PROCEDURES FOR MATERNITY LEAVE

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1 PROCEDURES FOR MATERNITY LEAVE Notification 1. Inform Human Resource Office in writing using the Maternity Leave Request Form in this packet. 2. Notify Human Resource Office ( ) of birthdate and anticipated return date. 3. File medical documentation and requests for sick bank with the Human Resource Office. 4. Child-rearing leave after maternity must be requested in writing to the Human Resource Office using the Leave of Absence Form in this packet. Eligibility: Employees are eligible for maternity leave as follows: NFT- Six weeks(30 days) of accumulated sick days starting the day the baby is born. In case of a Cesarean Section, this is extended to eight weeks(40 days). Additional days prior to the birth or following the birth will be considered only with personal physician's recommendation. If an employee is eligible for sick bank, such days may be granted by the sick bank committee. CSEA/NIAS/NIMS- Six weeks(30 days) of accumulated sick days starting the day the baby is born. In case of a Cesarean Section, this is extended to eight weeks(40 days). Additional days prior to the birth or following the birth will be considered only with personal physician's recommendation. If an employee is eligible for sick bank, such days may be granted by the sick bank committee. CSEA Associates- Six weeks (30 days) of accumulated sick days starting the day the baby is born. In case of a Cesarean Section, this is extended to eight weeks(40 days). Additional days prior to the birth or following the birth will be considered only with personal physician's recommendation. ASC- Six weeks(30 days) of accumulated sick days starting the day the baby is born. In case of a Cesarean Section, this is extended to eight weeks(40 days). Additional days prior to the birth or following the birth will be considered only with personal physician's recommendation. If an employee is eligible for sick bank, such days may be granted by the sick bank committee. Returning to Work For those employees returning to work from the six(6) or eight(8) week maternity leave, it is not necessary to see the School District Physician. For those who require additional time, normal contractual procedures will be followed. That is, a return to work slip from your personal physician and examination by the School District Physician.

2 Niagara Falls City School District Office of Human Resources th Street, Niagara Falls, NY (716) (Phone) (716) (Fax) Staff Leave Request Employee: Please complete the top section Employee: Phone: Home Mailing Address w/zip: Position: Location: Please check reason for Leave of Absence: Own serious health condition (not work related)... Care for newborn/placed child... Pregnancy leave... Personal leave (Discretionary)... Care for parent/spouse/child w/serious health condition C h i l d R e a r i n g... Educational (Discretionary)... Military Leave (attach orders).... Type of Leave (Select one:) From Through Medical (provide medical certification) FMLA (provide medical certification) Personal (provide letter giving brief description of reason for leave (i.e. pregnancy) Educational (provide brief description of need for leave and documentation to support enrollment in a college program) Military leave (attach orders) Other A leave of absence may consist of leave without pay and/or paid leave (i.e. vacation, personal illness, etc.) Paid leave may be used in accordance with applicable policy/contracts. Pregnancy Leave 6 Weeks 8 Weeks Child Rearing (FMLA) 12 Weeks 1 Semester Employee Signature: Date Designation of Leave To be completed by HRO Department: Your leave is denied for the following reason(s): Your leave has been approved Date Employee Notice of Approval Sent Signature: Administrator for Human Resources Date: Date FMLA Designation Notice sent out: cc: BBC/JW/eGroup/LLog Reviewed & Updated 01/10/14

3 The employee s guide to The Family and Medical Leave Act Wage and Hour division UniTed STATeS department of LAbor

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5 An introduction to the Family and Medical Leave Act When you or a loved one experiences a serious health condition that requires you to take time off from work, the stress from worrying about keeping your job may add to an already diffcult situation. The Family and Medical Leave Act (FMLA) may be able to help. Whether you are unable to work because of your own serious health condition, or because you need to care for your parent, spouse, or child with a serious health condition, the FMLA provides unpaid, job-protected leave. Leave may be taken all at once, or may be taken intermittently as the medical condition requires. This guide provides a simple overview of how the FMLA may benefit you. In your time of need, sometimes you just need time. This Guide Will explain: Who Can Use FMLA Leave? When Can I Use FMLA Leave? What Can the FMLA Do for Me? How Do I Request FMLA Leave? Communication With Your Employer Medical Certification Returning to Work How to File a Complaint Web Site Resources

6 Who Can Use FMLA Leave? In order to take FMLA leave, you must first work for a covered employer. Generally, private employers with at least 50 employees are covered by the law. Private employers with fewer than 50 employees are not covered by the FMLA, but may be covered by state family and medical leave laws. Government agencies (including local, state and federal employers), and elementary and secondary schools are covered by the FMLA, regardless of the number of employees. If you work for a covered employer, you need to meet additional criteria to be eligible to take FMLA leave. Not everyone who works for a covered employer is eligible. First, you must have worked for your employer for at least 12 months. You do not have to have worked for 12 months in a row (so seasonal work counts), but generally if you have a break in service that lasted more than seven years, you cannot count the period of employment prior to the seven-year break. Second, you must have worked for the employer for at least 1250 hours in the 12 months before you take leave. That works out to be an average of about 24 hours per week, over the course of a year. Lastly, you must work at a location where the employer has at least 50 employees within 75 miles of your worksite. So even if your employer has more than 50 employees, if they are spread out and there are not 50 employees within 75 miles of where you work, you will not be eligible to take FMLA leave. airline Flight attendants/flight Crew employees Due to non-traditional work schedules, airline flight attendants and flight crew members are subject to special eligibility requirements under the FMLA. You meet the hours of work requirement if, during the 12 months prior to your need for leave, you have worked or been paid for at least 60% of your applicable monthly guarantee, and have worked or been paid for at least 504 hours, not including personal commute time, or time spent on vacation, medical or sick leave. 2 The Employee s Guide to The Family and Medical Leave Act

7 Am I Eligible for FMLA Leave? I work for an employer who has 50 or more employees or I work for a public agency, elementary, or secondary school NO Your employer is not covered by the FMLA and does not have to offer FMLA leave YES Your employer is covered by the FMLA You are not eligible for FMLA leave NO AND I have worked for my employer for at least 12 months You are not eligible for FMLA leave You are not eligible for FMLA leave NO NO YES I have worked for my employer for at least 1250 hours in the last 12 months YES My employer has 50 or more employees within 75 miles of my jobsite YES You are eligible for FMLA leave The Employee s Guide to The Family and Medical Leave Act 3

8 When Can i Use FMLA Leave? If you work for an employer that is covered by the FMLA, and you are an eligible employee, you can take up to 12 weeks of FMLA leave in any 12-month period for a variety of reasons including: serious Health Condition You may take FMLA leave to care for your spouse, child or parent who has a serious health condition and when you are unable to work because of your own serious health condition. The most common serious health conditions that qualify for FMLA leave are: 1) conditions requiring an overnight stay in a hospital or other medical care facility; 2) conditions that incapacitate you or your family member (for example, unable to work or attend school) for more than 3 consecutive days and have ongoing medical treatment (either multiple appointments with a health care provider, or a single appointment and follow-up care such as prescription medication); 3) chronic conditions that cause occasional periods when you or your family member are incapacitated and require treatment by a health care provider at least twice a year; and 4) pregnancy (including prenatal medical appointments, incapacity due to morning sickness, and medically required bed rest). Military Family Leave The FMLA also provides certain military family leave entitlements. You may take FMLA leave for specified reasons related to certain military deployments. Additionally, you may take up to 26 weeks of FMLA leave in a single 12-month period to care for a covered servicemember with a serious injury or illness. 4 The Employee s Guide to The Family and Medical Leave Act

9 expanding Your Family You may take FMLA leave for the birth of a child and to bond with the newborn child, or for the placement of a child for adoption or foster care and to bond with that child. Men and women have the same right to take FMLA leave to bond with their child but it must be taken within one year of the child s birth or placement and must be taken as a continuous block of leave unless the employer agrees to allow intermittent leave (for example, a part-time schedule). Parent Parent means a biological, adoptive, step or foster father or mother, or any other individual who stood in loco parentis to the employee when the employee was a son or daughter. This term does not include parents in law. son or daughter Son or daughter means a biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person standing in loco parentis, who is either under age 18, or age 18 or older and incapable of self-care because of a mental or physical disability at the time that FMLA leave is to commence. in Loco Parentis A child under the FMLA includes not only a biological or adopted child, but also a foster child, a stepchild, a legal ward, or a child of a person standing in loco parentis. The FMLA regulations define in loco parentis as including those with day-to-day responsibilities to care for and financially support a child. Employees who have no biological or legal relationship with a child may nonetheless stand in loco parentis to the child and be entitled to FMLA leave. For example, an uncle who is caring for his young niece and nephew when their single parent has been called to active military duty or an employee who is co-parenting a child with his or her same sex partner may exercise their right to FMLA leave. Also, an eligible employee is entitled to take FMLA leave to care for a person who stood in loco parentis to the employee when the employee was a child. (See Administrator s Interpretation No and Fact Sheets 28B and C.) The Employee s Guide to The Family and Medical Leave Act 5

10 What Can the FMLA Do for Me? If you are faced with a health condition that causes you to miss work, whether it is because of your own serious health condition or to care for a family member with a serious health condition, you may be able to take up to 12 weeks of job-protected time off under the FMLA. If you take FMLA leave, your employer must continue your health insurance as if you were not on leave (you may be required to continue to make any normal employee contributions). As long as you are able to return to work before you exhaust your FMLA leave, you must be returned to the same job (or one nearly identical to it). This job protection is intended to lessen the stress that you may otherwise feel if forced to choose between work and family during a serious medical situation. Time off under the FMLA may not be held against you in employment actions such as hiring, promotions or discipline. You can take FMLA leave as either a single block of time (for example, three weeks of leave for surgery and recovery) or in multiple, smaller blocks of time if medically necessary (for example, occasional absences due to diabetes). You can also take leave on a part-time basis if medically necessary (for example, if after surgery you are able to return to work only four hours a day or three days a week for a period of time). If you need multiple periods of leave for planned medical treatment such as physical therapy appointments, you must try to schedule the treatment at a time that minimizes the disruption to your employer. FMLA leave is unpaid leave. However, if you have sick time, vacation time, personal time, etc., saved up with your employer, you may use that leave time, along with your FMLA leave so that you continue to get paid. In order to use such leave, you must follow your employer s normal leave rules such as submitting a leave form or providing advance notice. Even if you don t want to use your paid leave, your employer can require you to use it during your FMLA leave. For example, if you are out for one week recovering from surgery, and you have two weeks of paid vacation saved up, your employer can require you to use one week of your vacation time for your FMLA leave. When you use paid leave for an FMLA-covered reason (whether at your request or your employer s), your leave time is still protected by the FMLA. 6 The Employee s Guide to The Family and Medical Leave Act

11 How Do I Request FMLA Leave? To take FMLA leave, you must provide your employer with appropriate notice. If you know in advance that you will need FMLA leave (for example, if you are planning to have surgery or you are pregnant), you must give your employer at least 30 days advance notice. If you learn of your need for leave less than 30 days in advance, you must give your employer notice as soon as you can (generally either the day you learn of the need or the next work day). When you need FMLA leave unexpectedly (for example, if a family member is injured in an accident), you MUST inform your employer as soon as you can. You must follow your employer s usual notice or call-in procedures unless you are unable to do so (for example, if you are receiving emergency medical care). While you do not have to specifically ask for FMLA leave for your first leave request, you do need to provide enough information so your employer is aware it may be covered by the FMLA. Once a condition has been approved for FMLA leave and you need additional leave for that condition (for example recurring migraines or physical therapy appointments), your request must mention that condition or your need for FMLA leave. If you don t give your employer enough information to know that your leave may be covered by the FMLA, your leave may not be protected. You do not have to tell your employer your diagnosis, but you do need to provide information indicating that your leave is due to an FMLA-protected condition (for example, stating that you have been to the doctor and have been given antibiotics and told to stay home for four days). The Employee s Guide to The Family and Medical Leave Act 7

12 Communication With Your employer Ongoing communication between you and your employer will make the FMLA process run much more smoothly. Each of you has to follow guidelines about notifying the other when FMLA leave is being used. You will need to inform your employer if your need for FMLA leave changes while you are out (for example, if your doctor determines that you can return to work earlier than expected). Your employer may also require you to provide periodic updates on your status and your intent to return to work. Your employer must notify you if you are eligible for FMLA leave within 5 business days of your first leave request. If the employer says that you are not eligible, it has to state at least one reason why you are not eligible (for example, you have not worked for the employer for a total of 12 months). At the same time that your employer gives you an eligibility notice, it must also give you a notice of your rights and responsibilities under the FMLA. This notice must include: a definition of the 12-month period the employer uses to keep track of FMLA usage. For example, it can be a calendar year, 12 months from the first time you take leave, a fixed year such as your anniversary date, or a rolling 12-month period measured backward from the date you use FMLA leave. You need to know which way your employer measures the 12-month window so that you can be sure of how much FMLA leave you have available when you need it; 8 The Employee s Guide to The Family and Medical Leave Act

13 whether you will be required to provide medical certification from a health care provider; your right to use paid leave; whether your employer will require you to use your paid leave; your right to maintain your health benefits and whether you will be required to make premium payments; and your right to return to your job at the end of your FMLA leave. When your employer has the information necessary to determine if your leave is FMLA protected, it must notify you whether the leave will be designated as FMLA leave and, if possible, how much leave will be counted against your FMLA entitlement. If your employer determines that your leave is not covered by FMLA, it must notify you of that determination. The Employee s Guide to The Family and Medical Leave Act 9

14 The FMLA Leave process This flowchart provides general information to walk you through your initial request for FMLA leave. It is a step-by-step guide that will help you navigate the sometimes complicated FMLA process. Please note, it is ESSENTIAL that you are familiar with your employer s leave policy. There are several instances throughout the FMLA leave process where you will need to comply with BOTH the FMLA regulations AND your employer s leave policy. STarT here t STEP 1 You must notify your employer when you know you need leave Please see pg. 7 Your employer must provide you with your FMLA rights & responsibilities, as well as any request for certification Please see pg. 8 eligible STEP 2 Your employer must notify you whether you are eligible for FMLA leave within 5 business days Please see pg. 8 certification requested certification not requested not eligible STEP 3 You must provide a completed certification to your employer within 15 calendar days Please see pg. 12 STOP Your leave is not FMLA-protected (You may request leave again in the future. Employee eligibility can change.) 10 The Employee s Guide to The Family and Medical Leave Act

15 your responsibility your employer s responsibility STOP Your leave is not FMLA-protected (You may request leave again in the future.) not designated STEP 4 Your employer must notify you whether your leave has been designated as FMLA within 5 business days Please see pg. 8 designated STEP 5 Your leave is FMLA-protected (There are employee responsibilities while out on FMLA leave.) Please see pg. 8 STEP 6 When you return to work, your employer must return you to your same or nearly identical job Please see pg. 14 The Employee s Guide to The Family and Medical Leave Act 11

16 Medical Certification If your employer requests medical certification, you only have 15 calendar days to provide it in most circumstances. You are responsible for the cost of getting the certification from a health care provider and for making sure that the certification is provided to your employer. If you fail to provide the requested medical certification, your FMLA leave may be denied. The medical certification must include some specific information, including: contact information for the health care provider; when the serious health condition began; how long the condition is expected to last; appropriate medical facts about the condition (which may include information on symptoms, hospitalization, doctors visits, and referrals for treatment); whether you are unable to work or your family member is in need of care; and whether you need leave continuously or intermittently. If you need to take leave a little bit at a time, the certification should include an estimate of how much time you will need for each absence, how often you will be absent, and information establishing the medical necessity for taking such intermittent leave. If your employer finds that necessary information is missing from your certification, it must notify you in writing of what additional information is needed to make the certification complete. You must provide the missing information within 7 calendar days. If your employer has concerns about the validity of your certification, it may request a second opinion, but it must cover the cost. Your employer may request a third opinion if the first and second opinion differ, but it must cover the cost. If your need for leave continues for an extended period of time, or if it changes significantly, your employer may require you to provide an updated certification. 12 The Employee s Guide to The Family and Medical Leave Act

17 Certification at a Glance STEP 1 Your employer must notify you if a certification is required STEP 2 You must provide a completed certification to your employer within 15 days STEP 3 Your employer must designate your leave if it is FMLA-protected your employer may require you to: l Correct any deficiencies in your certification identified by your employer within 7 days l Obtain a 2nd medical opinion if your employer doubts the validity of your certification l Obtain a 3rd medical opinion if the 1st and 2nd opinions differ YOUR EMPLOYER MAY DENY FMLA LEAVE IF YOU FAIL TO PROVIDE A REQUESTED CERTIFICATION your responsibility your employer s responsibility The Employee s Guide to The Family and Medical Leave Act 13

18 Returning to Work When you return to work, the FMLA requires that your employer return you to the same job that you left, or one that is nearly identical. If you are not returned to the exact same job, the new position must: involve the same or substantially similar duties, responsibilities, and status; include the same general level of skill, effort, responsibility and authority; offer identical pay, including equivalent premium pay, overtime and bonus opportunities; offer identical benefits (such as life insurance, health insurance, disability insurance, sick leave, vacation, educational benefits, pensions, etc.); and offer the same general work schedule, and be at the same (or nearby) location. Please keep in mind that if you exhaust your FMLA leave entitlement and are unable to return to work, your employer is not required to restore you to your position. SPECIAL CIRCUMSTANCES: Key employees Certain key employees may not be guaranteed reinstatement to their positions following FMLA leave. A key employee is defined as a salaried, FMLA-eligible employee who is among the highest paid 10 percent of all the employees working for the employer within 75 miles of the employee s worksite. Teachers Special rules apply to employees of local education agencies. Generally, these rules apply when you need intermittent leave or when you need leave near the end of a school term. Please visit our web site for more complete information. 14 The Employee s Guide to The Family and Medical Leave Act

19 How to File a Complaint The U.S. Department of Labor s Wage & Hour Division (WHD) is responsible for administering and enforcing the Family and Medical Leave Act for most employees. If you have questions, or you think that your rights under the FMLA may have been violated, you can contact WHD at You will be directed to the WHD offce nearest you for assistance. There are over 200 WHD offces throughout the country staffed with trained professionals to help you. The information below is useful when filing a complaint with WHD: your name; your address and phone number (how you can be contacted); the name of the company where you work or worked; location of the company (this may be different than the actual job site where you worked); phone number of the company; manager or owner s name; and the circumstances of your FMLA request and your employer s response. Your employer is prohibited from interfering with, restraining, or denying the exercise of FMLA rights, retaliating against you for filing a complaint and cooperating with the Wage and Hour Division, or bringing a private action to court. You should contact the Wage and Hour Division immediately if your employer retaliates against you for engaging in any of these legally protected activities. To contact the WHD offce nearest you, visit: The Employee s Guide to The Family and Medical Leave Act 15

20 Web Site Resources Visit the Wage and Hour Division web site at for resources containing information about the FMLA, including: Key News General Guidance Fact Sheets e-tools posters Forms interpretive Guidance Law Regulations 16 The Employee s Guide to The Family and Medical Leave Act

21 u.s. department of Labor Wage and Hour division 200 Constitution Avenue, NW Washington, DC USWAgE ( ) WH-1506 august 2012

22 Section Pregnancy Disability Leave CSEA ARTICLE XI EXTENDED LEAVES OF ABSENCE Employees covered under this agreement who request a pregnancy disability leave shall be granted the aforementioned leave with pay. The leave time taken shall be deducted from the accumulated paid leave of the employee desiring the leave. Notwithstanding the above, an employee who does not wish to use her accumulated leave or who does not have any accumulated leave shall be granted an unpaid leave in accordance with Section 3 below. The affected employee shall submit a written application for the leave to the administrator for Human Resources one (1) month prior to the date the leave is to begin except in cases of emergency. The application shall be accompanied by a physician s statement attesting to the employee s physical fitness to remain on active duty. The employee s pregnancy disability leave shall commence on the date her physician determines that she is no longer able to perform the duties of her position. From such day until her physician determines that she is ready to return to work, the employee shall be allowed to use her accumulated paid leave credits or shall be allowed an unpaid leave of absence as provided in Section of this Article. In the event the employee exhausts her accumulated paid leave prior to becoming medically fit to return to duty, the employee shall be placed on leave without pay until such time as she is able to return. An employee on pregnancy disability leave shall be reinstated, if she so desires, within one (1) week of the date she obtains a statement from her physician confirming the fact that the employee is able to return to work and delivers such statement to the Administrator for Human Resources, or the employee shall be allowed a child rearing leave in accordance with Section of this Article. Section Child Rearing Leave Child rearing leave without pay shall be granted an employee at the expiration of her maternity leave as set forth in Section if she requests such leave. An employee shall be granted a child rearing leave for a period of up to two (2) years. The duration of the child rearing leave shall be stated in the request for leave. Extension of the leave beyond two (2) years may be granted at the discretion of the Board of Education. The leave request shall be sent or delivered to the Administrator for Human Resources who shall approve the leave and any extensions up to two (2) years by sending the employee a letter(s) granting the leave or any extension.

23 Section 5.50 Sick Leave Bank A sick leave bank (SLB) shall be implemented for use by employees whose accumulated sick leave has been exhausted as a result of a long term catastrophic illness or injury. Review Committee: A mutually representative committee shall be established to review and approve or disapprove requests for withdrawal from the bank, keep records of membership, and maintain an appropriate level of days for use in the bank. The Review Committee shall call upon participants for contributions of two (2) additional days whenever the Committee, as a whole, feels a need. Membership: Participants of the plan shall consist of all employees, regardless of their classification. New employees shall be eligible for membership after one year and one day of employment. Contributions: An initial contribution of each eligible member shall be two (2) sick leave days. Sick Bank Members who retire with more than three hundred (300) accumulated sick days shall have the excess number of days over three hundred (300) added to the sick bank. Withdrawals: Applicants may request a withdrawal from the Review Committee upon exhausting all leave accruals and upon having been absent due to a long term catastrophic illness for at least thirty (30) days including the balance of their accumulated sick leave. Withdrawals may only be made in connection with a long term illness, or injury of a participant or in the case where a participant s accumulated sick leave has been exhausted as a result of long term illness or injury. This shall not include illness or injury of another member of a participant s family or time taken to assist such other family members. In the event a participant is incapacitated and unable to request a withdrawal for himself, a member of the participant s family may prepare a sick leave withdrawal request. Each request must be accompanied by a statement signed by a physician, confirming the nature of the illness and the anticipated duration of the disability. A participant shall not receive a withdrawal of more than thirty (30) days at one time. Additional leave requests may be made by a participant after the thirty (30) day grant, but it must be resubmitted to the Committee for review. No more than a total of sixty (60) days can be taken during a school year. The Committee has the right to disapprove a sick leave withdrawal request for appropriate reasons, including improper use of accumulated sick leave by the participant. A participant s membership in the SLB shall terminate upon the employee s termination of employment, and a failure to contribute to the bank as requested by the Committee.

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26 NFT Article 23 EXTENDED LEAVES OF ABSENCE Women teachers shall be granted maternity leave, to be deducted from and to the extent of accumulated sick leave. In the event the teacher's accumulated sick leave expires before she is medically fit for duty, the teacher shall be placed in leave without pay status until such time as she is able to return, subject to the provisions of Paragraph of this article For non-tenure teachers, maternity leave, when taken without pay, shall be an interruption of the probationary period and not be taken in lieu of service in meeting the requirements for serving a probationary period A teacher shall not accumulate additional leave days during maternity leave when taken without pay The Board shall grant a leave of absence without pay for up to two (2) years for any teacher or teachers (total at any one time not to be more than 3) for the purpose of full-time or part-time employment or related office with the Niagara Falls Teachers and/or its affiliates. Upon return from such leave, said teachers shall return at the same pay step they would have been entitled to if they had remained in the employment of the School District. All benefits accrued to said teachers prior to their leave shall be reinstated upon their return to the school district. Such leave may be extended by the Board for an additional period of two years upon written application 30 days prior to the end of such leave. Monies paid to the New York State Teachers Retirement System in the teacher's name by the School District during the duration of this leave shall be reimbursed to the District by the "Employee Organization." 23.9 All benefits to which a teacher was entitled at the time his or her leave of absence commenced, provided he/she returns under the conditions stipulated in the leave grant, including unused accumulated sick leave and credits, shall be restored to him/her upon his return, and he/she shall be assigned to the same position which he/she held at the time said leave commenced, if available, or, if not, to a substantially equivalent position Teachers on leave shall continue to receive the Board's life insurance protection All requests for extensions or renewals of leaves shall be applied for and acted upon in writing Teachers shall be granted leave without pay or increment and with no loss of accrued benefits in cases of adoption for up to two years. Such leave may be extended a maximum of one year at the discretion of the Board. Notification of such leave shall be given thirty days in advance. Later notice shall be permissible in cases of emergency need but emergency leaves of less than thirty days notice shall be granted at the Board's discretion and provided that a qualified replacement teacher is available. Leave for purposes of adoption shall not be counted as part of the three-year probationary period.

27 Child-rearing leave, without pay or increment, shall be granted teachers if they so request, in multiples of one semester for a total maximum leave period of two and one-half years. Child rearing leave shall constitute an interruption of the probationary period, and not be taken in lieu of service to meet the requirements for serving a probationary period. Childrearing leave following a second, successive instance of pregnancy, i.e., which occurs during an extended leave, may be granted or denied, at the discretion of the Board Teachers taking childrearing leave for only one (1) semester shall have the option of returning to their pre-leave assignment or being transferred pursuant to provisions set forth in Article 16 of the NFT Agreement. The Administrator for Human Resources must be notified of the option selected at the time childrearing leave is requested. Article 21 Sick Bank 21.4 The Board will establish a sick leave bank to be used when an employee is incapacitated by long-term sickness or injury, if as many as 500 employees agree to participate in accordance with the terms contained herein Membership in the sick leave bank is automatic on the part of the employees The first 30 consecutive days of illness or disability will not be covered by the bank but must be covered by the employee's own accumulated sick leave or absence without pay A maximum of 60 days each school year can be drawn by any one member from the bank. Regular substitutes may draw a maximum of 30 days from the sick bank each school year Participating members must return to work and must meet the requirements of item "21.4.3" before becoming eligible to utilize sick leave bank benefits again A member of the bank will not be able to utilize sick leave bank benefits until his or her own sick leave is depleted Members utilizing sick leave days from the bank will not have to replace these days except as a regular contributing member to the bank Upon termination of employment or withdrawal of membership from the bank, a participating employee will not be permitted to withdraw his contributed days A committee composed of two Board representatives and two NFT members will be established to determine the eligibility of a teacher to draw from the sick bank Should the NFT decide to discontinue the sick bank, all accumulated days will be carried to the next year and/or until the bank is depleted.

28 No more than 120 days may be used from the sick bank by the same individual in any consecutive contractual three-year.

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31 NIAS ARTICLE 23 MATERNITY AND CHILD REARING LEAVES A. Employees covered under this Agreement who request a maternity leave shall be granted the aforementioned leave with pay. The leave time taken shall be deducted from the accumulated paid leave of the employee desiring the leave. Notwithstanding the above, an employee who does not wish to use her accumulated leave or who does not have any accumulated leave shall be granted an unpaid leave in accordance with Paragraph C below. The affected employee shall submit a written application for the leave with the Administrator for Human Resources one (1) month prior to the date the leave is to begin except in cases of emergency. The application shall be accompanied by a physician s statement attesting to the employee s physical fitness to remain on active duty. B. The employee s maternity leave shall commence on the date her physician determines that she is no longer able to perform the duties of her position. From such day until her physician determines that she is ready to return to work, the employee shall be allowed to use her accumulated paid leave credits or shall be allowed an unpaid leave of absence as provided in Section A of this article. C. In the event that the employee exhausts her accumulated paid leave prior to becoming medically fit to return to duty, the employee shall be placed on leave without pay until such time as she is able to return. D. An employee on maternity leave shall be reinstated, if she so desires, within one (1) week of the date she obtains a statement from her physician confirming the fact that the employee is able to return to work and delivers such statement to the Administrator for Human Resources. Or, the employee may be allowed a child rearing leave in accordance with Paragraph E of this article. E. Child rearing leave without pay may be granted an employee for a period of up to two (2) years. The duration of the child rearing leave shall be stated in the request for the leave. Extension of the leave beyond two (2) years may be granted at the discretion of the Board of Education. The leave request shall be sent or delivered to the Administrator for Human Resources who shall approve the leave and any extensions up to two (2) years by sending the employee a letter(s) stating the leave or any extension has been approved. F. An employee covered under this Agreement whose personal illness extends beyond the period of accumulated leave may be granted a leave of absence up to two (2) years without pay, upon verification of the need for such leave by the School Medical Inspector. The duration of the leave shall be determined by the employee in consultation with his/her physician. The employee shall notify the Administrator for Human Resources of the approximate time of the leave.

32 Niagara Falls City School District Office of Human Resources th Street Niagara Falls, NY Certification Health Care Provider Form (Non FMLA Leave) Instructions This form is intended for use to substantiate the need for use of personal or medical leave due to medical conditions. Do not use this form if requesting leave under FMLA. If you are (1) applying for a leave of absence that involves your own medical condition, or (2) have been asked to provide information to the district to substantiate a personal or medical leave, please follow these steps: 1. Take this form to the health care provider who is treating you. 2. Ask the health care provider to complete this form and return it to you as soon as possible. (In emergency situations, the health care provider may fax it to (716) The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information off employees or their family members. In order to comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information. Genetic information, as defined by GINA, includes an individual's family medical history, the results of an individual's or family member's genetic tests, the fact that an individual or an individual's family member sought or received genetic services, and genetic information of a fetus carried by an individual or an individual's family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services. 3. The employee should return this form (completed) to: Human Resources Attn: Ms. Maria Massaro th Street Niagara Falls, NY Fax: Approval of your leave of absence or use of sick leave may bee delayed or denied if this form is not completed and/or submitted timely with your Leave Request Form. Certification of Health Care Provider 12/ /3/13

33 Niagara Falls City School District Office of Human Resources th Street Niagara Falls, NY Certification of Health Care Provider Health Care Provider: When completed, this form goes to thee employee or may be faxed to: Human Resources (716) Patient s Name: 1. Describe the medical facts which support your certification. 2. State the approximate date the conditionn commenced, and the probable duration of the condition (and also the probable duration of the patient s present incapacity if different): 3. If the conditionn is a chronic condition or pregnancy, state whether the patient is presently incapacitated and the likely duration and frequency off episodes of incapacity. 4. Additional treatments: a. If additional treatments will be required for the condition, provide an estimate of the probable number of such treatments. If the patient will be absent from work or other daily activities because of treatment, also provide an estimate of the probable number of and interval between such treatments, actual or estimate dates of treatment if known, and period required for recovery if any: Certification of Health Care Provider 12/ /3/13

34 Niagara Falls City School District Office of Human Resources th Street Niagara Falls, NY b. If any of these treatments will be provided by another provider of health services (e.g., physical therapist), please state the nature of the treatments: c. If a regimen of continuing treatment by the patient is required under your supervision, provide a general description of such regimen (e.g., prescription drugs. Physical therapy requiring special equipment): 5. Medical Leave: a. If medical leave is required for the employee s absence from work (including absences due to pregnancy or a chronicc condition), is the employee unable to perform work of any kind? b. If able to perform some work, is the employee unable to perform any one or more of the essential functions of the employee s job (the employee or the employer should supply you with information about the essential job functions) )? If yes, please list the essential functions the employee is unable to form: c. If neither, a. nor b. applies, is it necessary for the employee to be absent from work for treatment? Signature of Health Care Provider Street Address City State ZIP Telephonee Number Date Certification of Health Care Provider 12/ /3/13