Contra Costa California FMLA Certification of Physician
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How to fill out FMLA Certification Of Physician?
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FAQ
This brochure outlines an employee's right for leave under the California Family Rights Act (CFRA). You may choose to give this brochure to each employee eligible for CFRA and/or who requests leave that qualifies as CFRA, but there is no requirement that you do so.
To apply for a medical leave of absence: Submit your application: Online, or. Print, complete and fax an Application for Leave of Absence. Have your treating physician complete one of the following: FMLA Certification of a Serious Health Condition, or. Non-FMLA Medical Certification. Not sure if you qualify under the FMLA?
The CFRA certification shall be sufficient if it includes all of the following: The date on which the serious health condition commenced. The probable duration of the condition. A statement that, due to the serious health condition, the employee is unable to perform the function of his or her position.
FMLA is a federal program, while CFRA is state based in California. Simply being pregnant under FMLA qualifies, while CFRA only covers time off for pregnancy complications. It is more difficult to be covered as a domestic partner by FMLA than by CFRA.
29 C.F.R. § 825.313. Information about the FMLA may be found on the WHD website at . Either the employee or the employer may complete Section I.
To be eligible for CFRA employees must meet 2 requirements: (1) the employee must have worked for the covered employer for more than 12 months and (2) The employee must have worked at least 1,250 hours in the 12 months prior to their leave.
Request for Leave of Absence - FMLA CFRA PDL - English » Spanish » Provide this form if you're an employer covered by the federal Family and Medical Leave Act (FMLA) or the California Family Rights Act (CFRA) and either an employee has requested a leave of absence or you recognize the need.
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.
You do not have to tell your employer your diagnosis, but you do need to provide information indicating that your leave is due to an FMLA-protected condition (for example, stating that you have been to the doctor and have been given antibiotics and told to stay home for four days).
While FMLA guarantees the employee unpaid leave of 12 weeks over a 12 month period, the PFL provides for up to 6 weeks of paid leave in a 12 month period. 4. While the PFL does provide for partial pay during leave, however, it does not guarantee leave. 5.