Massachusetts Leave of Absence Application Form

State:
Multi-State
Control #:
US-AHI-269
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is to be filled by an employee who is requesting a leave regarding medical, family, military, or personal leave.

How to fill out Leave Of Absence Application Form?

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FAQ

The FMLA is a federal labor law that guarantees up to 12 weeks during the year of job-protected leave to take care of a health condition that you or an immediate family member is facing, or to bond with a new child.

To qualify for FMLA, an employee must have been with their employer for at least 12 months, with at least 1,250 hours worked over that time. Private sector employers must have over 50 employees to qualify for eligibility. FMLA also applies to all public sector employees and employees in all public and private schools.

If you are applying for military-related paid family leave benefits, or if you are currently self-employed or unemployed, please call the Department's Contact Center at (833) 344-7365 to begin your application.

If you are applying for military-related paid family leave benefits, or if you are currently self-employed or unemployed, please call the Department's Contact Center at (833) 344-7365 to begin your application.

Massachusetts employers are subject to the FMLA if they have at least 50 employees for at least 20 weeks in the current or previous year. Employees are eligible for 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.

You may not be eligible for Unemployment Insurance (UI) benefits if your only source of employment is from working as: An employee of a non-profit or religious organization. A worker trainee in a program run by a nonprofit or public institution. A real estate broker or insurance agent who work only on commission.

Claimants who are on a leave of absence granted at their request will be considered not in unemployment and therefore ineligible for UI benefits during the period of their leave.

When the Department has enough information to consider your application complete, they will begin review and make a decision within 14 calendar days.

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.

Generally no, you are not eligible for unemployment benefits if you take medical leave under the Family and Medical Leave Act and you cannot work.

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Massachusetts Leave of Absence Application Form