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Leave of Absence Information

Employees must submit leave of absence requests for leaves which will exceed twenty
consecutive days. Leave forms should be submitted thirty days in advance of the beginning date
of the leave (whenever possible), and must include a beginning and ending date. Please contact
Tamica Harrison, Benefits Accountant at the Robertson County Finance Office/615-384-0202,
with questions about insurance premiums during leaves. Types of long term leave available
include:

  • Family and Medical Leave: Available to employees who have been employed by the
    district for twelve months and have worked a minimum of 1,250 hours during the
    preceding year. According to federal law, this leave allows up to twelve weeks of job
    protected leave during which the district will continue to pay 90% of the employee’s
    insurance premium, even if the employee has used all accrued paid sick leave and
    personal leave. After twelve weeks and when all paid leave is exhausted, the employee
    will be responsible for the entire cost of their medical insurance premium. All available
    paid leave must be used concurrently with FMLA.
    Forms required for FMLA Leave include:
  1. FMLA Leave of Absence Request Form (submitted prior to leave)
  2. WH-380-E Certification by Health Care Provider for Employee’s Serious Health
    Condition     (submitted prior to leave); OR WH-380-F Certification by Health Care Provider for Family Member’s Serious Health Condition (submitted prior to leave)
  3. Fitness for Duty Certification Form (must be submitted before return to work)
  • Long Term Leave of Absence: Requests may be submitted by employees who have not
    worked for the district for twelve months and/or have not worked a minimum of 1,250
    hours during the preceding year. All available paid leave must be used concurrently
    with a Long Term Leave. When all paid leave is exhausted, the employee will be
    responsible for their entire insurance premium. Required Long Term Leave forms
    include:
  1. FMLA Leave of Absence Request Form (submitted prior to leave)
  2. WH-380-E Certification by Health Care Provider for Employee’s Serious Health
    Condition     (submitted prior to leave); OR WH-380-F Certification by Health Care Provider for Family Member’s Serious Health Condition (submitted prior to leave)
  3. Fitness for Duty Certification Form (must be submitted before return to work)