Indiana University FMLA Form 2E 2011 free printable template

Medical Certification for EMPLOYEE FMLA - Form 2E SECTION 1 To be completed by the EMPLOYEE Name of Employee Print Employee Contact Information phone email My regular work hours/schedule is to from a.m./p.m. to a.m./p.m. days of the week I o authorize o do not authorize check one the health care provider identified below to provide the information requested on this form for the purpose of determining if I qualify for an FMLA leave and for a desig...

How to fill out Indiana University FMLA Form 2E

How to fill out Indiana University FMLA Form 2E

1. Obtain the Indiana University FMLA Form 2E from the university's official website or HR department.
2. Read the instructions carefully to understand what information is required.
3. Fill out your personal details, including your full name, employee ID, and department.
4. Specify the type of leave you are requesting under the FMLA guidelines.
5. Provide the dates when the leave will begin and end.
6. Describe the reason for your leave, ensuring it meets FMLA criteria.
7. Sign and date the form at the bottom.
8. Submit the completed form to your supervisor or HR department as instructed.

Who needs Indiana University FMLA Form 2E?

1. Employees of Indiana University who need to take a leave of absence for qualifying family and medical reasons.

People Also Ask about

Can an employee be terminated after exhausting FMLA?

A: No, FMLA leave provides employees with job protection and protection against behavior that can be seen as “penalizing” someone for taking leave. For example, an employer cannot demote, fire, or harass an employee when they return from FMLA leave.

What is the longest you can take FMLA?

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave.

Can you go on vacation while on FMLA?

Taking Vacation While on FMLA Leave Depending on company policy, taking vacation time while on FMLA may be possible. If you're considering vacation while on medical leave, it's important to communicate with your employer, approve the vacation, and ensure that it meets certain requirements.

What happens when my 12 weeks of FMLA is exhausted?

When employees exhaust twelve weeks of FMLA leave and still cannot return to work due to their own medical impairment, the employer may have an obligation under the ADA to grant additional unpaid leave as a reasonable accommodation, in some situations.

How much does FMLA pay in PA?

You do not get Paid while on FMLA Under the Family and Medical Leave Act, your leave is unpaid. You do have the right to keep group health benefits during the leave. You can, however, file a disability insurance claim for short term and long term disability at the same time.

Can FMLA exceed 480 hours?

FMLA provides up to 12 weeks of leave. A week is determined by the number of hours you normally work. Leave taken as full weeks: An employee who works 35 hours per week is entitled to 12 weeks of leave, which would total 420 hours (35 x 12), not 480 (40 x 12) hours.

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What is Indiana University FMLA Form 2E?

Indiana University FMLA Form 2E is a form used to request leave under the Family and Medical Leave Act (FMLA) for eligible employees at Indiana University.

Who is required to file Indiana University FMLA Form 2E?

Employees who wish to take FMLA leave for qualifying reasons must file Indiana University FMLA Form 2E.

How to fill out Indiana University FMLA Form 2E?

To fill out Indiana University FMLA Form 2E, employees should provide their personal information, the reason for the leave, and any necessary medical documentation to support the request.

What is the purpose of Indiana University FMLA Form 2E?

The purpose of Indiana University FMLA Form 2E is to formally request leave under the FMLA for medical or family reasons that qualify under the act.

What information must be reported on Indiana University FMLA Form 2E?

The information that must be reported on Indiana University FMLA Form 2E includes the employee's name, department, the reason for the leave, dates of requested leave, and relevant medical certification if applicable.