New York 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

To politely ask for a leave of absence, begin with a respectful greeting. Clearly state your intention to submit the New York Leave of Absence Application Form while outlining your reasons briefly and respectfully. Make sure to express gratitude for their understanding. This approach demonstrates professionalism and consideration.

The key difference in FMLA vs PFL is that FMLA is not a paid leave. It offers no compensation to employees taking time off. PFL in New York, on the other hand, provides both job protection and income for employees on leave.

An FMLA leave allows employees to take up to 12 weeks off in a 12-month period. If their absence is not protected by the Family and Medical Leave Act (FMLA), then it's considered a non-FMLA medical leave. However, their leave may still be protected under the ADA and ADA Amendments Act (ADAAA).

To apply for leave under FMLA, contact the personnel office of your employer agency. If eligible and approved, the personnel office will provide to the Fund's administrative office the appropriate information for continuation of Fund benefits.

Employees are eligible for leave if they have worked for their employer at least 12 months, at least 1,250 hours over the past 12 months, and work at a location where the company employs 50 or more employees within 75 miles.

Voluntary Short Term Disability You can receive income replacement benefits up to a maximum of 26 weeks. An employee working at least 50 percent of full time on a regular appointment and whose annual salary is at least $15,000 is eligible to enroll in the plan.

According to the FMLA, your employees can take up to 12 weeks off in a 12-month period if they have already worked for 1,250 hours. Under the EFMLA, your employee only needs to have worked 30 days before being eligible.

Special Leave of Absence Coverage (SLOAC) entitles City of New York eligible and approved employees up to a maximum of 18 weeks or 4 months (depending on your pay cycle) of benefits coverage in a 12-month period during unpaid leave resulting from a disability or serious illness of the employee.

In 2020, employees can take up to ten weeks off and receive up to 60 percent of their usual wages. Starting in 2021 and continuing thereafter, employees will be able to take up to 12 weeks off and receive up to 67% of their usual wages. Learn more about New York paid family leave.

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 Leave of Absence Application Form