PLEASE READ CAREFULLY BEFORE TAKING FORMS TO YOUR DOCTOR
- The Request for Extended Leave is for you and your principal to complete and sign so he/she knows you are requesting leave. Check off the type of leave you are requesting. Most will be #1 sick days and #2 extended sick days. Read all others if #1 and #2 don't fit with the leave you are requesting. You must use your regular sick days first then you can use extended sick leave days. These are a benefit of 90 days to be used over a 6 year period and pay you 65% of your days absent in each month of your absence.
- The FMLA form is for you and your doctor to complete. One form is for your own illness, the other form is for a family member's serious illness. There must be a start date to leave as well as a return date. If the doctor is not sure he/she must put one and if you cannot return on that date you must complete all forms again. THESE FORMS MUST BE MAILED DIRECTLY FROM THE DOCTOR TO ME AT THE ADDRESS ON THE FORMS.
- If you have short term disability you and your doctor must complete the short term disability application. Throw away page 2 as that is for the Employer to complete. Send me an email if you are applying for STD so I can fill out that page. If you file for STD and are receiving 100% of your salary using sick days, the benefit is $25.00 a week. If you are out more than your sick pay and start receiving ESL at 65%, then STD will pay the additional 35%. Your doctor must mail the forms DIRECTLY TO THE STANDARD AT THE ADDRESS ON TOP OF PAGE 1 OF THE FORM.