Will my second EDD PFL caregiving claim be denied due to previous denial? (Mom now in hospice)

I'm so sorry about your mom. The good news is that your new claim should be treated separately since there's been a significant change in circumstances. Hospice care definitely qualifies as a new medical condition requiring caregiving. Make sure your doctor completed the certification form (DE2501F) specifically noting hospice care began, as this creates a new qualifying event. \n\nAlso, if you haven't already, call the PFL helpline first thing in the morning (right when they open) and explain your situation - specifically mention the hospice care aspect. Document who you speak with and what they tell you. I'd also recommend following up with a message through your online account specifically mentioning \

Thank you so much for this guidance. I did make sure her oncologist specifically noted \

this hapened to me but with my dad, they are NOT going to connect yr claims as long as u put new dates. the second time around make sure u mark it as NEW MEDICAL CONDITION not continuing care. thats proly why they denied u first time

That's really helpful - I think I might have checked

I WENT THROUGH EXACT SAME NIGHTMARE!!! My original PFL claim for my husband's cancer care was denied after 5 MONTHS of waiting - they said I didn't provide

Oh no, this is exactly what I'm afraid of. I'm so sorry you went through that. It's cruel to make families deal with bureaucratic nonsense during such a difficult time. Did you ever find someone helpful to talk to at EDD or were they all just reading from scripts?

hey just wondering did your mom get her cancer from smoking or was it environmental? my aunt just got diagnosed and we're trying to figure out what caused it. also did u get fmla from ur job before going on pfl?

Her cancer wasn't smoking related - it was pancreatic which often has no clear cause. And yes, I did qualify for FMLA through my employer first, which protected my job while I reduced hours. The PFL is separate and is meant to provide income replacement during caregiving leave.

Having worked with many caregivers, I can tell you that you're absolutely right to file a new claim. Hospice care creates a totally different caregiving situation than treatment-phase care. A few critical tips from my experience:\n\n1. The certification from the hospice physician needs to specifically state new care requirements\n2. Include a brief letter explaining this is a new claim for a new phase of care (not an appeal)\n3. Call EDD and specifically ask to speak with a PFL specialist about a hospice care claim\n4. If your mom's prognosis is less than 6 months (standard hospice definition), have the doctor note this on the form\n\nPFL claims for hospice care are generally processed with higher priority, but you still need to get through to an agent to flag it properly.

Thank you for these specific tips. I don't think I included a letter explaining the new situation - is it too late to submit one now? The claim was filed last week. And I've been trying desperately to reach an agent but spend hours on hold only to get disconnected. Is there a specific time of day or specific number that works better for hospice-related claims?

Have you tried using Claimyr to get through to EDD? After spending days trying to reach someone about my PFL transition, I was ready to give up. A friend recommended Claimyr (claimyr.com) and they got me connected to an actual EDD agent in about 25 minutes. There's a video showing how it works: https://youtu.be/DOLxZQb92wM?si=6N1iCQ3a8Cdb2Ay5. It was especially helpful for explaining my complicated caregiving situation where I needed to speak to someone who could actually look at my specific case details. Might be worth checking out since your situation with the previous claim and hospice care needs special attention.

does this actually work? im so sick of calling edd and getting nowhere!!!

Yes, it worked for me twice now. Not instant but waaaaay better than the hours of redialing I was doing before. definitely worth it for complicated cases like caregiver claims that need actual humans to review

I know exactly what youre going threw. My mom had stage 4 lung cancer in 2024 and I had to refile my PFL claim 3 times!!!! First they \

Thank you for the suggestion about the hospice social worker letter - I hadn't thought of that. Our social worker has been amazing and I'm sure she'd write a detailed explanation. I'll ask her tomorrow when she visits. And you're right, it does feel like they want us to give up sometimes.

Quick follow-up question - when you filed the new claim, did you check \

I'm pretty sure I checked

Don't panic! When you get through to an agent (which you will eventually), just explain your reasoning. You can also submit a supplemental statement through your online account clarifying that while you checked \

hey just checking in...did u hear anything back yet?? im in a similar boat and wondering how long ur waiting this time

It's been 9 days and still shows