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192-800-002  <<  192-800-003 >>   192-800-005

PDFWAC 192-800-003

Designating an authorized representative.

(1) The department may authorize another individual to act on the employee's behalf for the purposes of paid family and medical leave benefits if:
(a) An employee designates an authorized representative by submitting written documentation as required by the department;
(b) A court-appointed legal guardian with authority to make decisions on a person's behalf submits documentation as required by the department;
(c) An individual designated as a power of attorney submits documentation satisfactory to the department to act on the employee's behalf; or
(d) If an employee is unable to designate an authorized representative due to a serious health condition, an individual may represent the employee by submitting a complete and signed authorized representative designation form made available by the department, which must include:
(i) Documentation from the employee's health care provider certifying that the employee is incapable of completing the administrative requirements necessary for receiving paid family and medical leave benefits and is unable to designate an authorized representative to act on the employee's behalf; and
(ii) An affidavit or declaration authorized by RCW 9A.72.085 attesting to the responsibility to act in the employee's best interest.
(2) The department will terminate the authority given to the authorized representative:
(a) When the employee or authorized representative notifies the department verbally or in writing; or
(b) At the department's discretion.
(3) For the purposes of paid family and medical leave the term employee is used for both employee and authorized representative.
[Statutory Authority: RCW 50A.04.215. WSR 19-08-016, ยง 192-800-003, filed 3/22/19, effective 4/22/19.]
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