Human Resources Disability Management

Glossary

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Adoption:Legally and permanently assuming the responsibility of raising a child as one’s own. The source of an adopted child (e.g., whether from a licensed placement agency or otherwise) is not a factor in determining eligibility for FMLA/CFRA leave.
Actual Hours:These are hours the employee actually worked – not including paid sick leave, vacation leave, compensatory time off, Mandatory Time Off (MTO), holiday, or any leave without pay.

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Child:See “Son, daughter or child”.
COBRA:Gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan. For more information got to: http://www.dol.gov/dol/topic/health-plans/cobra.htm
Covered Servicemember:A member of the U.S. Armed Forces, including a member of the National Guard or Reserves or Regular U.S. Armed Forces, who is undergoing medical treatment, recuperation, or therapy, is otherwise in outpatient status, or is on the temporary retired list, for a serious injury or illness. A member of the U.S. Armed Forces would have a serious injury or illness if he/she has incurred an injury or illness in the line of duty while on covered active duty in the U.S. Armed Forces provided that the injury or illness may render the servicemember medically unfit to perform duties of the member’s office, grade, rank or rating.

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Domestic Partner:Two adults who have established a registered domestic partnership in accordance with the requirements of California law or have signed a County Domestic Partner affidavit.

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Essential Functions Worksheet (EFW):Describes in detail all specific skills (including: physical & environmental activities, lifting & carry requirements, sensory skills and mental activities) required for a job class.

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Foster child/care:24-hour care for children in substitution for, and away from, their parents or guardian. Such placement is made by or with the agreement of the State as a result of a voluntary agreement between the parent or guardian that the child be removed from the home, or pursuant to a judicial determination of the necessity for foster care, and involves agreement between the State and foster family that the foster family will take care of the child. Although foster care may be with relatives of the child, State action is involved in the removal of the child from parental custody.

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Health Care Provider:(1) A doctor of medicine or osteopathy who is authorized to practice medicine or surgery (as appropriate) by the State in which the doctor practices; (2) podiatrists, dentists, clinical psychologists, optometrists, chiropractors (limited treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by x-Ray to exist) authorized to practice under the State law and performing within the scope of their practice as defined by State law; (3) nurse practitioners, nurse-midwives, clinical social workers and physician assistants authorized under State law and performing within the scope of their practice as defined by State law; (4) Christian Science practitioners (may be required to submit to second or third certification through examination - not treatment of a health care provider); (5) any other health care provider from whom the employer or the employee's group health plan benefits manager will accept certification of the existence of a serious health condition to substantiate a claim for benefits; and (6) a health care provider who practices in a country other than the United States who is authorized to practice in accordance with the laws of that country and is performing within the scope of his or her practice as defined under such law. For purposes of leave taken to care for a covered servicemember, any one of the following health care providers may complete such a certification: (1) a United States Department of Defense (“DOD”) health care provider; (2) a United States Department of Veterans Affairs (“VA”) health care provider; (3) a DOD TRICARE network authorized private health care provider; or (4) a DOD non-network TRICARE authorized private health care provider. Under the Pregnancy Disability Leave Act, this may also include "(1) an individual holding either a physician's and surgeon's certificate issued pursuant to Article 4 (commencing with Section 2080) of Chapter 5 of Division 2 of the Business and Professions Code or an osteopathic physician's and surgeon's certificate issued pursuant to Article 4.5 (commencing with Section 2099.5) of Chapter 5 of Division 2 of the Business and Professions Code, or any other individual duly licensed as a physician, surgeon, or osteopathic physician or surgeon in another state or jurisdiction, including another country, who directly treats or supervises the treatment of the pregnancy, childbirth or related medical condition."

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Incapable of self-care:The individual requires active assistance or supervision to provide daily self-care in three or more of the “activities of daily living” (ADLs) or “instrumental activities of daily living” (IADLs). Activities of daily living include adaptive activities such as caring appropriately for one’s grooming and hygiene, bathing, dressing and eating. Instrumental activities of daily living include cooking, cleaning, shopping, taking public transportation, paying bills, maintaining a residence, using telephones and directories, using a post office, etc.
In loco parentis:Persons with day-to-day responsibilities to care for and financially support a child, or, in the case of an employee, who had such responsibility for the employee when the employee was a child. A biological or legal relationship is not necessary.
Intermittent Leave:Under certain circumstances, leave may be taken in separate blocks of time due to a single qualifying reason, rather than for one continuous period of time.

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Key employees:A salaried FMLA-eligible employee who is among the highest paid 10 percent of all the employees (salaried and non-salaried, eligible and ineligible) employed by the employer within 75 miles of the employee's worksite. (29 C.F.R. 825.217; CA Govt. Code section 12945.2(r)) For determination if an individual is a “key employee”, please contact the Human Resources Disability Management unit.

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Mental or physical disability:Means a physical or mental impairment that limits one or more of the major life activities of an individual. Regulations at 29 CFR 1630.2(h), (i), and (j), issued by the Equal Employment Opportunity Commission under the Americans with Disabilities Act (ADA), 42 U.S.C. 12101 et seq., define these terms.

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Next of kin of a covered servicemember:The nearest blood relative other than the covered servicemembers spouse, parent, son, or daughter, in the following order of priority: blood relatives who have been granted legal custody of the covered servicemember by court decree or statutory provisions, brothers and sisters, grandparents, aunts and uncles, and first cousins, unless the covered servicemember has specifically designated in writing another blood relative as his or her nearest blood relative for purposes of military caregiver leave under the FMLA. When no such designation is made, and there are multiple family members with the same level of relationship to the covered servicemember, all such family members shall be considered the covered servicemembers next of kin and may take FMLA leave to provide care to the covered servicemember, either consecutively or simultaneously. When such designation has been made, the designated individual shall be deemed to be the covered servicemembers only next of kin.

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Parent: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 child. This term does not include parents “in law.”
Parent of a covered servicemember:A covered servicemembers biological, adoptive, step or foster father or mother, or any other individual who stood in loco parentis to the covered servicemember. This term does not include parents “in law.”
Placement:Placement of a child with an employee for adoption or foster care, or of a child of a person standing in loco parentis.

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Qualifying exigencies:May include attending certain military events, arranging for alternative childcare, handling certain school issues, addressing certain financial and legal arrangements, attending certain counseling sessions, spending up to five (5) days of leave with a covered military member who is on short-term temporary, rest and recuperation leave during a period of deployment, and attending post-deployment reintegration briefings.9

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“Rolling” 12 months:A rolling 12-month period is measured backward from the date leave first occurs. Each time an employee takes FMLA/CFRA leave, the remaining leave entitlement would be any balance of the 12 weeks that has not been during the immediately preceding 12 months. For example, if an employee used four weeks beginning February 1, 2010, four weeks beginning June 1, 2010 and four weeks beginning December 1, 2010, the employee would not be entitled to any additional FMLA/CFRA leave until February 1, 2011.

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Serious health condition:An illness, injury, impairment, or physical or mental condition that involves one of the following:
  1. Hospital Care
    1. Inpatient care (i.e., an overnight stay) in a hospital, hospice, or residential medical care facility, including any period of incapacity or subsequent treatment in connection with or consequent to such inpatient care.
  2. Absence Plus Treatment
    1. A period of incapacity of more than three (3) consecutive calendar days (including any subsequent treatment or period of incapacity relating to the same condition), that also involves:
    2. Treatment two (2) or more times by a health care provider, by a nurse or physician’s assistant under direct supervision of a health care provider, or by a provider of health care services (e.g., physical therapist) under orders of, or on referral by, a health care provider; or,
    3. Treatment by a health care provider on at least one (1) occasion which results in a regimen of continuing treatment under the supervision of a health care provider.
  3. Pregnancy
    1. Any period of disability due to pregnancy, childbirth, or for pregnancy related conditions, including for prenatal care counts toward FMLA and CPDL leave entitlements. (Note: An employee’s own incapacity due to pregnancy is covered as a serious health condition under FMLA but not under CFRA.)
    2. CPDL allows up to four (4) months unpaid leave for disability due to pregnancy. CPDL approval requires medical certification. There are no service time requirements to qualify for CPDL. CPDL runs concurrently with FMLA (for FMLA eligible employees).
    3. Once the disability portion of the pregnancy leave has concluded, the employee can take up to 480 hours of CFRA leave for bonding purposes. Bonding leave shall be completed within one year of the birth or placement of the child.
  4. Chronic Conditions Requiring Treatments
    A chronic condition which:
    1. Requires periodic visits for treatment by a health care provider, or by a nurse or physician’s assistant under direct supervision of a health care provider;
    2. Continues over an extended period of time (including recurring episodes of a single underlying condition); and
    3. May cause episodic, rather than a continuing, period of incapacity (e.g., asthma, diabetes, epilepsy, etc.).
  5. Permanent/Long-term Conditions Requiring Supervision
    A period of incapacity which is permanent or long-term due to a condition for which treatment may not be effective. The employee or family member must be under the continuing supervision of, but need not be receiving active treatment by, a health care provider. Examples include Alzheimer’s, a severe stroke, or the terminal stages of a disease.
  6. Multiple Treatments (Non-Chronic Conditions)
    Any period of absence to receive multiple treatments (including any period of recovery there from) by a health care provider or by a provider of health care services under orders of, or on referral by, a health care provider, either for restorative surgery after an accident or other injury, or for a condition that would likely result in a period of incapacity of more than three consecutive calendar days in the absence of medical intervention or treatment, such as cancer (chemotherapy, radiation, etc.), severe arthritis (physical therapy) kidney disease (dialysis).
  7. Qualifying exigencies
    May include attending certain military events, arranging for alternative childcare, handling certain school issues, addressing certain financial and legal arrangements, attending certain counseling sessions, spending up to five (5) days of leave with a covered military member who is on short-term, temporary, rest and recuperation during a period of deployment, and attending post-deployment reintegration briefings.
Son, daughter or child:For purposes of FMLA/CFRA leave taken for birth, or adoption, or foster placement; or to care for a family member with a serious health condition, a biological, adopted, or foster child, a stepchild (including children of a domestic partner under CFRA), 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” or an adult dependent child at the time that FMLA/CFRA leave is to commence.
Son or daughter on covered active duty or call to active duty status:The employee’s biological, adopted, or foster child, stepchild, legal ward, or a child for whom the employee stood in loco parentis, who is on active duty or call to active duty status, and who is of any age.
Son or daughter of a covered servicemember:The servicemembers biological, adopted, or foster child, stepchild, legal ward, or a child for whom the servicemember stood in loco parentis, and who is of any age.
Spouse:A husband or wife as defined or recognized under State law for purposes of marriage in the State where the employee resides, including common law marriage in States where it is recognized.

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Written Request:A written request from an employee can take the form of an email, a letter or other type of note, or completion of applicable forms.

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Treatment includes examinations to determine if a serious health condition exists and evaluations of the condition. Treatment does not include routine physical examinations, eye examinations, or dental examinations. A regimen of continuing treatment includes, for example, a course of prescription medication (e.g., an antibiotic) or therapy requiring special equipment to resolve or alleviate the health condition. A regimen of treatment does not include the taking of over-the-counter medications such as aspirin, antihistamines, or salves; or bed-rest, drinking fluids, exercise, and other similar activities that can be initiated without a visit to a health care provider.

Contact Information

Lynne Durrell

Disability Programs Manager

Risk Management Division

Human Resources Department

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

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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