District of Columbia Absence From Work Form

State:
Multi-State
Control #:
US-AHI-262
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is to be filled out by an employee who will be absent form work for various reasons. The employee checks one of the reasons listed and gives dates and times for the absence.

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FAQ

Leave of absence meaning. A leave of absence policy allows employees to take an extended period of time off from work. It can be voluntary (like a sabbatical or maternity leave) or involuntary (like a health problem or work performance issue).

To qualify for leave pursuant to DCFMLA, an employee must meet the following requirements: (1) been employed by the employer for at least one year without a break in service and (2) worked for at least 1,000 hours (an average of 19 hours per week or approximately 6 months of full time) during the 122010month period

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.

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.

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.

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.

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.

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.

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District of Columbia Absence From Work Form