How to Fill Out and Submit Your Oregon Paid Leave Form

To file an Oregon paid leave application, submit it through Frances Online at frances.oregon.gov anywhere from 30 days before your leave starts to 30 days after it begins.¹ Before you open the application, confirm you meet the wage threshold, give your employer the required notice, and gather the verification documents that match your type of leave.

Check That You Qualify

You need at least $1,000 in Oregon wages during your base year, which is the first four of the last five completed calendar quarters before the Sunday preceding your first day of leave. If your earnings during that window fall short, the department looks at an alternate base year: the four most recently completed calendar quarters.² Coverage reaches nearly all Oregon workers, whether full time, part time, or holding multiple jobs.³

Benefits run up to 12 weeks per benefit year, taken as family leave (bonding with a new child or caring for a family member with a serious health condition), medical leave for your own serious health condition, or safe leave tied to domestic violence, sexual assault, harassment, stalking, or a bias crime.⁴ A parent who gives birth and has pregnancy-related complications or limitations can receive up to two additional weeks on top of that.¹

Notify Your Employer First

Tell your employer before you file. For foreseeable leave, your employer can require 30 days’ written notice. Skip that notice or shorten it without good reason and the department can reduce your first weekly benefit by up to 25%.⁵ The reduction is automatic; your employer does not have to request it.

When leave is unexpected, notify your employer within 24 hours (a phone call or text works), then follow up with written notice within three days of starting leave. If you have worked for that employer at least 90 consecutive days, your job and position are protected while you are out.⁶

Gather the Documents That Match Your Leave

Every applicant needs the basics: your Social Security Number or Individual Taxpayer Identification Number, your legal name matching official records, and current contact information.⁷ After that, the verification requirements split by leave type.

Family Leave

For bonding leave after a birth, you need either the child’s official state-issued birth certificate or a document from the child’s or birthing parent’s healthcare provider confirming the birth. For adoption or foster placement, acceptable proof includes a court order verifying initial placement, a document from the agency or social worker confirming the placement, or a USCIS document for the child. If you are taking family leave to care for a family member with a serious health condition, you use the medical verification form described below.¹

Medical Leave

Medical leave requires the Verification of Serious Health Condition Form from the Paid Leave Oregon forms page.⁸ You fill out Part A, plus Part B if the leave is to care for a family member. Your healthcare provider completes and signs Parts C and D. Two rules trip people up: the form cannot be signed more than 60 days before your expected leave start date, and no alterations are accepted (no whiteouts, strikeouts, or corrections). Missing information can delay or defeat your claim.⁹

A broad range of providers can sign, including physicians, nurse practitioners, psychologists, naturopathic physicians, dentists, optometrists, midwives, and regulated social workers, as long as they are licensed and treating within their scope of practice.⁹

Safe Leave

You need at least one of the following: a completed Safe Leave Verification Form, a police report, a protective order, a formal Title IX complaint, or documentation from an attorney, health care provider, mental health professional, counselor, victim services provider, or recognized religious community representative. If none of those are available due to lack of services or safety concerns, you can submit a self-attestation, a brief written statement explaining why you need safe leave and time off work.¹⁰

File Through Frances Online

The preferred method is Frances Online at frances.oregon.gov.¹¹ Create an account using your SSN or ITIN, then work through the prompts for your employment details, leave type, requested dates, and typical work schedule. Upload your verification documents directly in the portal.

The application asks whether your leave will be continuous (all at once) or intermittent (days or weeks of leave mixed with working days). If you pick intermittent, you have to file for benefits each week so the department knows which days you took leave and which you worked. The minimum leave increment is a full day; you cannot claim a few hours. On any day you take leave, you must take it from all of your employers, not just one.¹²

Review everything on the final screen and submit. You get an immediate confirmation and tracking number. Keep the tracking number for any follow-up. Anything wrong in your application should be corrected before you submit; filing false information can cost you eligibility across multiple quarters until any fraudulently paid benefits are repaid, on top of criminal penalties.¹³

If You Cannot Apply Online

Request a paper application by calling the department at 833-854-0166. Mail the completed application and all supporting documents in the same envelope so nothing gets separated, and use a tracking service so you have proof of delivery.

What Happens After You Submit

The department verifies your identity, sends your claim details to your employer for review, then evaluates your application and supporting documents. You receive a Notice of Determination stating whether the claim is approved or denied and, if approved, your calculated weekly benefit amount. Electronic filers can download the notice from Frances Online; paper applicants receive it by mail.

Processing times vary based on claim volume and how complete your file is. Incomplete documentation is the most common source of delay, so before submitting, confirm the health condition form is fully filled out, signed within the 60-day window, and free of alterations.

Once approved, you choose direct deposit or a prepaid debit card. Direct deposit timing depends on your bank. A debit card takes 10 to 14 business days to arrive by mail. If the banking information you provide turns out to be incorrect, the department automatically switches you to a debit card.²

If You Are Self-Employed

Self-employed workers and independent contractors are not automatically covered but can opt in. To qualify for elective coverage, you must have earned at least $1,000 in Oregon net self-employment income in the previous tax year, and you commit to paying contributions for a minimum of three years. The rate for 2025–2026 is 0.6% of your Oregon net self-employment income, up to a maximum of $184,500 in income. Have copies of your federal and state personal income tax returns from the previous year ready when you sign up.¹⁴

If Your Employer Uses an Equivalent Plan

Some employers run their own paid leave plans in place of the state program, with plans that must provide benefits equal to or greater than the state fund and receive Employment Department approval.¹⁵ If your employer has an approved equivalent plan, apply through your employer or their third-party administrator rather than Frances Online. Being covered by an equivalent plan does not prevent you from also applying through the state program if you are otherwise eligible.

If Your Claim Is Denied

The Notice of Determination includes an appeal deadline of either 20 days or 60 days after the notice is mailed, depending on the type of decision. To appeal, complete the Request for Hearing form and mail it with a copy of the decision to:

Attn: Paid Leave Oregon
Oregon Employment Department
875 Union St NE
Salem, OR 97311¹⁶

If you miss the deadline, you can still request a hearing, but you will need to show the Office of Administrative Hearings that you had good cause for filing late. A representative can file on your behalf if they already hold status as a claimant-designated representative or authorized agent; if not, set that up through the forms at paidleave.oregon.gov before submitting the hearing request.¹⁶

1
Paid Leave Oregon. Applying for Family Leave
2
Paid Leave Oregon. What to Expect
3
Paid Leave Oregon. Employers – Paid Leave Oregon
4
Oregon State Legislature. Oregon Code 657B.020 – Qualifying Purposes for Benefits; Duration of Benefits
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Public.Law. Oregon Code 657B.040 – Notice to Employers Prior to Commencing Leave
6
Paid Leave Oregon. Common Questions About Paid Leave
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Paid Leave Oregon. What You Need to Apply for Benefits Checklist
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Paid Leave Oregon. Forms – Paid Leave Oregon
9
Oregon Employment Department. Verification of Serious Health Condition Form Instructions
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Paid Leave Oregon. Applying for Safe Leave
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Paid Leave Oregon. Home – Paid Leave Oregon
12
Oregon Employment Department. Paid Leave Oregon Employee Guidebook
13
Public.Law. Oregon Code 657B.334 – Ineligibility for Benefits Upon Conviction of Fraud in Obtaining Benefits
14
Paid Leave Oregon. Self-Employed and Independent Contractors
15
Public.Law. Oregon Revised Statutes 657B.210 – Equivalent Plans, Generally
16
Oregon Employment Department. Request for Hearing Form