3599.1 In addition to the definitions in 34 DCMR § 3499, the following definitions shall apply to this chapter:
"Applicant" - means a person for whom a claim for paid family leave benefits has been submitted pursuant to section 3501.
"Authorized representative" - means an individual or entity who is legally permitted to act on behalf of an applicant or eligible individual. Such individual or entity may act as an authorized representative only if approved by DOES to act as an authorized representative for the applicant or eligible individual under the provisions of Subsection 3501.12.
"Average weekly wage" - means the average weekly wage as calculated by Subsection 3503.1(b).
"Biweekly" - means intervals of fourteen (14) calendar days.
"Bonding" - means the formation of a close emotional and psychological relationship between a parent or primary caregiver and an infant or child.
"Calendar week" - means each seven (7) day period beginning on Sunday and ending on Saturday.
"Child"-means a biological, adopted, or foster son or daughter, a stepson or stepdaughter, a legal ward, a son or daughter of a domestic partner, or a person to whom an eligible individual stands in loco parent is.
"Closed claim" - means a claim that was an open claim but whose last payable date has passed.
"Daily benefit amount" - means, with respect to eligible individuals electing intermittent leave, the weekly benefit amount divided by the intermittent leave indicator.
"DOES" - means the District of Columbia Department of Employment Services.
"D.C. FMLA" - means the District of Columbia Family and Medical Leave Act of 1990, effective October 3, 1990 (D.C. Law 8-181; D.C. Official Code §§ 32-501et seq.)
"Eligible individual" - means a person whose claim for paid-leave benefits is not based on employment for the United States, the District of Columbia, or an employer that the District of Columbia is not authorized to tax under federal law or treaty, who meets the requirements of this Chapter and:
(a) Has been a covered employee during some or all of the fifty-two (52) calendar weeks immediately preceding the qualifying event for which paid leave is being taken; or(b) Is a self-employed individual who has:(1) Opted into the paid-leave program established pursuant to Chapter 34; and(2) Earned self-employment income for work performed more than 50% of the time in the District of Columbia during some or all of the fifty-two (52) calendar weeks immediately preceding the qualifying event for which paid leave is being taken."Exigent circumstances" - means
(a) Physical or mental incapacity of the applicant that prevented the applicant or the applicant's authorized representative from filing for benefits following the occurrence of the qualifying event;(b) A demonstrable inability to reasonably access the means by which a claim could have been filed by the applicant or the applicant's authorized representative following the occurrence of the qualifying event; or(c) Actual lack of knowledge by the applicant of their right to apply for benefits under this chapter due to the noncompliance of all of the individual's covered employers with the notice requirements required by 7 DCMR 3407 during the period when the individual could have received benefits under this chapter. Such employer noncompliance shall be confirmed by DOES before the individual shall be eligible for benefits due to exigent circumstances under this section."Family member" - means:
(b) A biological, foster, or adoptive parent, a parent-in-law, a stepparent, a legal guardian, or other person who stood in loco parent is to an eligible individual when the eligible individual was a child;(c) A person to whom an eligible individual is related by domestic partnership, as defined by Section 2(4) of the Health Care Benefits Expansion Act of 1992, effective June 11, 1992 (D.C. Law 9-114; D.C. Official Code § 32-701(4) ), or marriage;(d) A grandparent of an eligible individual, which means the biological, foster, adoptive, or step parent of the eligible individual's biological, foster, adoptive, or step parent; or(e) A sibling of an eligible individual, which means the biological, half-, step-, adopted-, or foster-sibling or sibling-in-law of the eligible individual. "FMLA" - means the Family and Medical Leave Act of 1993, approved February 5, 1993 (107 Stat. 6; 29 USC §§ 2601et seq.).
"Health care provider" - shall have the same meaning as provided in Section 2(5) of the D.C. FMLA (D.C. Official Code § 32-501(5) ).
"In loco parent is" - means in place of a parent.
"In-person treatment" - includes all medical visits attended by a health care provider and the patient in the same physical space and telehealth services that meet the requirements for reimbursement under the Telehealth Reimbursement Act of 2013, approved July 23, 2013 (D.C. Law 20-26; D.C. Official Code § 31-3861) .
"Intermittent leave indicator" - means the number of days designated by the eligible individual in Subsection 3506.5(b)(1) or the default intermittent leave workweek provided in Subsection 3506.5(b)(2).
"Long-term disability payments" - a monetary benefit (excluding in-kind or medical benefits) payable from a public or private long-term disability program.
"Long-term disability program" - a plan or policy, including insurance plans whether funded through premiums paid by the covered individual or another entity or person, that is intended to compensate for an individual's lost wages due to the individual's own disability. This definition includes such plans or policies only when their maximum allowable duration of benefits payable to the individual, as established in the program's rules, is twenty-four (24) months or longer.
"Maximum leave entitlement" - means the maximum duration of qualifying parental leave applicable in the fiscal year during which the individual files a claim for paid leave benefits.
"Open claim" - means a claim whose last payable date has not yet occurred.
"Payable date" - means a day for which paid-leave benefits provided under this chapter have been approved as payable by DOES.
"Placement" - means the transfer of physical custody of a child into the household of an eligible individual.
"Pre-natal medical care" - means:
(a) Routine and specialty appointments, exams, and treatments, provided by a health care provider, that are associated with a pregnancy;(b) Pre-natal check-up appointments with a health care provider;(c) Diagnostic appointments with a health care provider that are intended to provide medical information about the health or wellbeing of the embryo or fetus carried by the eligible individual, such as amniocentesis, ultrasounds, or blood tests;(d) Treatment by a health care provider for pregnancy complications, including any treatment associated with a high-risk pregnancy;(e) Bedrest that is required or prescribed by a health care provider;(f) Physical therapy provided by a health care provider necessary to treat symptoms of, or to relieve physical discomfort associated with, pregnancy; or(g) Other medical care that medical documentation submitted by the claimant demonstrates is associated with a pregnancy. "Primary caregiver" - means legal guardian, or other person who stands in loco parent is to a child.
"Qualifying pre-natal leave" - means paid leave that an eligible individual who is pregnant may take for pre-natal medical care following the occurrence of a qualifying pre-natal leave event and prior to the occurrence of a qualifying parental leave event.
"Qualifying pre-natal leave event" - means the diagnosis of pregnancy by a health care provider.
"Qualifying event" - means a qualifying family leave event, a qualifying medical leave event, a qualifying parental leave event, or a qualifying prenatal leave event.
"Qualifying family leave" - means paid leave that an eligible individual may take in order to provide care or companionship to a family member because of the occurrence of a qualifying family leave event.
"Qualifying family leave event" - means the diagnosis or occurrence of a serious health condition of a family member of an eligible individual.
"Qualifying medical leave" - means paid leave that an eligible individual may take following the occurrence of a qualifying medical leave event.
"Qualifying parental leave" - means paid leave that an eligible individual may take within one year of the occurrence of a qualifying parental leave event.".
"Qualifying parental leave event" - means:
(a) The birth of a child of an eligible individual;(b) The placement of a child with an eligible individual for adoption or foster care; or(c) The placement of a child with an eligible individual for whom the eligible individual legally assumes and discharges parental responsibility."Regular and customary work" - means any work performed by the individual:
(a) During any of the five (5) completed quarters preceding the filing of the claim;(b) During the calendar quarter in which the claim was filed up to and including the date on which the claim was filed; or(c) During an open claim up to and including the date on which the individual elected any change to the claim, including any change to the leave schedule, the length of leave, and the intermittent days of leave. "Self-employment income" - means gross income earned from carrying on a trade or business as a sole proprietor, an independent contractor, or a member of a partnership.
"Serious health condition" - means the occurrence of a stillbirth; or a physical or mental illness, injury, or impairment that requires inpatient care in a hospital, hospice, or residential health care facility, or continuing treatment or supervision at home, or at the home of a caregiver or other family member, by a health care provider or other competent individual.
(a)(1) The term "treatment" includes, but is not limited to, examinations to determine if a serious health condition exists and evaluations of the condition.(2) Treatment does not include routine physical examinations, eye examinations, or dental examinations.(3) A regimen of continuing treatment such as the taking of over-the-counter medications, bed rest, or similar activities that can be initiated without a visit to a health care provider is not, by itself, sufficient to constitute continuing treatment for the purposes of this chapter.(b) The term "inpatient care" is the care of a patient in a hospital, hospice, or residential medical care facility for the duration of one overnight period or longer or any subsequent treatment in connection with such inpatient care.(c) The term "incapacity" means inability to work, attend school, or perform other regular daily activities due to the serious health condition, treatment of the serious health condition, or recovery from the serious health condition.(d) Conditions for which cosmetic treatments are administered are not serious health conditions; provided, that procedures related to an individual's gender transition or restorative surgery following surgery or treatments for diseases or injury shall not be considered cosmetic treatments for the purposes of this subparagraph.(e) A serious health condition involving continuing treatment by a health care provider means any one or more of the following:(1) A period of incapacity of more than three (3) consecutive, full calendar days, and any subsequent treatment or period of incapacity relating to the same condition that also involves: (A) Treatment of two (2) or more times within thirty (30) days of the first day of incapacity, unless extenuating circumstances exist, by a health care provider, by a nurse under direct supervision of a health care provider, or by a provider of health care services under orders of, or on referral by, a health care provider. For the purposes of this subsubparagraph, "extenuating circumstances" means circumstances beyond an individual's control that prevent the follow-up visit from occurring as planned by the health care provider;(B) The first, or only, in-person treatment visit within ten (10) days after the first day of incapacity if extenuating circumstances exist; or(C) Treatment by a health care provider on at least one (1) occasion, which results in a regimen of continuing treatment under the supervision of the health care provider;(2) Any period of incapacity or treatment, including prenatal care, for such incapacity due to a chronic serious health condition. A chronic serious health condition is one which: (A) Requires two (2) or more periodic visits annually for treatment by a health care provider or by a nurse under direct supervision of a health care provider;(B) Continues over an extended period of time, which shall include recurring episodes of a single underlying condition; and(C) May cause episodic rather than a continuing period of incapacity;(3) A period of incapacity that is permanent or long-term due to a condition for which treatment may not be effective. The family member of an eligible individual must be under continuing supervision of, but need not be receiving active treatment by, a health care provider;(4) Any period of absence to receive multiple treatments (including any period of recovery from the treatments) by a health care provider or by a provider of health care services under orders of, or on referral by, a health care provider, for: (A) Restorative surgery after an accident or other injury; or(B) A condition that would likely result in a period of incapacity of more than three (3) consecutive, full calendar days in the absence of medical intervention or treatment; or(5) Treatment by a health care provider on at least one (1) occasion to treat symptoms related to the occurrence of a miscarriage. "Wages" - shall have the same meaning as provided in Section 1(3) of the District of Columbia Unemployment Compensation Act, approved August 28, 1935 (49 Stat. 946; D.C. Official Code § 51-101(3) ); provided, that the term "wages" also includes self-employment income earned by a self-employed individual who has opted into the paid-leave program established pursuant to this chapter.
"Weekly benefit amount" - means the amount calculated using the procedure described in Subsection 3503.1(b).
"Workweek" - means the number of days within a calendar week provided by the indication made pursuant to Subsection 3506.5(b).