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When you are receiving disability benefits in accordance with the E3 disability benefit plan, the use of PTO is not
required. However, where permissible under both state law and disability plan rules, you may, with the approval of
E3, choose to supplement disability plan benefits with PTO up to but not to exceed the level of wages compensation
you were receiving at the time disability leave began.

Where applicable, workers’ compensation and disability benefits will run concurrently with FMLA.

Requests for FMLA Leave
In the event of a foreseeable leave of absence, the employee must apply 30 days prior to the date on which the
employee wants to commence his/her leave. If 30 days’ notice is not possible, notice must be given as soon as
practicable under the facts and circumstances. When an employee becomes aware of the need for leave, it should
ordinarily be practicable for the employee to provide notice of the need for leave either the same day or the next
business day. In the case of unforeseeable leave, the employee must provide notice as soon as practicable and,
absent unusual circumstances, within the time period prescribed by E3’s usual and customary procedures for
requesting leave. If the employee does not comply with these requirements, FMLA-leave may be delayed or denied.

FMLA Certification
If the leave of absence is to the care for a parent, spouse or child with a serious health condition or to care for a
covered service member or because of the employee’s own serious health condition, the employee will be required
to provide a certification from the health care provider, which is available from Human Resources. If the leave of
absence is because of a qualifying exigency arising out of the active duty status of a military member, the employee
will be required to provide a certification which includes a copy of the military member’s covered active duty orders
or other similar documentation. If the leave of absence is because of a qualifying exigency arising out of a military
member’s rest and recuperation, the employee will be required to provide the military member’s rest and
recuperation orders or other similar documentation. The required certification for qualifying exigency leave should
also set forth the reason for the leave and the amount and frequency of leave needed. This form is also available
from Human Resources. Employees may also be asked to furnish periodic reports on the status of a continued
serious health condition. If E3 has reason to doubt the validity of the certification, it may, at its own expense, require
the employee to receive a second opinion from a health care provider designated and approved by E3. If this opinion
conflicts with the first opinion, E3, again at its own expense, may request a third opinion from a health care provider
mutually agreed upon by both E3 and the employee. The third opinion will be binding on both parties.

E3 also reserves the right to require an employee to provide documentation of the birth of a child, the placement of
a child for adoption or foster care, or the placement of a child with the employee for whom the employee
permanently assumes and discharges parental responsibilities.
Certification of Fitness for Duty
Prior to returning from a leave due to the employee’s own serious health condition, the employee may be required
to obtain a fitness for duty certification from his/her medical provider. If required, this certification must be given
to Human Resources on the day the employee returns to work.

Employment During FMLA Prohibited
Employees on FMLA leave may not be employed by or perform significant services for any other entity. Failure to
adhere to this requirement will result in appropriate disciplinary action, up to and including termination of
employment.

Questions about FMLA Leave
Employees with questions about the FMLA or who need to obtain the appropriate forms should contact Human
Resources.

Information in this document is proprietary to E3 and should not be discussed with third parties without consent.
Printed copies are uncontrolled and for reference only.