Other Types of Leave
Employee Self Service
Use remote access to log in to Employee Self Service and review and/or change your benefits information.
If you do not qualify for a Family Medical Leave of Absence, you may be eligible for Other Medical Leave if your request pertains to your own medical condition. Approved Other Medical Leaves allow for the continuation of your benefits for up to 12 weeks but do not offer job protection.
Requesting Other Medical Leave
- You are required to notify your immediate supervisor of the leave request and obtain the appropriate forms to apply for a leave. It is your responsibility to complete and return all required paperwork to your HR Benefits Administrator to determine your leave eligibility. Failure to do so may result in the denial of your leave request.
- Download the Leave of Absence Application and Certification of Healthcare Provider form regarding an Employee's Serious Health Condition.
- Complete the LOA form including the effective date of leave and estimated return to work date.
- Give the Certificate of Healthcare Provider form to the Physician to complete based on the medical condition and the need for you to be out of work during the time period listed on your request. These dates must match the Certification of Healthcare Provider form.
- Completed forms must be submitted to HR within 15 days of your first day out of work or within 30 days of a foreseeable leave request.