Information for Employees
When requesting leave for a serious health condition (defined below), a medical documentation form will be sent to you from our leave administration vendor Workpartners. (Forms for union employee use only are provided below.) From the date of that letter, you will have 15 days to submit your completed documentation.
- If you do not provide your completed documentation within 15 days, you will be placed on an unpaid leave, known as a Leave Without Pay (LWOP).
- If you provide medical documentation within 15 days but it is not sufficient, you will be provided a 7-day extension. If sufficient medical documentation is not received by day 22, you will be placed on LWOP.
- Please be aware any documentation received after day 30 will result in a denial of the leave and pay.
If you have questions about medical documentation, please contact Workpartners at 1-833-852-2207 (TTY users, please call 711 and provide the Workpartners telephone number).
The PFMLA defines a serious health condition as a physical or mental condition that prevents one from doing their job either because they are unable to, or because they need time to get treated or recover from treatment. A Serious Health Condition is an illness, injury, impairment, or physical or mental condition that involves (a) inpatient care in a hospital, hospice, or residential medical facility; or (b) continuing treatment by a Healthcare Provider.
The term Serious Health Condition includes any period of incapacity due to pregnancy or for prenatal care, and for childbirth and recovery from childbirth ("maternity leave").
Because an illness that extends beyond three days may qualify as FMLA, serious illnesses should be reported to Workpartners as soon as possible.
Information for DLCI Administrators
See DLCI actions that may be required regarding medical documentation in the Manager and DLCI Resource Center.
For Union Employee Use Only
- Certification of Provider for Serious Injury or Illness of Covered Servicemember
- Certification of Qualifying Exigency for Military Family Leave Form