Iowa FMLA Information Letter to Employee

State:
Multi-State
Control #:
US-288EM
Format:
Word; 
Rich Text
Instant download

Description

This form is used to provide information to employees about extended absences under the FMLA.
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FAQ

Dear (Supervisor / HR Manager): Please be advised that I hereby request an FMLA leave for a period of (number of weeks) in connection with my serious health condition. The leave is to start on (date). Attached is my medical note reflecting the need for FMLA leave.

Please contact your employer regarding potential telecommuting, sick leave, paid time off (PTO), Family & Medical Leave Act (FMLA), Disability and other options they may be offering. If paid time off is not available, you may be eligible for unemployment benefits.

Doctors aren't the only health care providers who may certify FMLA leave. Podiatrists, dentists, clinical psychologists, optometrists and chiropractors can all certify leave, as can nurse practitioners, nurse-midwives, clinical social workers and physician assistants.

How Do I Request FMLA Leave? To take FMLA leave, you must provide your employer with appropriate notice. If you know in advance that you will need FMLA leave (for example, if you are planning to have surgery or you are pregnant), you must give your employer at least 30 days advance notice.

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.

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.

I will be having surgerymy surgeon has ordered a minimum three-week recovery period (see doctor's signed recommendation attached.) I am happy to assist in handling any necessary preparations before beginning my leave, including training colleagues on upcoming projects. Thank you so much for your understanding.

Eligible employees are entitled to up to 12 workweeks of FMLA leave in a fiscal year. FMLA leave runs concurrently with paid leave. The State of Iowa requires employees to use accrued sick leave, vacation time, comp time, banked time, and/or Iowa United Professionals (IUP) personal time while on FMLA.

Eligibility. Any employee who has been employed by the state for a total of at least 12 months in the past seven years and has worked for at least 1,250 hours in the previous 12-month period is eligible. Eligibility determinations are made as of the date that the FMLA leave is to begin.

To qualify for the stress leave, you must be suffering from a serious medical condition. Not all stress causes an FMLA-eligible condition. But, if your doctor agrees that you are suffering from a severe condition and that you are unable to work during this time period, you will be eligible for protected leave.

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Iowa FMLA Information Letter to Employee