Catastrophic Illness or Injury Leave
Applying for Catastrophic Illness or Injury Leave
The Process
Applying for Catastrophic Illness or Injury Leave: The Process
The Forms
- Your Rights Under FMLA
- Extended Leave Information
- Form A
- Checklist for Eligibility for Recipient
- Catastrophic Leave Application for Recipient
- Form B
- FMLA Form WH-380E Employee Illness
- FMLA Form WH-380 F Care of a Family Member
- FMLA Form WH-384 Qualifying Exigency
- FMLA Form WH-385 Illness or Injury of Covered Service Member –for Military Family Leave
- FMLA Usage Tracking Spreadsheet
- Return to Work: Administration
- Return to Work: Campus Security
- Return to Work: Clerical
- Return to Work: Custodian
- Return to Work: Food Service
- Return to Work: Maintenance & Operations
- Return to Work: Para Professional
- Return to Work: Patrol-Transport
- Return to Work: Police
- Return to Work: Teacher
These leaves are applied for and approved in the Human Resources Leaves Office, 6400 Uptown Blvd. NE, Suite 210 East, Phone 889-4865.
All paperwork must be original and no third party faxes.
Definition:
“Catastrophic illness or injury” means an illness or injury which results in the employee requiring a level of care and treatment beyond what he or she could provide without assistance.
Who is eligible?
Employees covered under the following contracts CSE, CSN, ESE, FSN, MSE, MSN, PSE, PSN, and SPE Management/Technical Support are eligible to donate to this program or receive from this program.
For purposes of this procedural directive an employee who is not covered by a negotiated agreement such as... AEAA, CWA Food Service Unit, CWA Maintenance and Operations Unit, EPOA, ASA and ATF.
Extended Leaves Policy
All leaves of ten (10) consecutive work days or less must be requested through and approved by the employee’s principal or supervisor. Extended leave of more than ten (10) consecutive days, with or without pay, must be requested through the Human Resources Leaves Office. Employees must complete the required Leave Forms and receive the necessary approval before the leave requested may be taken.
When an employee becomes ill or is injured on the job, sick leave begins at the time of inability to continue work, to the nearest half-hour. An employee, who is already on annual leave, personal leave or leave without pay, including parental leave, may not be eligible to use sick leave benefits.
While on an approved leave, an employee may not volunteer or perform any duties for the APS District or utilize APS property for personal use.


