Arizona FMLA Information Letter to Employee

State:
Multi-State
Control #:
US-288EM
Format:
Word; 
Rich Text
Instant download

Description

This form is used to provide information to employees about extended absences under the FMLA.
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FAQ

The FMLA allows an employee to take up to 12 weeks of unpaid leave in an FMLA year. The FMLA year may be the same as the calendar year, but does not have to be.

Dear (Supervisor / HR Manager): Please be advised that I hereby request an FMLA leave for a period of (number of weeks) in connection with my serious health condition. The leave is to start on (date). Attached is my medical note reflecting the need for FMLA leave.

To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.

Arizona families will face increased family and medical care needs. Paid leave means older adults and working people of all ages can get the support they need to receive and provide critical care.

EligibilityHave worked for your employer for at least 12 months; and.Have worked for your employer for at least 1,250 hours in the 12 months before you are taking leave; and.Work at a location where your employer has at least 50 employees within 75 miles of your worksite.

Under the FMLA, a serious health condition is an illness, injury, impairment or physical or mental condition that involves inpatient care (defined as an overnight stay in a hospital, hospice or residential medical care facility; any overnight admission to such facilities is an automatic trigger for FMLA eligibility) or

Doctors aren't the only health care providers who may certify FMLA leave. Podiatrists, dentists, clinical psychologists, optometrists and chiropractors can all certify leave, as can nurse practitioners, nurse-midwives, clinical social workers and physician assistants.

Below is a summary and descriptions of reasons that qualify for FMLA leave under current FMLA regulations.Parental Leave after the Birth of a Child.Pregnancy Leave.Adoption or Foster Care.Medical Leave to Care for a Family Member with a Serious Health Condition.Medical Leave for Your Own Serious Health Condition.More items...?

Employers cannot hold an employee accountable for work that was not completed during an FMLA leave, and employees cannot be disciplined, terminated, or otherwise retaliated against in any way for requesting or taking a leave.

To take the leave, you must have recently given birth or adopted a child, have a serious health condition, including pregnancy-related health conditions or incapacities, or be taking care of a family member with a serious health condition.

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Arizona FMLA Information Letter to Employee