Page 76 - Foltz Trucking Driver Handbook

Incapacity due to pregnancy and incapacity due to a chronic condition which requires periodic treatment (at least twice a year as directed by the provider) by a health care provider, continues over an extended period of time and which may cause episodic rather than a continuing period of incapacity are also included within the definition of continuing treatment.
All employees requesting FMLA leave must provide verbal or written notice of the need for leave to Human Resources. Within five business days after the employee has provided this notice, Human Resources will complete and provide the employee with the DOL Notice of Eligibility and Rights (form WH381).
Employees requesting FMLA leave must give 30 days advance notice of the need to take FMLA leave when the need is foreseeable. When 30 days notice is not possible, such as in the case of medical emergencies, the employee must provide notice as soon as practicable by informing their supervisor and Human Resources.
Employees must provide sufficient information for the Company to determine if the leave may qualify for FMLA protection and the anticipated timing and duration of the leave. Sufficient information may include that the employee is unable to perform job functions; the family member is unable to perform daily activities, the need for hospitalization or continuing treatment by a health care provider, or circumstances supporting the need for military family leave. Employees also must inform the Company if the requested leave is for a reason for which FMLA leave was previously taken or certified.
Within five business days after the employee has submitted the appropriate certification form (discussed below), Human Resources will complete and provide the employee with a written response to the employee's request for FMLA leave using the DOL Designation Notice (form WH382).
Required Certifications
Employees or Family Members Serious Health Condition
The Company will require certification for the employee's serious health condition and will provide the employee with the DOL Certification of Health Care Provider for Employee's Serious Health Condition (form WH380-E). Additionally,theCompanywillrequirecertificationforafamilymember'sserioushealthcondition and will provide the employee with the DOL Certification of Health Care Provider for Family Member's Serious Health Condition (form WH380-F). The employee must respond to such request within 15 days or provide a reasonable explanation for the delay. Failure to provide certification may result in denial of continuation of leave.
The Company may directly contact the employee's (or family member's) health care provider for verification or clarification purposes using a health care professional, an HR professional, leave administrator or management official. The Company will not use the employee's direct supervisor for this contact. Before the Company makes this direct contact with the health care provider, the employee must be given an opportunitytoresolveanydeficienciesinthemedicalcertification. IncompliancewithHIPAAMedicalPrivacy Rules, the Company will obtain the employee's (or family member's) permission for clarification of individually identifiable health information.
The Company has the right to ask for a second opinion if it has reason to doubt the certification. The Company will pay for the employee (or family member) to get a certification from a second doctor, which the Company will select. The Company may deny leave to an employee who refuses to release relevant medical records to the health care provider designated to provide a second or third opinion. If necessary Page 11
Requesting FMLA Leave