and

2. Any other reasonable information or documentation necessary to adjudicate the claim for benefits, as requested by the Division.

7. For applications for benefits requiring certification by a health care provider, the health care provider may not be the claimant or a family member of the claimant.

8. Applications may be submitted using the FAMLI Division's online system, by mail, or by email.

9. Requirements for an application to be considered filed:

A. Upon receipt of an application for benefits, the Division will review the application. If the Division needs more information or documentation to adjudicate the claim for benefits, it will make a reasonable effort to promptly obtain the additional information or documentation from the claimant, using the claimant's preferred language and method of contact.

B. An application will not be considered filed until all required information and documentation has been received by the Division, and the Division has been notified that the paid family and medical leave has begun.

C. If an application is not properly filed within sixty (60) days after the Division receives it, the application will be closed and the Division will take no further action on it, absent a finding of good cause based on evidence submitted by the claimant. The Division will notify the claimant prior to any such closure in their preferred language and method of contact, and will describe the claimant's opportunity to establish good cause to keep the application open.

D. Once an application is properly filed, the Division will notify the claimant and the employer of the proper filing within five (5) business days.

Notes

7 CCR 1107-3.6

45 CR 18, September 25, 2022, effective 10/15/2022 46 CR 23, December 10, 2023, effective 1/1/2024