Employment Department
Chapter 471
Division 70
Paid Family Medical Leave Insurance
471-070-1130
Benefits: Verification of Safe Leave
(1) A claimant applying for Paid Family and Medical Leave Insurance (PFMLI) benefits for safe leave must provide verification certifying the claimant or the claimant’s child as defined in OAR 471-070-1000 is a survivor of domestic violence, harassment, sexual assault, bias, or stalking. Any of the following documents may be provided as verification:
(a) A copy of a federal agency or state, local, or tribal police report, or a formal complaint to a school’s Title IX Coordinator indicating that the claimant or the claimant’s child was a survivor of domestic violence, harassment, sexual assault, bias, or stalking;
(b) A copy of a protective order or other evidence from a federal, state, local, or tribal court, administrative agency, school’s Title IX Coordinator, or attorney that the claimant or the claimant’s child appeared in or was preparing for a civil, criminal, or administrative proceeding related to domestic violence, harassment, sexual assault, bias, or stalking;
(c) Documentation from an attorney, law enforcement officer, health care provider, licensed mental health professional or counselor, member of the clergy, employee of the Department of Justice division providing victim and survivor services, or victim services provider, verifying that the claimant or the claimant’s child was undergoing treatment or counseling, obtaining services, or relocating as a result of domestic violence, harassment, sexual assault, bias, or stalking;
(d) The PFMLI Safe Leave Verification Form; or
(e) Another document approved by the department for this purpose.
(2) The documentation listed in section (1) of this rule must include:
(a) The full name of the claimant, and
(b) The full name of the child of the claimant, if the claimant’s child is a survivor of domestic violence, harassment, sexual assault, bias, or stalking.
(3) The documentation listed in section (1) of this rule must be dated no more than 12 months before the date the claimant applied for leave.
(4) If the documentation is dated earlier than 12 months before the date the claimant applied for leave, the claimant must provide a written statement in addition to documentation listed in section (1) of this rule that describes the current need for leave, along with any additional information requested by the department.
(5) In cases where a claimant can demonstrate good cause for not providing one of the forms of documentation in section (1) of this rule, the claimant may instead provide a written statement attesting that they are taking eligible safe leave, which includes a brief description of the purpose for taking leave. Good cause for not providing the documentation is determined at the discretion of the department and includes, but is not limited to, the following:
(a) Difficulty obtaining verification due to a lack of access to services; or
(b) Concerns for the safety of the claimant or the claimant’s child.
[Publications: Contact the Oregon Employment Department for information about how to obtain a copy of the publication referred to or incorporated by reference in this rule.]
Statutory/Other Authority: ORS 657B.340 & ORS 657B.090
Statutes/Other Implemented: ORS 657B.090
History:
ED 2-2024, temporary amend filed 03/13/2024, effective 03/15/2024 through 09/10/2024
ED 1-2024, amend filed 01/04/2024, effective 01/12/2024
ED 9-2022, adopt filed 07/22/2022, effective 07/22/2022