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Renata's Journey (Employee having a baby - Birth Parent)

Renata goes out of work on February 14, 2021—and has a baby February 15, 2021

Renata goes out of work February 14th. She lets her manager know she may need to start her maternity claim immediately.

Renata has her baby February 15th. Her partner calls MetLife to confirm the delivery. Since Renata has already filed a claim, the confirmation is all that is needed to approve the claim at this time.

Tina, a MetLife Disability Claims Specialist, approves Renata’s claim. Tina uses Renata’s preferred communication method—a phone call—to let Renata know. Renata is approved for short-term disability (STD), FMLA, and California Pregnancy Disability Leave, all running concurrently. Renata receives one STD payment per week from MetLife. If she chooses, Renata can use accrued paid sick time to make up the difference between her disability payment and her pre-disability earnings. Because Renata is fully recovered from the birth of her child and has no additional complications, STD payments end six weeks after the delivery date. Please note, there is a 7-day waiting period for the STD benefit.

After 6 weeks of child-birth recovery, Tina calls Renata to discuss her bonding options. Because Renata is fully recovered from the birth of her child and has no additional complications, STD payments end.  To allow for bonding with her newborn, Renata can stay out of work for the remainder of her FMLA and/or baby bonding leave under the California Family Rights Act (CFRA)—both of which are unpaid, job-protected leaves.  Renata decides she would like to stay out with her new baby for as long as possible. Tina approves a bonding claim for Renata for 12 additional weeks under CFRA, allowing Tina to stay out for 18 weeks total.  

Tim's Journey (Employee having a baby - Birth Parent)

Tim’s partner has a baby on February 15, 2021.

Tim goes out of work February 15th. He’s already let his manager and coworkers know about his paternity leave.  He previously reported his absence as FMLA, so when the baby is born, all he has to do is call MetLife to confirm the birth.  MetLife will also make two attempts to confirm the actual date of birth if Tim forgets to call.

Cheryl, a MetLife Absence Management Specialist, approves Tim’s claim. Cheryl then sends a letter to let Tim know he is now approved under FMLA and CFRA (to protect his job). Tim is not eligible for disability benefits through MetLife, as he does not have a disabling medical condition of his own.  But If he chooses, Tim may use accrued time to receive pay from the San Bernardino County.

After 12 weeks, Tim has exhausted his bonding leave. Tim coordinates his return to work with his manager—and reports to MetLife that he has gone back. Tim’s MetLife absence is now closed.

Nicole’s Journey (Employee has a 2-year-old child that is diagnosed with asthma and requires care)

On January 21, 2021 her 2-year-old son is diagnosed with asthma and requires care.

Nicole is told by her pediatrician that she may need to take her son to get breathing treatments at least once a week and that he might suffer flare-ups due to his condition.  

Nicole contacts her manager and MetLife. She lets her manager know that she might need intermittent leave. Her manager directs her to call MetLife to report her intermittent leave since it might qualify for FMLA and/or CFRA.  Nicole calls MetLife to file the claim.

Bob, a MetLife Absence Management Specialist, receives Nicole’s claim. It turns out Nicole is eligible for FMLA and CFRA, running concurrently.  Bob sends Nicole a Health Care Provider Certification (HCPC) form to have her son’s pediatrician complete.

Nicole’s claim is certified. The pediatrician has certified Nicole for 7 days per month for the next 4 months to care for her son’s asthma.  Nicole will receive a letter confirming the certification. If Nicole requires any time out of work, she will report her absence to MetLife and her manager. If Nicole chooses to supplement her intermittent leave benefit amount with accrued time, she will coordinate with the San Bernardino County.

Irene’s Journey (Employee trips on the sidewalk while walking her dog and breaks her arm)

On January 31, 2021, she trips on the sidewalk while walking her dog and breaks her arm.

Irene calls her doctor due to a recent non-work-related injury. She’s advised to stay out of work for 6 weeks because she can’t lift or carry and that’s part of her usual occupation in the department where she works.

Irene contacts her manager and MetLife. She lets her manager know she won’t be able to come to work because of her injury. She then calls MetLife to file a disability claim as well as a concurrent FMLA and CFRA. She then receives her claim number and instructions on what to do next. She signs her medical authorization and returns it to MetLife. MetLife and Irene coordinate with her physician to send the necessary paperwork to MetLife.

Will, a MetLife disability Claims Specialist, calls Irene. MetLife has received Irene’s documents and approved her medical disability claim for 6 weeks. She’s also been approved for job-protected leave under both FMLA and CFRA, running concurrently. She will receive a weekly payment from MetLife for her disability benefits. If she chooses, Irene can use accrued paid sick time to make up the difference between her disability payment and her pre-disability earnings. Please note, there is a 7-day waiting period for the STD benefit

After 6 weeks of disability, Irene is experiencing complications in her recovery and requests an extension to her disability. She is still in ongoing physical therapy and has a doctor’s restriction from lifting more than 5 pounds for an additional two weeks.  Will advises Irene that additional medical records will be needed to support her disability claim, and an updated certification will be needed to extend her job-protected leaves.  Irene may obtain these records on her own if she wishes, but Will also sends a request for this information on Irene’s behalf along with Irene’s signed medical authorization. Will receives the revised Health Care Provider Certification and extends the approval of Irene’s FMLA and CFRA absences.  Three days after receiving the Health Care Provider Certification, Will receives current physical therapy notes showing Irene remains unable to perform her occupation, so Will extends Irene’s STD claim for two more weeks.  Will sends a letter and calls Irene to advise her of the extension.

After the additional 2 weeks of disability, Irene is feeling great.  She has been released from physical therapy, and she notifies MetLife she’ll be returning to work with no restrictions. Will advises Irene to contact her manager to coordinate her return to work and confirms he’ll close out her claim. If anything changes with her claim, or if Irene requires additional time out, she can let her manager know and call Metlife to re-activate her claim.