260 R.I. Code R. 260-RICR-40-05-1.38

Current through December 3, 2024

Section 260-RICR-40-05-1.38 - Filing of Claims for Temporary Caregiver Insurance Benefits

A. Every individual who files a claim for Temporary Caregiver Insurance (TCI) under the provisions of the Rhode Island Temporary Disability Insurance Act shall file such claims in writing or otherwise as the Director may prescribe.

B. Every otherwise eligible claimant who files a claim for benefit credits shall be entitled to such for each week of unemployment due to the need to care for a seriously ill child, spouse, domestic partner, parent, parent-in-law, grandparent, or to bond with a newborn child, adopted child, or foster child only if:

1. The notice of the claim for benefits is mailed, delivered, or otherwise sent to the Department of Labor and Training no later than thirty (30) days after the first day of leave is taken.

C. New claims filed with a Benefit Year Begin Date of January 5, 2014 or later will not be required to serve a nonpaid waiting period week.

D. Claimants are required to be out of work, due to the need to provide care for a seriously ill child, spouse, domestic partner, parent, parent-in-law, grandparent, or to bond with a new child, adopted child, or foster child for seven (7) consecutive days or longer to be eligible for benefit payments.

E. At the discretion of the Director, or his/her authorized representative, a claimant may, at any time, be required:

1. To submit to the Department of Labor and Training, medical or laboratory reports, transcripts of hospital records, affidavits, certificates, evidence of separation from or accession to employment, or any other type of documentary evidence the Director deems necessary to validate the claim.

F. As used in the context of R.I. Gen. Laws § 28-41-34, "Continuing medical treatment or continuing supervision by a health care provider" means:

1. A period of incapacity (that is the inability to work, attend school or perform regular daily activities due to a serious health condition, treatment therefore and recovery therefrom) of at least seven (7) consecutive days for the same condition that also involves:

a. Treatment two or more times by a health care provider, or treatment by a health care provider on one occasion which results in a regimen of continuing treatment under the supervision of a health care provider.

G. A bonding leave claim must be for a period of at least seven (7) consecutive days.

H. A claimant shall provide written documentation of the parental relationship when filing a bonding leave claim, acceptable forms of documentation are: child's birth certificate, declaration of paternity, proof of foster placement certificate of adoption placement, or an independent adoption placement agreement.

I. Temporary Caregiver Insurance benefits are paid from the balance of credits a claimant qualifies for as determined according to R.I. Gen. Laws § 28-41-7.

J. Temporary Caregiver Insurance benefits weekly benefit rate and dependents' allowances are determined according to R.I. Gen. Laws § 28-41-5.

K. The first valid claim filed, for either Temporary Disability Insurance benefits or Temporary Caregiver Insurance benefits, under the provisions of the Rhode Island Temporary Disability Insurance Act, R.I. Gen. Laws Chapters 28-39 through 28-41, shall establish the claim's benefit year according to R.I. Gen. Laws § 28-39-2. Any subsequent claims for either Temporary Disability Insurance benefits or Temporary Caregiver Insurance benefits within the same benefit year shall only be payable from any remaining balance of credits.

L. Eligibility for Temporary Caregiver Insurance benefits shall be determined according to R.I. Gen. Laws § 28-41-11.

M. Medical documentation, indicating the serious health condition of the family member, is to be obtained and provided to the department by the claimant according to the department's eligibility requirements. Claims will not be determined without the required medical documentation.

1. Medical documentation must be signed by an approved licensed provider as specified in § 1.4 of this Part.

N. Temporary Caregiver Insurance benefit payments are taxable and the department will provide a statement, IRS Form 1099 G, of the total amount of benefits received during the year. This information will also be provided to the Internal Revenue Service (IRS).

1. If your home and/or mailing address changes, you must notify the department in writing.

O. Every individual claimant is required to inform the department when he/she returns to work in order to prevent overpayments of benefit payments.

P. A legal guardian or a person who stands in "loco parentis" will be required to provide proof as determined by the Department's Director to show the relationship with child and need for "bonding" as defined by R.I. Gen. Laws § 28-41-34 which shall involve being in one another's physical presence and day to day financial support.

Q. The Partial Return to Work (PRTW) option (R.I. Gen. Laws § 28-41-5(d)) is not applicable to Bonding and Caregiving claims. The PRTW option exists to facilitate the transition for an individual to return to their normal working hours while continuing their recuperation; and, therefore, is not pertinent to the Temporary Caregiver Program.

R. Temporary Caregiver Insurance (TCI) benefits are payable under R.I. Gen. Laws Chapter 28-41. Therefore, R.I. Gen. Laws § 28-41-6 applies to TCI and no individual shall be entitled to receive waiting period credit benefits or dependents' allowances with respect to which benefits are paid or payable to that individual under any workers' compensation law of this state, any other state, or the federal government, on account of any disability caused by accident or illness.

S. An employee shall file a written intent with their employer indicating the need to file for Temporary Caregiver Insurance (TCI) benefits. The written notice shall be delivered to the employer a minimum of 30 days prior to the commencement of the family leave except in the event that the time of need for the leave is unforeseeable or the time of the leave changes for unforeseeable reasons. The notice to the employer shall indicate the date that the leave will commence and the expected return to work date.

260 R.I. Code R. 260-RICR-40-05-1.38

Amended effective 12/3/2024