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Submit Online Request For Arbitration 

To complete and submit this Request for Arbitration ONLINE, you will need to:

  1. Fill out the Request for Arbitration form online;
  2. Be able to upload the Denial or PFL Benefits Letter and supporting documentation; and
  3. Pay the $25 filing fee by Credit Card


*NOTE: If you believe that you have been discriminated or retaliated against by your employer for taking or requesting Paid Family Leave, this kind of dispute cannot be resolved through arbitration. Please visit www.ny.gov/paidfamilyleave or contact the Paid Family Leave Hotline at (844) 337-6303 for more information about filing a Paid Family Leave discrimination claim with the Workers' Compensation Board.

For the purpose of Paid Family Leave, an employee has experienced discrimination if he or she has been refused reinstatement to the same or a comparable position or has been disciplined as a result of taking or requesting Paid Family Leave.

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PLEASE NOTE

If you are not able to complete all 3 steps as listed, you may either:

Print a blank Request for Arbitration form (see below), complete by hand and mail to NAM with a copy of the Denial or PFL Benefits Letter, supporting documentation and $25 filing fee (ONLY money order or credit card authorization form will be accepted);

OR

Fill out the Request for Arbitration form on your computer, print it and mail the completed form to NAM with a copy of the Denial or PFL Benefits Letter, supporting documentation and $25 filing fee (ONLY money order or credit card authorization form will be accepted)

Visit the Get Forms section to download the appropriate Request for Arbitration form.