Kentucky FMLA Certification of Physician

State:
Multi-State
Control #:
US-AHI-202
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is used by employers who have an employee that has requested medical leave. This form is filled out by the physician of the person that is being treated.
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FAQ

5226. In general, the Family and Medical Leave Act (FMLA) is a federal law that provides up to 12 weeks unpaid, job-protected leave to employees for certain family and medical reasons. Kentucky State Government also offers enhanced Family Medical Leave (FML) benefits in some areas.

Since the FMLA was revised in 2009, the certifications in support of leave for a serious health condition may include a diagnosis. This can help employers, but employers shouldn't rely solely on a diagnosis. This is, in part, because employers generally cannot require that a certification include a diagnosis.

In short, a medical certification is a relatively short form that is filled out by a health care provider and provided to the employer to establish a patient or family member's medical condition that requires FMLA-protected leave.

How do I write a medical certificate?be legible.include your name and your practice address.clearly state the name of the patient.avoid medical jargon.specify the date when the examination took place and the date the certificate was issued.identify the matter you are certifying and the applicable time period.

Go to your Human Resources department and let them know you would like to take an FMLA-approved absence for stress leave. They will provide you with the necessary paperwork that you must take to your doctor.

In order to qualify for FMLA for the purpose of care for your physical or mental health, you must show that you have a serious health condition. Often, this might include a condition which requires hospitalization or in-patient care for at least one night, treatments which require ongoing care and follow-up

A medical certificate or doctor's certificate is a written statement from a physician or another medically qualified health care provider which attests to the result of a medical examination of a patient. It can serve as a sick note (documentation that an employee is unfit for work) or evidence of a health condition.

Mental health conditions can trigger compliance requirements under both the FMLA and the ADA. An anxiety attack, PTSD episode, major depression or other mental health event may qualify as a serious health condition under the FMLA.

To qualify, you need to have worked for your employer for at least 12 months. In the last year, you need to have worked at least 1,250 hours, or about 26 hours per week. FMLA allows up to 12 weeks of unpaid leave. Your job is protected during this time.

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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Kentucky FMLA Certification of Physician