New York FMLA Information Letter to Employee

State:
Multi-State
Control #:
US-288EM
Format:
Word; 
Rich Text
Instant download

Description

This form is used to provide information to employees about extended absences under the FMLA.
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FAQ

FMLA retaliation violates the law. Your employer cannot refuse to authorize your leave, discourage you from taking leave, or factor in your leave when making employment decisions. If your rights have been violated, a workplace retaliation lawyer can help.

Dear (Supervisor / HR Manager): 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.

I will be having surgerymy surgeon has ordered a minimum three-week recovery period (see doctor's signed recommendation attached.) I am happy to assist in handling any necessary preparations before beginning my leave, including training colleagues on upcoming projects. Thank you so much for your understanding.

FMLA leave is unpaid, but employees may be allowed (or required) to use their accrued paid leave during FMLA leave. And, if you are taking leave for a reason covered by New York's temporary disability insurance or paid family leave programs, you may be eligible for benefits during your time off; see below.

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.

The Family Medical Leave Act provides eligible employees up to 12 weeks of unpaid, job-protected leave a year whether you are unable to work because of your own serious health condition or because you need to care for a family member with a serious health condition.

To qualify for the stress leave, you must be suffering from a serious medical condition. Not all stress causes an FMLA-eligible condition. But, if your doctor agrees that you are suffering from a severe condition and that you are unable to work during this time period, you will be eligible for protected leave.

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.

For 2020, you are allowed to take up to 10 weeks of Paid Family Leave in a 12-month period and you will receive 60% of your average weekly wage, capped at $840.70. That maximum amount, however, is equal to 60% of the State Average Weekly Wage of $1,401.17.

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New York FMLA Information Letter to Employee