FILE GBRI-E Personal and Sick Leave

Sick Leave Form – 1                                                                                                                                                         FILE:  GBRI-E

PERSONAL LEAVE AND SICK LEAVE

Name of School:  _________________________          Date: ______________________

 School Month: From ______________________           To:   _______________, 20 ____ 

I hereby certify that during the above given school month, I was absent from work______ days and am entitled under Board Rules and Regulations to exemption for salary or wage deduction.

 DATE(S) OF ABSENCES

 ____________________________________          _______________________________

                                                                                  Employee Identification Number

 ____________________________________          _______________________________                  

                                                                                  Employee Signature                  

Check Reason For Absence (put number of days in blocks)

Date of Approval: _______________      ______________________________________

                                                                 Immediate Superior or Superintendent Signature

Sick Leave:  Sick leave claims in excess of two (2) days for any one illness for self or family shall bear the certification of a reputable physician.

Personal Leave:  Each employee shall be permitted four (4) days of personal leave annually, which may be taken without regard to the cause for the absence, except that personal leave without cause may not be taken on consecutive work days unless authorized or approved by the employee’s principal or immediate supervisor. Notice of such leave days shall be given to the employee’s principal or immediate supervisor, as the case may be, at least 24 hours in advance, except that in the case of sudden or unexpected circumstances, such notice shall be given as soon as reasonably practicable. However, the use of such days may be denied if, at the time notice is given, either fifteen percent (15%) of the employees or three (3) regular employees, whichever is greater, under the supervision of the principal or immediate supervisor, as the case may be, have previously notified the principal or immediate supervisor, of their intention to use that day for such leave. Personal Leave Days are included in your fifteen (15) days per year.

1.   Each employee will be allowed (15) days per year, or one and one-half (1½) days for each month they are employed during the fiscal year. Unused leave shall be accumulated without limitation.

2.   Sick leave claims shall be filed with the Financial Secretary within the payroll period during which the absence occurred, on a prescribed certificate which certifies the exemption due to illness.

3.   All approved claims for exemption from wages or salary deductions shall be paid at the close of each school month for which the employee has a contract or agreement with the Board of Education.

4.   All other Rules and Regulations of State Law relative to personnel sick leave will also apply.     

21-5D-4     FAMILY LEAVE

(a)    An employee shall be entitled to a total of twelve (12) weeks of unpaid family leave, following the exhaustion of all his or her annual and personal leave, during any twelve-month period:

(1)   Because of the birth of a son or daughter of the employee;

(2)   Because of the placement of a son or daughter with the employee for adoption; or

(3)   In order to care for the employee’s son, daughter, spouse, parent or dependent who has a serious health condition.

(b)   In the case of a son, daughter, spouse, parent or dependent who has a serious health condition, such family leave may be taken intermittently when medically necessary.

(c)    An employee may take family leave on a part-time basis and on a part-time leave schedule, but the period during which the number of work weeks of leave may be taken may not exceed twelve (12) consecutive months, and such leave shall be scheduled so as not to disrupt unduly the operations of the employer.

(d)         (1) If a leave because of birth or adoption is foreseeable, the employee shall

            provide the employer with two (2) weeks’ written notice of such expected birth or adoption.

(2) If a leave under this section is foreseeable because of planned medical    

      treatment or supervision, the employee:

(A)  Shall make a reasonable effort to schedule the treatment or     

supervision so as not to disrupt unduly the operations of the employer,

subject to the approval of the healthcare provider of the employee’s

son, daughter, parent, or dependent; and

(B)   Shall provide the employer with two (2) weeks’ written notice of the

treatment or supervision.

(e) This article shall not be construed as granting an employee the family leave rights provided in this section if he or she is entitled to such family leave rights under any other provision of this code. 

21-5D-5    CERTIFICATION

 (a)    If an employee requests family leave to care for a family member with a serious health condition as authorized in this article, the employer may require the employee to provide certification by a healthcare provider of the health condition.

(b)   The certification shall be sufficient if it contains the following:

(1)   That the child, dependent, parent, or employee has a serious health condition;

(2)   The date the serious health condition commenced and its probable duration; and

(3)   The medical facts regarding the serious health condition.

 Revised October 5, 1992 - Clay County Board of Education