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Medical certification for leave of absence Form: What You Should Know

Dependents leave to care for sick family member FMLA — General This form is for leave or disability related leave that qualifies under Federal, State or local law and must be used when the employee needs to take leave from a  job due to the serious illness or injury of a family member. FMLA— General Section 3: What kind of leave can be taken? When the FMLA is used for this purpose, there are two classes of leave.  Reciprocal Leave : the employee must be the beneficiary of the leave taken by a coworker. Reciprocal leave  can be taken by employees in the same firm or in  more than one firm in the same or a neighboring  country.  Reciprocal Leave: an employee who is the beneficiary of a reciprocal leave (if permitted) and who takes a FMLA leave (if permitted) may  take an equal amount of accrued pay for the FMLA vacation leave with  no requirement to notify their employer. Reciprocal Leave: Family Members: a family member who is not the employee for FMLA regulations will be considered a dependent  for the purposes of the FMLA. Flexible Leave: this is an additional type of leave that is not considered for purposes of FMLA,  but this type of leave may be taken pursuant to any State or Federal law and may be taken through a combination of employer-paid and leave bank accounts (which may be used with  FMLA leave). Lists of States With Leave Requirements — USES This section gives a very brief summary of state requirements for FMLA leave.  A few of the states with the most specific requirements for FMLA leave listed are listed and the states that require employers to provide  FMLA leave to their employees with a disability. California : leave for “serious health condition.” Hawaii : leave for illness or injury. Hawaii : leave for “serious illness, injury or disability.” Michigan : leave required between FMLA dates. Mississippi : leave only for “serious illness.” New Jersey : leave for “serious health condition.” New Mexico : leave for “serious illness” or “serious injury.” NY : leave for “serious illness or injury.” Utah: leave for injury (a serious medical condition). Vermont: leave for “serious illness or injury.

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