Delaware Application for Family Medical Leave of Absence

State:
Multi-State
Control #:
US-425EM
Format:
Word; 
Rich Text
Instant download

Description

This form may be used by an employee to request leave under the FMLA.
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How to fill out Application For Family Medical Leave Of Absence?

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FAQ

In order to be eligible to take leave under the FMLA, an employee must (1) work for a covered employer, (2) work 1,250 hours during the 12 months prior to the start of leave, (3) work at a location where 50 or more employees work at that location or within 75 miles of it, and (4) have worked for the employer for 12

FMLA runs concurrently with the Parental Leave benefit, as applicable. The State provides up to 12 calendar weeks of Parental Leave to eligible employees upon the birth of a child of the employee, or upon the adoption by the employee of a child who is six (6) years of age or younger.

Delaware employers must comply with the FMLA if they have at least 50 employees for at least 20 weeks in the current or previous year. Employees may take FMLA leave if: They have worked for the company for at least a year. They worked at least 1,250 hours during the previous year, and.

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.

The FMLA provides eligible employees up to 12 weeks of unpaid leave for qualifying family and medical reasons in a 12-month period from the first date of FMLA leave use.

Your request for a leave of absenceDuring the first paragraph of your letter, state your request for a leave of absence. This is where you include the start date of your absence and the approximate return date. You can include your reason for a leave of absence with as much detail as you feel comfortable with.

Sample LetterI am writing to inform you that I will be taking a sick leave because of a serious infection in my throat. I will be absent from work until October 14. I have attached a note from my doctor to confirm that it is necessary for my health and the health of my coworkers for me to take a medical leave.

Here's how to ask for a leave of absence from your job:Understand your legal rights regarding time off and pay.Make the request in person.Give sufficient advance notice.If possible, work with your boss to develop an agreeable plan.Keep track of relevant paperwork.

The eligibility notice may be either oral or in writing and must: Be provided within five business days of the initial request for leave or when the employer acquires knowledge that an employee leave may be for an FMLA-qualifying reason; Inform the employee of his or her eligibility status; and.

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Delaware Application for Family Medical Leave of Absence