Application for Disability Leave Benefits. The employee, a member of the employee’s family, or a representative of the employee, may file a claim for disability leave benefits with the Employer. The claim shall be filed on a form designated by the Director of Administrative Services and shall be filed with the Employer within 28 days of the last day the employee worked. Where extenuating circumstances exist which prevent an employee from filing a claim, a written statement by the employee’s physician and/or the Employer explaining such extenuating circumstances must be filed within a reasonable time after the 28 day time period has expired. The Employer shall, within five (5) days of receipt of the claim, forward the claim and the claim recommendation to the Director of Administrative Services.
Application for Disability Leave Benefits
