ESD paid family leave nightmare - doctor paperwork issues delaying benefits for 4 weeks
Completely fed up with ESD's Paid Family Medical Leave system! Had surgery on June 12th and still haven't seen a PENNY almost 4 weeks later. Every time I call, I get the stupid recording saying 'all agents are busy' and then it HANGS UP ON ME. No queue, no callback option, NOTHING. When I finally got through last week (by calling literally 37 times in one morning), they tell me my claim is delayed because my surgeon filled out the medical certification form at my pre-op appointment on June 9th instead of on the actual surgery date (June 12th). Are you kidding me?! The form clearly states my surgery date as June 12th, but apparently that's not good enough because the doctor signed it 3 days before. Now I have to get my surgeon to fill out ANOTHER form with the "correct date" which means more delays. Meanwhile, my mortgage is due and I have medical bills piling up. The agent had the nerve to say "Don't worry, when it's approved you'll get paid for all weeks" like that helps me NOW. These bureaucrats have no clue what it's like for regular people waiting on these benefits. Four weeks with no income is DEVASTATING. Has anyone else dealt with this absurd paperwork nitpicking? Any advice on how to get this resolved faster? I'm desperate!
19 comments
Nia Harris
ugh i feel ur pain!! same thing hapend 2 me last yr when i had my knee surgery. ESD is THE WORST with these stupid technicalities. took them 6 weeks to process my claim bcuz they said my doctors signature was 'illegible' or somethin. like who cares?? they new it was from my doctor!!
0 coins
GalacticGuardian
•6 WEEKS?! I can't wait that long! Did calling them every day help at all or is there nothing we can do but wait?
0 coins
Mateo Gonzalez
I'm sorry you're dealing with this frustration. Unfortunately, ESD is very strict about documentation dates on PFML claims. The certification date needs to match or be after the qualifying event (your surgery). Two suggestions that might help: 1. Ask your doctor's office if they can expedite the corrected paperwork and specify it's urgent because your benefits are on hold. Most medical offices have staff who handle these forms regularly. 2. Request that your claim specialist place a note that corrected documentation is forthcoming. This can sometimes help expedite processing once they receive it. Also, while waiting, document every call attempt (date, time) and interaction with ESD. This can be helpful if you need to escalate later.
0 coins
GalacticGuardian
•Thank you for these practical suggestions. I'll call my surgeon's office today and see if they can prioritize the paperwork. It's just so frustrating that a obvious technicality is causing this much hardship. I've already documented everything, including the agent's name who told me about the date issue.
0 coins
Aisha Ali
When this happened to me I just had my doctor redate the form and send it in again. My doctor was annoyed at the bureaucracy but did it. My claim was approved in about 10 days after that. But yeah the whole system is broken. They make everything so complicated on purpose I swear.
0 coins
Ethan Moore
Just FYI - the PFML program technically isn't part of regular unemployment, it's a separate department within ESD. They have different rules and processes than regular UI claims. Unfortunately they're extremely strict about documentation being precisely correct because they're worried about fraud. I work in HR and we see this all the time with our employees on leave. My advice is to get the new form from your doctor ASAP, then upload it directly to your PFML account rather than mailing or faxing it. Then immediately call to confirm they received it. With the corrected paperwork, they should be able to process everything within 7-10 business days. Hang in there - I know it's incredibly frustrating!
0 coins
GalacticGuardian
•Thanks for the clarification. I didn't realize PFML was completely separate from regular unemployment, but that explains some things. I'll definitely upload the form directly to my account once I get it - that's a good tip. Really hoping it doesn't take another 10 days after that though...
0 coins
Yuki Nakamura
If you're having trouble getting through to ESD on the phone, I discovered a service called Claimyr that will connect you with an ESD agent without having to spend hours redialing. It worked great for me - got me through to someone in about 20 minutes when I'd been trying for days. Their website is claimyr.com and they have a video showing how it works: https://youtu.be/7DieNd3C7zQ?si=26TzE_zGms-DODN3 I was skeptical at first but desperate after getting hung up on dozens of times. Getting through to an actual person made a huge difference in resolving my claim issues.
0 coins
Nia Harris
•does this actually work? seems 2 good 2 b true tbh
0 coins
Yuki Nakamura
•It worked for me! I was in the same boat - calling dozens of times and getting nowhere. Was able to get through and get my claim moving forward. Definitely worth it when you're stuck in paperwork hell.
0 coins
StarSurfer
The date thing happened to me too!!! But with disability not PFML. It's SO STUPID. My doctor wrote the date when he filled out the form, not when my disability started. I had to bug his office for 2 weeks to get a corrected form, then waited another 3 weeks for ESD to process it. Total of 7 weeks with no income. WHAT I LEARNED: you can request an expedited hardship review if you're facing eviction, utility shutoff, or can't afford medications. Call and specifically say "I need to request a hardship expedite" - they have to at least consider it. Doesn't always work but worth trying. Also, if you have documentation showing financial hardship (eviction notice, past due bills, etc.), email those to the general PFML email with your claim ID in the subject line. Sometimes that gets attention. Good luck - the system is truly broken!
0 coins
GalacticGuardian
•Thank you for sharing this! I didn't know about the hardship review option. My mortgage is already late (thankfully they give a 15-day grace period), and I have medical bills that are due. I'll definitely request this and send documentation. At least it's a little hope!
0 coins
Carmen Reyes
Here's something that might help - contact your state representative's office. I was getting NOWHERE with my claim for weeks, then I reached out to my rep's constituent services person. They contacted ESD directly and suddenly my claim was processed within 48 hours. They have special liaisons who can cut through the red tape. Worth a try!
0 coins
Mateo Gonzalez
•This is excellent advice. Legislative offices often have direct channels to agency leadership. Be sure to provide your claim ID, contact information, and a brief summary of the issue when you reach out to them.
0 coins
GalacticGuardian
•I never would have thought of this! Going to look up my representative right now. If my doctor's office drags their feet on getting the new form to me, this might be my best option. Thank you!
0 coins
StarSurfer
UPDATE: Got the new form from my doctor (his office manager was actually super helpful once I explained the situation). Uploaded it yesterday afternoon and - surprise! - got an approval email this morning! Money should be deposited by the end of the week. Thanks everyone for the advice and support. This system is still ridiculous, but at least there's light at the end of the tunnel. For anyone else dealing with this, be SUPER specific about date requirements when talking to your doctor's office - apparently this is a common issue but nobody warns you about it!
0 coins
Ethan Moore
•That's great news! Glad you got it resolved. And thank you for coming back to update - it's helpful for others to see success stories.
0 coins
GalacticGuardian
•Wait, I think you might have meant to post this under your own thread! This is my post and I haven't gotten the new form from my doctor yet... But I'm glad your situation worked out! Gives me hope.
0 coins
StarSurfer
•Omg I'm so embarrassed! You're right - I thought this was my thread from last week. Sorry for the confusion! Hope your situation gets resolved just as quickly!
0 coins