How to Complete and Submit Colorado’s FAMLI Serious Health Condition Form

Colorado’s FAMLI Serious Health Condition form is the medical certification a licensed healthcare provider completes to verify your need for paid leave under the state’s Family and Medical Leave Insurance program. You cannot receive FAMLI wage-replacement benefits for your own serious health condition, or for caring for a family member with one, without it. You start the process by filing a claim in the My FAMLI+ portal at myfamliplus.state.co.us, which generates the form for your provider. The FAMLI Division typically issues a decision within two weeks of receiving a complete certification.¹

When You Need This Form

Colorado Revised Statute § 8-13.3-503 defines a serious health condition as an illness, injury, impairment, pregnancy, recovery from childbirth, or physical or mental condition that involves either inpatient care in a hospital, hospice, or residential medical facility, or continuing treatment by a healthcare provider.² The “continuing treatment” branch is where most claims land: a condition keeping you out of work for more than three consecutive days with ongoing care, a chronic condition like severe asthma or epilepsy with recurring episodes, or a long-term condition requiring medical supervision even when treatment is not curative.

Pregnancy and recovery from childbirth qualify on their own. If complications extend your leave beyond the standard 12 weeks, up to 16 weeks are available, but your provider has to file a separate Serious Health Condition form documenting the complication.³ The same form and the same medical standard apply when you are taking leave to care for a family member; the provider simply documents that person’s condition instead of yours.

Bonding with a new child, safe leave, and military exigency leave use different documentation, so the Serious Health Condition form is not the right paperwork for those reasons.

Getting the Form to Your Provider

Log in to My FAMLI+ and open a claim. During the claims process, the system generates the Serious Health Condition form and asks you to complete your employee section, which includes your identifying information and an authorization releasing medical information to the Division.⁴

What happens next depends on whether your healthcare provider is registered in My FAMLI+. If they are, the portal sends the form directly to them for digital completion, and their certification attaches to your claim automatically once signed. If they are not registered, you download and print the form from within your claim, bring it to your appointment, and have the provider complete and sign it on paper. You then scan the signed form and upload it back into your claim.⁴

If your provider’s office handles a lot of FAMLI claims, ask whether they are already registered. Digital submission through the portal shaves days off the timeline and lets practices assign staff to help with certifications.⁵

What Your Provider Must Certify

A U.S.-licensed provider — physician, physician assistant, nurse practitioner, or other qualifying professional — must complete and sign the certification. The provider documents the diagnosis, the date the condition started, the expected duration of incapacity, and specific medical facts explaining why you cannot perform your job functions. Vague statements along the lines of “patient is unable to work” without supporting clinical detail are the most common reason the Division sends back a request for more information, which pauses your claim.

The Absence Parameters Section

This is the part of the form that most often causes problems. The provider has to specify how many hours of leave you need during either a 7-day period or a rolling 30-day period. Not both. That choice determines whether your leave is treated as continuous or intermittent and controls how many leave hours the system will approve in each reporting period.⁵

If your condition calls for a single unbroken block away from work, the provider certifies continuous leave and estimates the total duration. If your condition involves cycles like chemotherapy or dialysis, or unpredictable flare-ups from a chronic illness, the provider certifies intermittent leave with a specific Absence Parameter. Intermittent leave cannot be filed as a weekly average — the provider must certify specific parameters and you report actual hours.⁶

A few things to know if your leave is intermittent:

You receive a Report Leave Hours task in My FAMLI+ every week and must log your absences for each day.
You can file for fewer than eight hours in a claim, but wage-replacement payments do not begin until reported hours reach the eight-hour threshold.
If the provider chose the 30-day parameter, the system runs a rolling look-back over the 30 days leading up to each reported day. Reporting hours that push you past your parameter triggers errors.

Submitting the Completed Form

If your provider signed off digitally through My FAMLI+, submission is automatic. For paper forms, log in, open your active claim, and upload the scanned document. When the system asks you to classify the upload, select the medical certification category so it routes to the right reviewer. The portal shows a confirmation screen once the upload completes; that is your receipt.⁷

Before you upload, check every field and every signature date. Incomplete forms are the quickest way to trigger a request for information that pauses your claim. If you cannot use the portal, call the FAMLI Division at 1-866-CO-FAMLI (1-866-263-2654) for alternative submission options.

When To File and What Happens Next

You can open a planned FAMLI leave claim up to 30 days before your first day of absence. For unplanned medical events, you have up to 30 days after the absence begins to file. Your employer is notified automatically through the system once you file, so there is no separate portal notification you need to send.¹ Company policies may still require you to tell your employer directly, so check your employee handbook.

Once your claim is fully submitted with all required paperwork, the FAMLI Division has two weeks to approve or deny it.¹ You receive the decision by email and inside your My FAMLI+ account. If the certification is missing information or the medical documentation is unclear, the Division sends a request for information, and the two-week clock resets when you provide the corrections. There is no waiting period before leave takes effect once the claim is approved.

If the Certification Is Rejected

Denials tied to the form itself usually come down to three things: the medical certification lacked sufficient clinical detail, the Absence Parameters section was incomplete or contradictory, or the wage-history check showed insufficient FAMLI-covered earnings. The first step is to request a reconsideration inside your My FAMLI+ account, where you can upload additional documentation aimed at whatever triggered the denial.⁸

If reconsideration does not resolve the issue, you can file a formal appeal. Your appeal must state the reason you are appealing, include a copy of the determination notice being challenged, and attach any supporting documentation. The Appeals Unit assigns valid appeals to a Hearing Officer, who may hold a status conference to see whether the matter can be resolved informally. Otherwise the case proceeds to an evidentiary hearing with sworn testimony and documents, and the Hearing Officer issues a written decision that explains any further appeal rights.⁸

1
Family and Medical Leave Insurance (FAMLI). Individuals and Families FAQs
2
FindLaw. Colorado Revised Statutes Title 8 Labor and Industry 8-13.3-503 – Definitions
3
Family and Medical Leave Insurance (FAMLI). Parental (Bonding) Leave
4
Family and Medical Leave Insurance (FAMLI). Medical Leave to Care for Yourself
5
Family and Medical Leave Insurance (FAMLI). Health Care Providers
6
Family and Medical Leave Insurance (FAMLI). How FAMLI Leave Can Be Used
7
My FAMLI+. My FAMLI+ Benefits Portal
8
Family and Medical Leave Insurance (FAMLI). Appeals FAQ