EDD PFL caregiving claim denied due to out-of-state doctor - appeal submitted but total silence

First, I'm sorry for your loss. Unfortunately, the radio silence from EDD during PFL appeals is completely normal, especially for caregiving claims (they seem to prioritize baby bonding claims). When my mom was dying last year, I had a similar issue with her out-of-state doctor in Oregon. The good news is that you've done everything right by submitting multiple medical sources. The hospice documentation will be particularly important. Here's what you need to know: 1. PFL caregiving appeals typically take 3-4 weeks to process, sometimes longer. 2. They won't update you online during the process. 3. They're supposed to send you an acknowledgment letter when they receive your appeal paperwork, but half the time they don't. 4. They CAN approve out-of-state doctors, but the reviewer needs to manually verify their credentials. Keep trying to call them. Ask specifically for a PFL specialist who handles caregiving claims. Regular EDD representatives often don't know how to check on these specialized appeals.

I work with PFL claims regularly, and yes, the lack of online visibility for PFL caregiving claims (especially appeals) is a major flaw in their system. Here's what's likely happening: your appeal is sitting in a specialized queue waiting for a medical eligibility reviewer to look at your documentation. If it's been more than 14 days since you submitted your appeal, I'd recommend trying to reach someone by phone ASAP. The appeal window has specific deadlines, and you want to make sure they received everything properly. One thing to note: for out-of-state providers, EDD has to verify their medical license manually in that state's system. This often causes delays, but doesn't mean automatic denial. The hospice documentation should be sufficient regardless of state lines.

I had the EXACT same thing happen!!! my dad passed in Ariozna too but in 2024 and EDD rejected my caregiving claim because his doctor was "out of network" or whatever. I appealed and then heard NOTHING for like a month!!! I was freaking out bc I took unpaid leave and needed that money. The worst part is theres literally no way to check status online for PFL caregiving stuff. its like they dont care about people taking care of dying parents but if its a baby suddenly they care 🙄 after calling like 50 times i FINALLY got thru to someone who told me my appeal was approved but the letter was "still being processed" whatever that means! got the money 3 days later. keep calling!!

I used to work for EDD (not anymore thank god) and the PFL system is a mess. The caregiving claims get way less attention than baby bonding. Your appeal is probably sitting in a pile and hasn't even been looked at yet. Keep calling!

I had a similar nightmare with EDD when my father was ill. After weeks of trying to get through on the phone with no success, I discovered Claimyr (claimyr.com) and it saved me so much frustration. It got me connected to an actual EDD representative within 25 minutes when I'd been trying for days. The agent was able to tell me exactly what was happening with my PFL caregiving appeal and what additional documentation they needed. They have a video showing how it works: https://youtu.be/DOLxZQb92wM?si=6N1iCQ3a8Cdb2Ay5 For PFL caregiving appeals specifically, you need to talk to a specialist. Regular EDD reps often can't see the details of these claims, which is why getting through to the right person is so important.

this is so typical of edd!!!! they act like caregiving claims dont matter as much as baby bonding. my sister waited TWO MONTHS after appeal with zero communication. she finally got approved and back pay but seriously the stress was unreal. the absolute worst part is no online status updates for PFL caregiving claims. its like were still in 1995 or something

Just checking back - any updates on your situation? Were you able to get through to anyone at EDD about your appeal?

if their reviewing three drs notes and still giving u a hard time thats crazy. I only need to submit one form for my twins bonding time and got approved right away. maybe cuz bonding is more common than caregiving? either way edd is flakey and inconsistent. good luck!

Just wanted to add a quick update to this thread for anyone finding it later - the EDD has actually updated their policies regarding out-of-state medical providers for PFL caregiving claims as of March 2025. They're supposed to have a more streamlined verification process now, but it's clearly not working well yet. For caregiving claims with out-of-state providers, make sure you submit: 1. The regular DE-2501F form completed by the out-of-state doctor 2. A copy of the doctor's state medical license 3. The medical facility's contact information including the main phone number (not just the doctor's direct line) This helps EDD verify credentials more quickly. And remember that hospice documentation is considered priority evidence for PFL caregiving claims.

I'm so sorry for your loss and the additional stress EDD is putting you through during this difficult time. Reading through this thread, it's clear that the lack of transparency in PFL caregiving appeals is a widespread issue that needs to be addressed. I went through something similar when my grandmother was in her final days in Arizona. The complete information blackout from EDD during the appeal process is absolutely maddening, especially when you're already dealing with grief and financial pressure from taking unpaid leave. Based on what others have shared here, it sounds like you're on the right track with having multiple medical sources documented. The hospice documentation should carry significant weight in your appeal. I'd definitely recommend following up on the suggestion to include a copy of the doctor's medical license if you haven't already - that seems to help speed up their verification process. One thing that helped me was keeping a detailed log of every call I made to EDD, including dates, times, and what each representative told me. This became crucial when I finally got through to someone who could actually help, as I could reference specific previous conversations and show the timeline of my attempts to get information. Hang in there - from what I'm reading, most of these out-of-state provider appeals do eventually get approved, it just takes way longer than it should. The system is clearly broken when it comes to caregiving claims compared to bonding claims.