New Hampshire 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 entitles eligible employees to take job-protected leave for self and specified family for medical reasons. Eligible employees are entitled to: The birth of a child and to care for the newborn child within one year of birth.

Contact your Agency Human Resource representative as soon as you know you will be out due to a FMLA qualifying event. Human Resources will provide you with all the required forms needed to review your request. You will need to: Provide your agency Human Resources with certification of the need for leave.

Like employers in every state, New Hampshire employers must follow the federal Family and Medical Leave Act (FMLA), which allows eligible employees to take unpaid leave for certain reasons. Once an employee's FMLA leave is over, the employee has the right to be reinstated to his or her position.

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

What Are the State Plan Benefits? Eligible employees can receive: Up to six weeks a year with no minimum duration required. 60% of their average weekly wage, capped at the Social Security taxable wage maximum.

Below is a summary and descriptions of reasons that qualify for FMLA leave under current FMLA regulations.Parental Leave after the Birth of a Child.Pregnancy Leave.Adoption or Foster Care.Medical Leave to Care for a Family Member with a Serious Health Condition.Medical Leave for Your Own Serious Health Condition.More items...?

In New Hampshire, employers are not required to provide employees with paid family or sick leave employees may be entitled to 12 weeks of job-protected family and medical leave under the federal Family and Medical Leave Act (FMLA), but that leave is unpaid.

To care for the employee's spouse, child, or parent who has a serious health condition. A serious health condition that makes the employee unable to perform the essential functions of his or her job.

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New Hampshire Leave of Absence Application Form