Code of Massachusetts Regulations
458 CMR - DEPARTMENT OF FAMILY AND MEDICAL LEAVE
Title 458 CMR 2.00 - Family and Medical Leave
Section 2.09 - Determinations by the Department

Universal Citation: 458 MA Code of Regs 458.2

Current through Register 1531, September 27, 2024

(1) Except as limited by 458 CMR 2.12, the Department may approve a paid leave benefit for a qualifying reason for a period of family or medical leave stated in 458 CMR 2.08(8)(a) through (f).

(2) Application for Benefits Determination. The Department shall consider the following when making a determination on an application for benefits:

(a) confirmation that the covered individual provided the required notice pursuant to 458 CMR 2.08(2)(a);

(b) the financial eligibility test described in 458 CMR 2.02;

(c) certification, as required by M.G.L. c. 175M, § 5, including a certification by a health care provider, supporting the necessity for leave;

(d) whether the covered individual's request for family or medical leave associated with the application for benefits was approved or denied by the employer or covered business entity and the reason(s) for the approval or denial;

(e) whether the covered individual has actually taken or plans to take the leave associated with the application for benefits; and

(f) any other relevant information deemed necessary by the Director.

(3) The Department shall provide contemporaneous notice to the covered individual and to the employer or covered business entity, if any.

(4) The approval for payment of benefits notice shall include:

(a) The reason for the approved leave benefits;

(b) The duration of the approved leave benefits;

(c) For intermittent leaves, the frequency and duration of the leave benefits;

(d) The expiration of the approved leave benefits; and

(e) The weekly benefit amount.

(5) A denial of payment of benefits notice shall include:

(a) The reason for the denial of leave benefits; and

(b) A description of the individual's appeal rights under 458 CMR 2.14.

(6) Where the Department finds that a covered individual has failed to provide the Department with notice of a relevant change in circumstances which would have reduced the amount of benefits paid, the covered individual shall be responsible to reimburse the Department the amount overpaid within 30 calendar days of a request made by the Department.

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