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.
Washington 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
Processing times: Our goal is to process complete applications within three weeks.
How do I apply for leave? You can apply online or with a paper application. To request the paper application contact us at (833) 717-2273.
Washington employers are subject to the FMLA if they have at least 50 employees for at least 20 weeks in the current or previous year. Employees are eligible for FMLA leave if: they have worked for the company for at least a year. they worked at least 1,250 hours during the previous year, and.
During your leave, you'll file a weekly claim each week to receive your pay. The claim will include the hours you missed work and want to be paid using your Paid Leave. If you applied with a paper application, you submit weekly claims by calling the Customer Care Team.
Application processNotify your employer at least 30 days before you plan to take leave (if the event is foreseeable)Experience a qualifying event.Apply for leave (please wait to apply until after your qualifying event)Receive a determination letter in the mail.More items...
Most benefit payments are issued within two weeks after the EDD receives a properly completed claim online or by mail.
Processing times: Our goal is to process complete applications within three weeks.
For all leaves except baby bonding, there is a seven-day waiting period before an employee is eligible for PFML benefits. But note, the waiting period may not always be seven days2026. If ESD approves the application, ESD pays the benefit directly to the employee.
How to File a Paid Family Leave (PFL) Claim by MailVisit Online Forms and Publications and order a form online. A form will be mailed to you.Obtain the form from your physician/practitioner or employer.Visit an SDI Office.Call 1-877-238-4373. California Relay Service (711) Provide the PFL number (1-877-238-4373)