Maine 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

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.

The law (ME Rev. Stat. tit. 26, § 637), enacted in 2019, allows Maine workers to accrue one hour of paid leave for every 40 worked, up to 40 total hours per year, to use for any reason after 120 days of employment.

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.

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.

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.

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.

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. they work at a location with at least 50 employees within a 75-mile radius.

Under the FMLA, a serious health condition is an illness, injury, impairment or physical or mental condition that involves inpatient care (defined as an overnight stay in a hospital, hospice or residential medical care facility; any overnight admission to such facilities is an automatic trigger for FMLA eligibility) or

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.

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.

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Maine Leave of Absence Application Form