Get Leave Without Pay Benefit Info-workers Comp.doc

This guide provides clear, step-by-step instructions on how to fill out the LEAVE WITHOUT PAY BENEFIT INFO-WORKERS COMP.doc online. It is designed to assist users in navigating the form efficiently and ensuring all necessary information is accurately provided.

Follow the steps to complete the form correctly and efficiently.

1. Click ‘Get Form’ button to access the form and open it in your online editor.
2. Begin filling in your name at the designated area. This is important for the identification of the document and your benefits.
3. Input the current date in the 'Date' section. This helps to establish the timeline of your leave.
4. Review the health benefits section, which explains the duration and costs associated with your health benefits during your leave. Ensure you understand that your benefits continue for two years.
5. Fill in the retirement plan section acknowledging that your contributions will cease during your leave. Make a note to contact the Retirement Board after returning to work.
6. For leave extensions, include a note indicating your intent to contact the Personnel Office, and remember to mention that documentation from a physician is required for extensions.
7. If applicable, check the life insurance information and note that you must pay the full amount to continue coverage.
8. Complete the return to work section by preparing to obtain a physician's certificate for when you are able to return, noting the need to visit the Personnel Office prior to your return.
9. After filling out all necessary sections, review your information for accuracy. Confirm that you have included all relevant details regarding your leave.
10. Finally, save changes, and download or print the document as needed to submit it through the appropriate channels.

Complete your forms online today to ensure your benefits are properly managed.