Maine 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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How to fill out FMLA Certification Of Physician?

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FAQ

Employers with more than 49 employees are required to provide 4 weeks of paid maternity leave, including existing benefits, to an employee who gives birth and 2 weeks of paid parental leave to an employee whose spouse or domestic partner gives birth.

There is no paid family leave in Maine. While some businesses have disability insurance policies that allow for paid leave, there is no state mandated guarantee of paid leave. However, beginning in 2021, public and private employers with 25 or more employees will be required to provide paid leave.

1. Family medical leave entitlement. Every employee who has been employed by the same employer for 12 consecutive months is entitled to up to 10 work weeks of family medical leave in any 2 years unless employed at a permanent work site with fewer than 15 employees.

Under the Maine law, you can take up to 10 work weeks of leave in any two year period. The Federal Family and Medical Leave Act (FMLA) may give you more rights to leave. Different employers may calculate what is considered a leave period differently.

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.

EligibilityHave worked for your employer for at least 12 months; and.Have worked for your employer for at least 1,250 hours in the 12 months before you are taking leave; and.Work at a location where your employer has at least 50 employees within 75 miles of your worksite.

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.

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.

1. Family medical leave entitlement. Every employee who has been employed by the same employer for 12 consecutive months is entitled to up to 10 work weeks of family medical leave in any 2 years unless employed at a permanent work site with fewer than 15 employees.

Employees are eligible if they have worked for a covered employer for at least one year, for 1,250 hours over the previous 12 months, and if at least 50 employees are employed by the employer within 75 miles.

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Maine FMLA Certification of Physician