This form is an application for Family and Medical Leave. It is to be filled out by an employee who is requesting a leave of absence.
Rhode Island Employee Application for FMLA
State:
Multi-State
Control #:
US-AHI-200
Format:
Word
Instant download
Description
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How to fill out Employee Application For FMLA?
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FAQ
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.
EligibilityHave worked for your employer for at least 12 months; and.Have worked for your employer for at least 1,250 hours in the 12 months before you are taking leave; and.Work at a location where your employer has at least 50 employees within 75 miles of your worksite.
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
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.
First, you must have worked for your employer for at least 12 months. You do not have to have worked for 12 months in a row (so seasonal work counts), but generally if you have a break in service that lasted more than seven years, you cannot count the period of employment prior to the seven-year break.
Doctors aren't the only health care providers who may certify FMLA leave. Podiatrists, dentists, clinical psychologists, optometrists and chiropractors can all certify leave, as can nurse practitioners, nurse-midwives, clinical social workers and physician assistants.
FMLA leave is unpaid, but employees may be allowed (or required) to use their accrued paid leave during FMLA leave.
To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.