District of Columbia Employee Time Off Request Form

State:
Multi-State
Control #:
US-0503BG
Format:
PDF
Instant download

Description

This form is a sample of a request from an employee for time off from work.

How to fill out Employee Time Off Request Form?

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FAQ

1, 2021, the D.C. City Council expanded the local Paid Family Leave law and the D.C. Family and Medical Leave Act (D.C. FMLA). The new laws entitle employees to three times as much paid medical leave and a new category of paid prenatal leave. The modifications also expand the group of employees eligible for D.C. FMLA.

DC Paid Family Leave provides wage replacement of 90% of wages up to 1.5 times DC's minimum wage and 50% of wages above 1.5 times DC's minimum wage. The maximum weekly benefit amount is $1,000.

But instead of a gradual climb, now those changes will come all at once: Starting this year, eligible workers will be provided with 12 weeks of paid parental, family and medical leave with a cap of 12 weeks in a year, according to a letter from then-acting chief financial officer Fitzroy Lee.

Can I take leave without pay? It is usually granted at the discretion of the employer. An employer can offer annual leave (or LSL if applicable) if the employee requests this and has an adequate annual leave balance.

The District of Columbia Family and Medical Leave Act (DCFMLA) requires employers with 20 or more employees to provide eligible employees with 16 weeks of unpaid family leave and 16 weeks of unpaid medical leave during a 24 month period.

We encourage you to use our benefits application portal to file a claim. If you are unable to apply online, please call our contact center at (202) 899-3700. Click to download our PFL Employee Handbook for additional information about qualifying events and the program.

You are eligible for Paid Family Leave benefits if you: Spend more than 50% of your time working in DC. Eligible workers must spend a majority of their time working the Districtincluding teleworking or telecommutingfor a covered employer, and must have completed that work during the year prior to needing leave.

We encourage you to use our benefits application portal to file a claim. If you are unable to apply online, please call our contact center at (202) 899-3700. Click to download our PFL Employee Handbook for additional information about qualifying events and the program.

An employee is eligible under the Act if she or he has been employed by the employer for at least one year without a break in service, and worked at least 1,000 hours during the 12 month period immediately preceding the requested leave.

DC workers can now apply for paid family leave. The Paid Leave Act provides up to: 2 weeks to care for your pregnancy. 8 weeks to bond with a new child.

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District of Columbia Employee Time Off Request Form