Leave of Absence

Leave of Absence

Applying for FMLA

Block

Reporting Absences is Easy

Just log in to our website and click on Check Status.  Choose the leave you want to report and select Report Time.  Enter the date and time of your planned absence and click the Confirm button.  That's all there is to it.

Your Source for Information

Call or go online for expert answers to your questions about leaves of absence.

Call:  877.GO2.FMLATDD: 800.697.0353
Fax: 877.309.0218Online: https://www.fmlasource.com

An eligible employee who has completed twelve (12) months of employment and has worked at least 1250 hours in the past twelve (12) months and who works at a location that has at least 50 employees of County employer within a 75 mile radius may request an unpaid leave of absence for a period not to exceed twelve (12) weeks in any twelve (12) month period measured forward from the date the employee’s FMLA leave first begins. The request should be in writing, must give the reason for the request and must give the expected duration of the leave. The leave may be taken for the following reasons:

  1. A serious health condition that makes the employee unable to perform the functions of his/her position;
  2. In order to care for the employee’s spouse, child or parent if the person being cared for has a serious health condition;
  3. Because of the birth of a child of the employee, and in order to care for the child within twelve (12) months of the child’s birth;
  4. Because of the placement of a child with the employee for adoption or foster care, and in order to care for the child within twelve (12) months of the child’s placement.

For more details regarding FMLA, please click on the fact sheets below

FMLA Forms

PDF IconFMLA Card

PDF IconFLMA Poster

PDF IconFMLA Fact Sheet #28

PDF IconFMLA Fact Sheet #28 D

PDF IconFMLA Fact Sheet #28 M - Military

PDF IconHow to File A Claim

PDF IconReporting Your Claim Online

PDF IconManager Training Instructions

Image IconFMLA Training Video

Short-Term Disability

Please contact CIGNA directly to submit for a Short-Term Disability Claim.  Claims can be submitted over the phone at 800-362-4462, or online at cigna.com/customer-forms.

Please click here for additional information on submitting a Short-Term Disability Claim with CIGNA.

Long-Term Disability

Please contact CIGNA directly to submit for a Long-Term Disability Claim.  Claims can be submitted over the phone at 800-362-4462, or online at cigna.com/customer-forms.

Please click here for additional information on submitting a Long-Term Disability Claim with CIGNA.