District of Columbia Request for Extended Personal Leave

State:
Multi-State
Control #:
US-300EM
Format:
Word; 
Rich Text
Instant download

Description

This form is used by an employee to request an extended leave of absence.
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FAQ

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.

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.

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.

There is no formal provision in the FMLA for extended leave beyond 12 weeks. However, it is possible for workers to negotiate an extension on a case-by-case basis by discussing their situation with their employer and requesting additional unpaid leave during a family or medical crisis.

Leave extension is written by a person who is already on leave but needs an extension for a certain period because of unexpected circumstances. You can extend your leave due to any reason it could be some emergency or personal commitments or any other reasons.

Dear Mr./Ms. (Name of recipient), I am writing to inform you that I find myself unable to return to work on (date), and must request for a leave extension.

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.

Also known as unpaid leave, this is a form of leave that employees may take in a variety of circumstances, including if they have used up other leave entitlements, for study leave, at the end of paid parental leave or if the employee cannot take paid parental leave.

2022 Accrued Extended Illness Benefit (EIB) provides continuation of pay for employees who are unable to work due. to hospitalization or extended illness and/or to care for immediate family (spouse and children) whose illness. requires his/her assistance.

As explained in Chapter 2, there is a 7-day waiting period for benefits. Benefit payments occur on a schedule every two weeks. You will always receive payment for your Paid Family Leave benefits after the week for which benefits were payable to you and during which you took leave.

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District of Columbia Request for Extended Personal Leave