Human Resources Disability Management

4-10 Medical Leave Policy

Return to Administrative Policy Manual

Approved: Board of Supervisors
Authority: Human Resources
Resolution: 10-0852
Revised Date: December 14, 2010

Table of Contents

  1. Introduction
  2. Purpose
  3. Policy
    1. Eligibility for Medical Leave: Federal & State Laws
    2. Type, Duration, and Reason for Leave
    3. Additional Medical Leave Provisions
    4. Restoration of Employment & Benefits Following a Leave
    5. Coordination of FMLA Leave with Other Leave Policies and Provisions
    6. Questions and/or Policy Compliance
  4. Responsibilities
    1. Department Head
    2. Department Human Resources/Payroll Liaison
    3. Human Resources Department
    4. Employee
  5. Leave of Absence Approval Process
    1. Employee Notice
    2. Timing of Employee Notice
    3. Required Documentation
    4. Submit Medical Certifications Supporting Need for Leave (Non-Military FMLA Leave)
    5. Submit Certifications Supporting Need for Military FMLA Leave
    6. Leave Approval Authority for Longer Duration Medical Leave Requests
    7. Cooperating in the Scheduling of Leave
    8. Medical Recertification
    9. Return to Work Medical Certifications
    10. Reporting Changes to Anticipated Return Date
    11. Using Paid Leave for Unpaid FMLA/CFRA/CPDL Leave
    12. Paying Employee’s Share of Health Insurance Premiums
  6. Where to Find Additional Information


Frequently Asked Questions

Contact Information

Lynne Durrell

Disability Programs Manager

Risk Management Division

Human Resources Department

Business Hours
Monday – Friday
8:00 AM – 5:00 PM

575 Administration Drive

Suite 116B

Santa Rosa, CA 95403
38.4646528, -122.725512

Where to Find Additional Information

In addition to this policy, the process and certification forms to request a leave of absence can be obtained by contacting your Department Human Resources liaison, the Human Resources Disability Management Unit, or on the County website

Request for Leave of Absence Form

Medical Certification for Employees

Medical Certification for Family Members

Medical Certification for Servicemembers

Certification of Exigency for Military Leave

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