Leave of Absence
Information, resources, and procedures for employee Leave of Absence requests.
INFORMATION
- FAQ - Frequently Asked Questions
- Leave of Absence Process for Employees
- Leave of Absence Process for Employers
- Explanation of New Leave Forms and Templates
- Rights and Responsibilities While on Leave
- Your Rights and Obligations as Pregnant Employee
LEAVE REQUEST FORMS (Contact your HR Analyst for all leave extensions)
- Request for Leave of Absence Form
- Medical Certification Form
- Leave Designation Letter
- ADA Reasonable Accommodations Request Form
- ADA Reasonable Accommodations Request Template Letter
RETURNING TO WORK
- Return to Work Medical Certification Request
- Notice of Return to Duty Form
- What to Expect in the Interactive Process for Employees
- What to Expect in the Interactive Process for Supervisors
ADDITIONAL DEPARTMENT TEMPLATES
An employee may request leave with or without pay for reasons of illness not covered by sick leave, to attend school or training; to accept appointment in the unclassified service; to work temporarily at another governmental agency; military leave; family leave; pregnancy disability or parental bonding.
There is current Federal and State law that governs leaves of absence: The Federal Family Leave and Medical Act (FMLA), the California Family Rights Act (CFRA), and State of California Pregnancy Disability Leave program (PDL).
All requests should be in writing to the department head and should be coordinated through your department payroll coordinator. Requests in excess of twenty (20) days shall be forwarded to the County Human Resources Director by the department head for prior approval. (Failure to report back within 5 working days following expiration of leave-of-absence may constitute automatic resignation.)
Leave of Absence FAQ
- A serious health condition that makes the employee unable to perform the essential functions of his or her job;
- The birth of a child and to care for the newborn child within one year of birth;
- The placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;
- To care for the employee’s spouse, child, or parent who has a serious health condition;
- Any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on "covered active duty";
- To care for a covered servicemember with a serious injury or illness if the eligible employee is the service member’s spouse, son, daughter, parent, or next of kin.*
- Be either a full-time or part-time permanent employee with the County;
- Have 12 months of service with the County;
- Have worked at least 1,250 hours in the 12-month period before the date the leave begins
*CFRA for bonding must be taken within 12 months of the child’s birth or date of placement if adoption/foster care.
*FMLA runs concurrently with PDL.
**For bonding unrelated to PDL, FMLA and CFRA run concurrently.
While on leave, your timecard will be coded with the number of hours per week in accordance with what you have requested on your leave of absence form. It is very important that if you are coordinating with SDI that you DO NOT code more than your allocated hours per week. Doing so could results in an overpayment that you would owe back to EDD.
Once all protected leave is exhausted, you must code a minimum of 20 hours a week of balances (sick, vacation, personal, administrative) to maintain your benefits. If you have exhausted all leave and are coding LWOP, you will not receive your negotiated cafeteria and will be billed for the entire cost of your benefits.
*The employee is required to pay any out-of-pocket expenses under their current plan while on leave.