Anyone has experience with PMLA?

Submitted by GezinhaDM t3_11693cb in massachusetts

I'm having cosmetic surgery, however, it is out of medical necessity, can someone tell me how it works? Can I still apply?

Edit: So, I guess I cannot get any money because... wait for it... I'm a public school teacher, so I have to go unpaid for a whole 3 weeks. Fuck my school district that didn't opt in to pay into the PMLA fund!

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Opening-Dimension742 t1_j95lqx1 wrote

I used it last year after a stroke. I had a case worker at the hospital get me the application and a doctor does need to fill certain parts out and sign, but once the application was in it took a little over a month and I started receiving payments. There is a number you can call and the people I spoke with were very friendly.

If the surgery will take you out of work at all then I see no reason you can't apply. It's an insurance you pay in to.

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samsummer t1_j966t4w wrote

I found it to be easy enough to apply and receive payments when I was out of work after having a baby. I believe it took about 2 weeks for payments to start after I sent confirmation that the baby had been born. My employer had to confirm my leave after my application was sent in, but I didn’t have to get involved with that. But yeah if you are an employee in Massachusetts you pay into it, so you are eligible and should receive benefits no problem.

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Rick_Sanchez1214 t1_j974ela wrote

You’ll still be eligible. The is a medical questionnaire that needs to be filled out by the doctors office and submitted with your application.

Go into it prepped for nearly everyone you speak to at the PFML office being completely useless. I cannot stress this enough. On 4 out of 5 calls we made, we got the most inept people on the other side. Couldn't answer the most basic questions we had.

Beyond that, expect the approval process to take WEEKS. We submitted our docs in perfect order. Took 5 weeks for it to be approved (supposed to be 2). Then took another 5 weeks for my wife to see her first payment.

As is tradition when dealing with the state, they are slow as molasses.

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GezinhaDM OP t1_j97h6go wrote

Good thing I'm trying to file 7 weeks in advance haha

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Initial_Dimension541 t1_j98r266 wrote

If medically necessary than not considered “cosmetic” and you would be covered

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rollergirl77 t1_j99bb9e wrote

I used it twice last year. In May I got COVID and it kicked my ass for a few weeks. This past November, I had surgery and was out for 8 weeks.

Filling out the forms online can be a pain, and make sure you get the paper form from your doc asap.

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SparkDBowles t1_j967yzh wrote

Apply online. Also talk to dr or their staff and see what they know about getting approved.

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GezinhaDM OP t1_j96g8kx wrote

Yes, I definitely will do that. It seems that cosmetic surgeries out of necessity aren't a specific thing that is included in those links and instructions, so I imagine my doctor could clear that doubt for me as well as fill out any paperwork necessary. Thanks!

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superbbuffalo t1_j95m80k wrote

I’ll never deal with it again. The employees were next to useless, you have to wait 20 minutes plus to talk to anyone, payments are delayed over and over and over, there’s no easy way to communicate necessary paperwork, and overall it makes the DMV look flat out efficient by comparison.

That was my experience twice, one year apart.

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SparkDBowles t1_j967wcp wrote

I’ve found the opposite.

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superbbuffalo t1_j968ryu wrote

Twice I’ve had to deal with it and twice I’ve had the worst experience imaginable. In BOTH cases I was back to work for more than a month before I saw any benefits paid out. I’ve had to deal with DUA and they’ve got their shit together for the most part, but PFML was absolutely comedically atrocious.

No email to send in color photos, fax or regular mail, no dedicated line to determine amount or schedule of payments, no supervisors or managers to escalate problems to, and no clue how to help when you finally get past the 20+ minute hold time.

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