Additional information about employee FMLA rights and responsibilities will be provided to you in writing within five business days after receipt of this notice. Determination of eligibility for leave under FMLA, and/or additional documentation may be required before making a final FMLA determination to approve or deny an FMLA request.
Employee Statement:
I understand that the OHP leave policy requires that I use any available paid accrued leave while on FMLA. I understand that using accrued sick leave must meet the requirements of the district’s sick leave policy. I understand that once I am no longer receiving a paycheck from OHP, I am required to pay for my portion of applicable benefit premiums. I also understand that it is my responsibility to stay in contact with my supervisor and the treasurer’s department concerning my return-to-work date. Failure to return to work on my designated date without an extension approval may be treated as a resignation. Additionally, I understand that I must submit a written medical release from my physician in order to return to work following leave for my personal health condition.
I certify that the above information provided is true and correct to the best of my knowledge and I understand the guidelines noted above.