Rhode Island 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

Employees are eligible to apply for leave if they are full- time employees who work an average of 30 hours a week or more and have been employed continuously for at least 12 months. for one or more of the following reasons: 1. Birth of a child of an employee.

Key TakeawaysNine states (California, Colorado, Connecticut, Massachusetts, New Jersey, New York, Oregon, Rhode Island, and Washington) and the District of Columbia offer PFML.Of the states that have PFML policies currently on the books, six and D.C. are presently in effect.More items...

The Temporary Caregiver Insurance Program (TCI) is Rhode Island's paid family leave program. As part of the RI Temporary Disability Program (TDI), TCI provides up to five weeks (6 weeks in 2023) per year of partial wage replacement benefits to most Rhode Island workers and protects your job security.

To be eligible for TDI/TCI benefits, you must have earned wages in Rhode Island and paid into the TDI/TCI fund. For claims filed effective 1/1/22 or later, you must have been paid at least $14,700 in the Base Period for the claim.

Reasonable Accommodation and Family and Medical Leave Forms:Families First Leave Request Form.Employee Certification of Necessary Absence (Affidavit) Form.WH-380-E U.S. Department of Labor Certification of Health Care Provider for Employee's Serious Health Condition (Family and Medical Leave Act)More items...

Under the law, Rhode Island employers with 18 or more employees will be required to offer paid sick and safe leave. Employers with fewer than 18 employees must provide sick and safe leave time, although it does not need to be paid. Covered employees may take up to 40 hours of leave.

How Do I File a Claim for a TDI in RI? You can apply online by going to the TDI website, or you can print an application from the same website and send it in to TDI, P.O. Box 20100, Cranston, RI 02920. Your doctor must also send in certification that you are unable to do your job.

Rhode Island employees may take up to 12 weeks of leave in a 12-month period for a serious health condition, bonding with a new child, or qualifying exigencies. This leave is available every 12 months, as long as the employee continues to meet the eligibility requirements explained above.

FOR FMLA LEA VE To be eligible for FMLA Leave, the employee must: 1. Have worked for the State for a total of 12 months within the past 7 years; 2. Have worked 1,250 hours during the 12 months immediately preceding the first day ofrequested leave ( paid leave does not count toward this requirement); and, 3.

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Rhode Island Application for Family Medical Leave of Absence