Iowa Family and Medical Leave Request Form

State:
Multi-State
Control #:
US-266EM
Format:
Word; 
Rich Text
Instant download

Description

An employee may use this form to request leave under the FMLA.
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  • Preview Family and Medical Leave Request Form
  • Preview Family and Medical Leave Request Form
  • Preview Family and Medical Leave Request Form

How to fill out Family And Medical Leave Request Form?

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FAQ

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.

FMLA leave is unpaid leave. However, workers may choose to, or employers may require them to, substitute accrued paid sick, vacation, or personal time for FMLA leave. Substitute means that the paid leave provided by the employer will run concurrently with the unpaid FMLA leave.

The FMLA only requires unpaid leave. However, the law permits an employee to elect, or the employer to require the employee, to use accrued paid vacation leave, paid sick or family leave for some or all of the FMLA leave period.

200bYes. Please contact your employer regarding potential telecommuting, sick leave, PTO, FMLA, Disability and other options they may be offering.

Although FMLA leave is unpaid, employees may choose or employers may require employees to use accrued paid leave, such as sick or vacation leave, to cover some or all of the FMLA leave period. An employee's ability to take paid leave during FMLA leave depends on the employer's normal leave policies.

To designate FMLA, managers and supervisors must contact their Human Resources Associate (HRA). Any requests for exceptions, 2nd opinions, or FMLA designations must be submitted by the agency's HRA to FMLA@iowa.gov.

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

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Iowa Family and Medical Leave Request Form