PFML-1782

Elena Rios

Medical leave
DeniedP2

Denied

Decided by Jordan Lee · May 19, 2026

Reasons cited

  • •

    Medical certification is incomplete or unsigned

  • •

    Information request response was incomplete

Provider signature missing on the amended certification, and functional limitations were not documented despite a follow-up RFI. Closing without prejudice; claimant may reapply with a complete medical certification.

Leave details

Leave type
Medical leave
Leave period
Mar 15, 2026 – May 15, 2026
Schedule
Continuous

Tasks

· 3 of 3 complete

Remaining · 0

No open tasks.

Completed · 3

Review amended medical certification

Jordan Lee · Completed 12 days ago

Request amended medical certification from provider

Elena Rios · Completed 13 days ago

Make determination

Jordan Lee · Completed 10 days ago

Decision criteria

· 4 of 5 complete

Verified

Identity verified

ID match confidence: 0.96
Verified

Leave reason qualifies

Qualifying reason: serious-health-condition
Failed

Medical certification received

Certification on file: yes
Provider signature: no
Functional limitations documented: no
Verified

Employer review received

Verified

Wage history sufficient

Activity

Jordan Lee moved case from
In reviewto
Denied· 10 days ago
Jordan Lee denied the case (2 reasons)

Medical certification is incomplete or unsigned; Information request response was incomplete

Provider signature missing on the amended certification, and functional limitations were not documented despite a follow-up RFI. Closing without prejudice; claimant may reapply with a complete medical certification.

· 10 days ago
Jordan Lee updated Medical certification receivedfrom
Evaluatingto
Failed· 12 days ago
Jordan Lee sent information request

Please provide an amended medical certification signed by the treating provider that documents specific functional limitations and the expected duration.

· 20 days ago
Jordan Lee moved case from
Submittedto
In review· 23 days ago
Elena Rios submitted the application· 25 days ago