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PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION Issued for Covered Employees and Dependents ofTHE UNIVERSAL PLAN Provided through UFCW Locals 186D and 8 Golden State by UFCW National Health and Welfare

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How to fill out medical sick leave and

01

Step 1: Obtain the medical sick leave form from your employer or doctor's office.

02

Step 2: Fill in your personal information, including name, address, and contact details.

03

Step 3: Provide details about your medical condition and the reason for needing sick leave.

04

Step 4: Include the dates you will be absent from work due to illness.

05

Step 5: Have the form signed by your doctor or healthcare provider.

06

Step 6: Submit the completed form to your employer as per company policy.

Who needs medical sick leave and?

01

Employees who are unable to work due to illness or injury

02

Individuals recovering from a medical procedure or surgery

03

People with chronic health conditions that require periodic time off for treatment

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What is medical sick leave and?

Medical sick leave is a period of time off work taken by an employee due to illness or injury.

Who is required to file medical sick leave and?

Employees who are unable to work due to illness or injury are required to file for medical sick leave.

How to fill out medical sick leave and?

Employees can fill out medical sick leave forms provided by their employer or HR department.

What is the purpose of medical sick leave and?

The purpose of medical sick leave is to allow employees time off work to recover from illness or injury without losing pay.

What information must be reported on medical sick leave and?

Information such as the employee's name, date of illness or injury, and expected return to work date must be reported on medical sick leave forms.

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