For information about these forms of leave, ... Pregnancy Disability Leave (PDL) California Family Rights Act Leave - Child Bonding Family & Medical Leave Act (FMLA) I am eligible if: I have a pregnancy-related disability and my employer has 5+ employees. (Gov. Code, § 12945 & Cal. Code Regs., tit. 2, §§ 11035 & 11037).

Visit Online Forms and Publications. Select Keyword(s) or Form Number from the dropdown. Enter DE 2501F for an English form or DE 2501F/S for a Spanish form. Select Search. You can also call 1-877-238-4373 and select Option 3. To view an example PFL claim form, review the DE 2501F – Sample claim form.

seeking PDL stating the reasons for the leave and the probable duration of the condition. However, the health-care provider may not disclose the patient. SALARY AND BENEFITS DURING PDL • An employer may require an employee to use accrued sick leave during any unpaid portion of their pregnancy disability leave. The employee may

800-884-1684 (voice), 800-700-2320 (TTY) or California's Relay Service at 711 [email protected]

Forms. Family Care and Medical Leave and Pregnancy Disability Leave Notice - Spanish Lactation Accommodation Policy - Spanish PDL Checklist for Employer Compliance - 5-49 Employees PDL/FMLA Documentation Checklist - For Employer Use Only Q&As

Pregnancy disability benefits are usually between 10 to 12 weeks. It depends on your pregnancy and delivery. Without medical complications, you can receive benefits up to: Four weeks before your estimated delivery date.

PREGNANCY DISABILITY LEAVE (PDL) 1. Employee Last Name 2. Employee First Name 3. Employee Middle Name 4. Date 5. Division/Unit 6. Telephone Number Part A: Leave Approval 1. Your leave request is approved on a: ... Information provided on this form will be maintained by the department above pursuant to the State

PREGNANCY DISABILITY LEAVE If your leave does qualify as PDL, you will have the following rights and responsibilities while on leave: 1. You have the right to take up to four months of unpaid disability leave. Four months is defined as 17.33 weeks. If additional time off is needed, then it will be processed through the reasonable accommodation ...

Pregnancy Disability Leave (PDL) - is a state law and available to employees, regardless of time of employment with the County, who becomes disabled due to pregnancy, childbirth, or related medical ... Process for Requesting PDL & Baby/Child Bonding The correct forms to use and submittal deadline will depend on the type of leave the employee is ...

2022年10月13日 · A sample health care provider certification form for pregnancy disability leave is available via the ... If an employee takes a pregnancy disability leave that does not qualify as FMLA leave and a ...