California Fmla Forms

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					FMLA / CFRA Leave Orientation

         FMLA/CFRA Leave – What is It?

         Benefits to Employees

         Qualifying Reasons for FMLA/CFRA Leave

         Eligibility Requirements

         Use of Leave Credits

         Medical Certification

         Periodic Reporting

         Benefits during FMLA/CFRA Leave
FMLA / CFRA Leave “Test Your Knowledge” Quiz

           What does FMLA/CFRA stand for?

           What are three ways in which FMLA leave benefits

           What three things qualify a person to take FMLA/CFRA

           What does one do to be eligible for FMLA leave?

           What kind of leave credits can an employee use while on
           FMLA leave…what increments, what justifications are

           Is medical certification needed? If so, by when?

           What is periodic reporting?

           What benefits is an employee entitled to while on FMLA
Definition of
FMLA          and    CFRA

    FMLA                                CFRA
    Family Medical Leave Act            California Family Rights Act

   Federal law                        State law
   Administered by Dept of Labor      Administered by Dept of Fair
                                        Employment and Housing
Benefits to Employees

              Twelve workweeks of paid
               or unpaid leave;

              Job is protected during
               this time;

              Employer-paid health,
               dental, and vision
Reasons for Leave

       Birth or adoption of child or foster care
        placement of child;

       To care for an immediate family member
        (spouse, child, or parent) with a serious
        health condition;

       Employee unable to work because of a
        serious health condition.
Serious Health Condition

    An illness, injury, impairment, or physical or mental
    condition that involves:

    -   Any period of incapacity or treatment connected with inpatient
        care (ie an overnight stay) in a hospital, hospice, or residential
        medical-care facility, and any period of incapacity or
        subsequent treatment in connection with such inpatient care; or
    -   Continuing treatment by a health care provider which includes
        any period of incapacity (ie inability to work, attend school or
        perform other regular daily activities) due to:

        1) A health condition (including treatment therefor, or recovery
           therefrom) lasting more than three consecutive days, and
           any subsequent treatment or period of incapacity relating to
           the same condition, that also includes:

        - Treatment two or more times by or under the supervision of
          a health care provider with a continuing regimen of
          treatment; or
Serious Health Condition

    2) Pregnancy or prenatal care. A visit to the health care provider is not
       necessary for each absence; or

     3) A chronic serious health condition which continues over an extended
      period of time, requires periodic visits to a health care provider, and may
      involve occasional episodes of incapacity (eg asthma, diabetes). A visit to
      a health care provider is not necessary for each absence; or

     4) A permanent or long-term condition for which treatment may not be
      effective (eg Alzheimer’s, a severe stroke, terminal cancer). Only
      supervision by a health care provider is required, rather than active
      treatment; or

    5) Any absences to receive multiple treatments for restorative surgery or for a
       condition which would likely result in a period of incapacity of more than
       three days if not treated (eg chemotherapy or radiation treatments for cancer).
Health Care Providers

   A doctor of medicine or
    osteopathy authorized
    to practice medicine or
    surgery by the state in
    which the doctor
Health Care Providers

   A podiatrist, dentist, clinical
    psychologist, optometrist or
    chiropractor (a chiropractor
    is limited to manual
    manipulation of the spine to
    correct a subluxation as
    demonstrated by X-ray to
    exist) authorized to practice,
    and performing within the
    scope of their practice, under
    state law.
Health Care Providers

               Nurse practitioners,
                nurse-midwives and
                clinical social workers
                authorized to practice,
                and performing within
                the scope of their
                practice, as defined
                under state law; or
Health Care Providers

           A Christian
            listed with the
            First Church of
            Christ, Scientist
            in Boston,
Health Care Providers

           A health care
            provider as defined
            above, who
            practices in a
            country other than
            the United States,
            who is authorized to
            practice in
            accordance with the
            law of that country.
Who is

            Must be employed at least
             12 months;

            Must have physically
             worked 1,250 hours
             during previous 12 month

            Time off for sick leave,
             vacation/annual leave,
             ATO, CTO, Holidays, ITO,
             or PL is not counted
             toward the 1250 hours.
Use of Leave Credits

      No limitation on employee’s use of paid vacation,
       annual leave, or personal leave.

      Sick leave may only be used in accordance with
       collective bargaining agreements and/or applicable
       civil service laws, rules and policies.

      Paid/unpaid leave may be taken in one twelve (12)
       workweek period or in increments of a tenth of an
       hour or more.

      Employee must make a reasonable effort to
       schedule FMLA/CFRA related appointment at a time
       that minimizes disruption to the department’s
Medical Information

   If requesting FMLA/CFRA leave because of serious health
    condition (self or relative), must provide medical certification
    (Appendix C), within 15 days.

   Failure to receive certification within 15 days may result in
    denial of FMLA/CFRA leave.

   Department may, at its expense, obtain a second opinion. If
    first and second opinions differ, the Department may, at its
    expense, obtain a third opinion jointly selected by employee
    and department. The third opinion is binding.

   Employee may request that the department furnish them with
    copies of any additional medical opinions.

   Department will reimburse employees for out-of-pocket travel
    expenses incurred to obtain second or third opinions.
Medical Information (continued)

   If time beyond original estimate is requested, re-certification
    may be required.

   Re-certification may be required if department receives
    information that raises a question about the stated reason of

   Failure to submit required re-certification may result in
    termination of the leave.

   No second or third opinions will be allowed on re-certifications.

   Upon completion of leave, health care provider must provide
    the supervisor with notification that employee is able to return
    to work.
Periodic Reporting

        Employees whose FMLA/CFRA leave does not
         have a stated amount of time, may be asked to
         periodically report on their status and intent to
         return to work.

        “Periodically” is defined as no more than every
         thirty (30) days.
Payment of

     During unpaid FMLA/CFRA leave, the department will pay
      the entire premiums of an employee’s health, dental, and
      vision benefits.

     When employee returns to work, an accounts receivable
      will be set up to recover the employee’s portion of the

     Employees who currently receive the “cash option”
      under the Flex-Elect program, will not receive the “cash
      option” during an FMLA/CFRA leave.

     If employee retires during the first thirty (30) calendar
      days after returning to work, or upon the continuance, or
      onset of a serious health condition (self or family) which
      would otherwise entitle employee to FMLA/CFRA leave,
      or any circumstances beyond the control of the
      employee, the department shall NOT collect the entire
      cost of the premium.
Checklist for

   Failure to notify employee of FMLA/CFRA rights. In all instances it is the
    employer’s responsibility to notice the employee and inform them of the
    FMLA/CFRA benefits, whether or not the employee requests FMLA/CFRA.

   Failure to notify an employee that FMLA/CFRA leave will be counted
    towards their twelve (12) workweeks entitlement. If the employer does not
    properly notice and designate, within two (2) days, the employee’s absence
    as FMLA/CFRA, then the leave is not FMLA/CFRA, and cannot be counted
    against the twelve (12) workweeks entitlement. Additionally, an employee
    cannot choose not to have FMLA/CFRA qualified leave designated against
    their unpaid twelve (12) workweek entitlement.

   Taking disciplinary action (due to absenteeism) against an employee with
    an absence that would qualify under the FMLA/CFRA.

   Failure to grant leave to provide physical care or psychological comfort to a
    seriously ill child, spouse, or parent.
Checklist for

   Failure to reinstate an employee to the same or equivalent position,
    including the same shift.

   Terminating an employee during or at the conclusion of an FMLA/CFRA

   Failure to grant FMLA/CFRA leave because of a misunderstanding of what
    qualifies as a “serious health condition”, especially “chronic health

   Asking for “diagnosis” on the Medical Certification Form. This is prohibited
    by the CFRA.

   Failure to request a medical certification in writing and not giving an
    employee at least fifteen (15) days to obtain medical certification.

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