If You Are Quarantined Yourself
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Overview

If you are under a mandatory or precautionary order of quarantine or isolation issued by the state of New York, the Department of Health, local board of health, or any government entity duly authorized to issue such order due to COVID-19, the leave available to you depends on the size of your employer as of January 1, 2020, and your employer’s net annual income. This benefit is not available to you if you are able to work through remote access or other means.

Employees Who Work for Small Employers

For most employees who work for an employer with 10 or fewer employees as of January 1, 2020, and a business net annual income less than $1 million.

You can use a combination of NYS Paid Family Leave and disability benefits.

  • Eligible employees can use NY Paid Family Leave (PFL). This is insurance coverage that provides up to 60% of your pay, up to a maximum weekly benefit of $840.70.
  • After receiving your full PFL benefit, you will receive disability benefits to match your full wages up to a maximum weekly disability benefit of $2,043.92, for a total of $2,884.62 per week.
  • There is no waiting period for either benefit.

 

You will have job protection for the duration of the quarantine.

 

Employees Who Work for Medium Employers

For most employees who work for an employer with between 11-99 employees as of January 1, 2020, and smaller employers (1-10 employees) with a business net annual income greater than $1 million.

  1. It starts with using paid sick leave. Your employer is required to provide you with at least five days of paid sick leave.
  2. After that, you can use a combination of NYS Paid Family Leave and disability benefits.
  • Eligible employees can then use NY Paid Family Leave. This is insurance coverage that provides up to 60% of your pay, up to a maximum weekly benefit of $840.70.
  • After receiving your full PFL benefit, you will receive disability benefits to match your full wages up to a maximum weekly disability benefit of $2,043.92, for a total of $2,884.62 per week.
  • There is no waiting period for either benefit.

 

You will have job protection for the duration of the quarantine.

 

Employees Who Work for Large Employers

For most employees who work for an employer with 100 or more employees as of January 1, 2020, as well as all public employees.

Your employer must provide you with at least 14 days of paid sick leave for a COVID-19-related quarantine, which should cover the period of a mandatory or precautionary order of quarantine or isolation.

 

You will have job protection for the duration of the quarantine.

 

 

Benefit Examples

Here are some examples of wage replacement benefits based on a worker’s average weekly wage (AWW).

Wage replacement examples
Employee Average Weekly Wage (AWW)

Paid Family Leave Benefit
(60% of AWW up to a cap of $840.70)

Disability Benefits (remainder of AWW up to a weekly cap of $2043.92) Total Employee Maximum Weekly Benefit (capped at $2884.62)
$600 $360 $240 $600
$850 $510 $340 $850
$1,500 $840.70 $659.30 $1,500
$3,000 $840.70 $2,043.92 $2,884.62

 

How to Apply

To apply for Paid Family Leave and/or disability benefits when you are under a mandatory or precautionary order of quarantine or isolation, follow these three steps:

  1. COLLECT YOUR FORMS AND DOCUMENTATION 
    The forms should be available from your employer, employer’s insurance carrier or you may download: Request for COVID-19 Quarantine DB/PFL - Self (Forms PFL-1  & SCOVID19)
    Translated versions: Español | Русский | Polski | 中文 | Italiano | Kreyòl ayisyen | 한국어 বাঙালি

    Required Forms
    The form package for leave due to your quarantine/isolation includes the following forms:
    Request for Paid Family Leave (Form PFL-1)
    Request for COVID-19 Quarantine DB/PFL - Self (Form SCOVID19)

    * Translated versions will be available soon.  For immediate interpretation assistance, please call the PFL Hotline at (844) 337-6303.

    Required Documentation
    Mandatory or precautionary order of quarantine or isolation issued by the state of New York, the Department of Health, local board of health, or any government entity duly authorized to issue such order due to COVID-19View guidance on how to obtain a quarantine order.
     
  2. COMPLETE & ATTACH
    FORMS SCOVID19 AND  PFL-1
    Form SCOVID19 and Form PFL-1 have sections that need to be completed by you and by your employer.
    1. Fill out your sections. Note: Leave Questions 11 and 12 blank on Form PFL-1. These questions are covered under Section 1 of Form SCOVID19.  
    2. Make copies and give the forms to your employer. If you are not at work due to the mandatory or precautionary order of quarantine or isolation, you can send the forms to your employer by email or regular mail.
    3. Your employer is required to return the forms to you within three business days.
    4. If your employer fails to return the forms to you, submit the forms that you have filled out, along with the mandatory or precautionary order of quarantine or isolation, to your employer’s insurance carrier.
       
  3. SUBMIT TO INSURANCE CARRIER WITHIN 30 DAYS
    You must submit your completed request package to your employer's insurance carrier within 30 days after the start of your leave to avoid losing benefits.

    Send your 
    Form SCOVID19 and Form PFL-1 and supporting documentation to your employer’s insurance carrier. Contact the insurance carrier to find out if they will accept submissions electronically or through other means.

    To find out who your employer’s insurance carrier is, you can:
    • Ask your employer.
    • Search your employer’s name to look up their insurance carrier.
       

Employer Search

 

If you cannot find your employer’s insurance carrier, call the Paid Family Leave Helpline for assistance: (844) 337-6303. The Helpline is available Monday through Friday, 8:30 a.m. to 4:30 p.m.

If you believe your employer is uninsured, you can submit your request for Paid Family Leave to the NYS Workers’ Compensation Board:

NYS Workers’ Compensation Board
Paid Family Leave
PO Box 9030,
Endicott, NY 13761-9030
 

In most cases, the insurance carrier must pay or deny benefits within 18 calendar days of receiving your completed request. Your request cannot be considered incomplete solely because your employer failed to fill out Section 3 of Form SCOVID19 and/or Part B of Form PFL-1 within three business days.

If you have a question regarding the status of your request, contact your employer's insurance carrier.

 

If you disagree with the insurance carrier's decision: 

You may request arbitration for a denial or any other PFL claim-related dispute, such as timeliness of the carrier’s payment. 

Arbitration for Paid Family Leave is handled by NAM (National Arbitration and Mediation).

If you are denied or partially denied for Paid Family Leave, your insurance carrier (or employer, if self-insured) must provide you with the reason for denial and information about requesting arbitration, or you can visit the arbitrator’s website at https://nyspfla.namadr.com.

If your request for Paid Family Leave is denied and you have already started your leave, you are not considered to be on Paid Family Leave, and it will be up to your employer to determine how to treat the time off.

 

Watch this video in Spanish.

Getting Paid

In most cases, the insurance carrier will pay benefits or deny your claim within 18 days of receiving your completed request. Your insurance carrier may provide options for how you will be paid, for example, via direct deposit, debit card or paper check.

Note: Pursuant to the Department of Tax Notice No. N-17-12 [PDF], Paid Family Leave benefits are taxable. Taxes will not automatically be withheld from benefits, but employees can request voluntary tax withholding. Questions related to the taxability of Paid Family Leave contributions should be referred to the NYS Department of Taxation and Finance.

Additional Resources