Paid Leave Oregon Bulletin

November spotlight: preventing fraud

Just like any benefits program, Paid Leave Oregon is experiencing fraud – including people who are using stolen identities to file fraudulent claims. Paid Leave is actively working to prevent and identify fraudulent claims. We have systems and procedures to stop and prevent fraud, and we constantly update them to stay ahead of people who are trying to commit fraud.

To protect both our customers and the Paid Leave trust fund, every single application goes through identity verification, which is an essential part of the fraud prevention and customer protection process.

If you have information about fraudulent claims, we want to know about it. The more information you can give us, the more it will help us investigate. Confidentiality laws keep us from sharing the results of any investigation based on the information you provide, but we do appreciate your help.

Any customer who wants to report possible fraud can through our new Paid Leave fraud web page. The web page also has some helpful tips on how people can protect themselves from identity theft.
 

How Paid Leave helps patients – watch our latest video

In our newest video testimonial, Nicole Broder, a forensic health nurse, explains how Paid Leave helps patients and their families have time to heal. Broder’s specialty includes working with patients who have experienced acts of violence, including domestic or sexual abuse. This video is online on our healthcare provider web page and on YouTube. Please share widely!

Your top questions answered

Question: I’m a little confused by all these letters I’m receiving. How do I know that you have approved my application and that I will start receiving my benefit payments?

Answer: When you apply for Paid Leave Oregon, we will send you several letters, and we will explain each of them below. When we have approved your application, you will receive a benefits decision letter, which is different from the letters we discuss below.

• First, we make sure that you made at least $1,000 in subject wages or subject self-employed taxable income during your base year or alternate base year. If you are self-employed, we make sure that you have also paid contributions during this time frame. We may send you messages in Frances about a “monetary determination.” These are letters that include details about your income during your base year or alternate base year. We send you this decision before we approve your application and send you a benefits decision letter. A monetary determination notice may include a letter that asks you for more information.
• Next, after we make sure you meet the income eligibility requirement, we look at other requirements related to your type of leave (family, medical, or safe) or other information. We often send you questionnaires and letters asking for additional information about your leave event or other related information. We send them to you after we have made sure you meet the income requirement, but before we approve or deny your application. With these letters, we are making sure that your life event for your type of leave (family, medical, or safe leave) is eligible for paid leave. Also, we often need you to fill out a form that your health care professional needs to sign. After you have completed these, you may receive messages in Frances that are related to these called “non-monetary determinations.”

Please respond to questionnaires or send us any information we request as soon as possible. If you don’t respond by the due date, you could delay the review of your application.

It is important to remember that receiving these letters doesn’t mean that we have approved your application. You will receive a final letter that will tell you if we have approved or denied your application.

Question: How long should I expect it to take for Paid Leave to approve my claim?

Answer: Our average time to approve a claim and start paying benefits is currently 21 days. When you apply for benefits, Frances Online automatically estimates your benefit amount and the start date of your benefit year. The system lists this amount and date on your Frances Online home page before we begin reviewing your application. This doesn’t mean that we have approved your application.

Please read the “Read this letter first” document we send you. It has important information about the review of your application. You can find it in your Frances Online account, or if you chose to receive letters in the mail, we will mail it to you.

We review different parts of your application separately. You might get more than a few requests for information and decision letters from Paid Leave. Everyone’s situation is different, and this is why it is important to carefully read the letters we send you.

Continue to check your Frances Online account, just in case we need more information from you.

Important: If you change anything on your claim at any time while we are reviewing your application, like financial or personal information, we may need to do an additional review, and this may delay your claim

Real Voices

“I am a die-hard Oregonian, and this program has given me another reason to be a proud Oregonian. Every step of this process that Paid Leave Oregon had a hand in was handled extremely well. Your response time is unequaled, especially for a new program. The benefit allows me to have surgery and not have to worry about finances. Your staff has been lovely! I tend to be a harsh critic and you have surpassed any expectations I had.”

-Beverly

We want to hear your stories about how Paid Leave Oregon will help you and your family. We will use these stories, using your first name only, on social media and in marketing materials to share what having paid leave will mean for you. Please email us your story at paidleaveconnect@employ.oregon.gov.

 

Join the Paid Leave Oregon team! 

Are you passionate about providing benefits to others and ensuring businesses, small employers, and employees are treated fairly? Consider joining the Paid Leave Oregon team. Additional Oregon Employment Department job openings are posted in Workday.

Contact Paid Leave Oregon

Form:  Contact Us
Email: PaidLeave@Oregon.gov
Call: 833-854-0166 (toll-free)