Michigan Application for Family Medical Leave of Absence

State:
Multi-State
Control #:
US-425EM
Format:
Word; 
Rich Text
Instant download

Description

This form may be used by an employee to request leave under the FMLA.
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FAQ

How Much FMLA Leave Is Available in Michigan? Michigan workers have up to 12 weeks FMLA in a 12-month time frame for health conditions, new babies, or other circumstances. These weeks renew every year as long as the worker meets eligibility requirements.

Your request for a leave of absenceDuring the first paragraph of your letter, state your request for a leave of absence. This is where you include the start date of your absence and the approximate return date. You can include your reason for a leave of absence with as much detail as you feel comfortable with.

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.

Sample LetterI am writing to inform you that I will be taking a sick leave because of a serious infection in my throat. I will be absent from work until October 14. I have attached a note from my doctor to confirm that it is necessary for my health and the health of my coworkers for me to take a medical leave.

How Much FMLA Leave Is Available in Michigan? Michigan workers have up to 12 weeks FMLA in a 12-month time frame for health conditions, new babies, or other circumstances. These weeks renew every year as long as the worker meets eligibility requirements.

The new law requires employers with 50 or more employees to provide eligible employees with paid medical leave to use for their own or their family members' medical needs and for purposes related to domestic violence, sexual assault, and public health emergencies.

In Michigan, employers must (as of March 29, 2019) allow employees to accrue up to 1 hour of sick leave for every 35 hours worked. The act further requires that an employer shall allow an eligible employee to use up to 40 hours of sick leave per 12-month period of eligibility.

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 let me know whether you approve this leave at your earliest convenience.

It gives workers up to 40 hours of sick time a year, which can be used to recover from physical/mental illness or injury; to seek medical diagnosis, treatment, or preventative care; to care for a family member who is ill or needs medical diagnosis, treatment, or preventative care; when the worker's place of business is

Some common reasons employees take a leave of absence are to recover from a serious illness, undergo a medical procedure, assist a family member, take an extended trip or welcome a new child into the family.

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Michigan Application for Family Medical Leave of Absence