Workers' Compensation leave

Request for Family Medical Leave form


Health Care Provider Certification for Employees under FMLA


Workers' Compensation Leave Options


All reports and claims for Workers’ Compensation go through the Risk Management Department. However, if an employee is going to be or has been out more than three days the employee must complete the Request for Family Medical Leave, the Workers’ Compensation Leave Option form, and their physician should complete the Physician’s Certification for Employee. Family Medical Leave and Workers’ Compensation Leave will run concurrent.


Any employee who is out on a Workers’ Compensation claim cannot apply to the Sick Leave Bank.


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