Leave of absence
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Leave of Absence Instructions
You must complete the steps below if you require any absence from work of more than 7 (seven) consecutive calendar days.
Click to get started on completing your LOA request:
Step One | Notification If you require a leave of absence from work, you are required by law to provide at least 30 days notice to your Director (or designee) should you require a leave of absence from work. If you have an unexpected leave of absence, please contact your Director (or designee) as soon as possible. To request a Personal Leave of Absence, contact your director and apply via paper application. You are not required to apply online for this type of leave. |
Step Two | Apply for Leave Online You are required to complete the online Leave of Absence request through Qcera/Leavesource at https://myleave.leavesource.com or through the MyLeave mobile app (available for iPhone and Android) if you require a leave of absence from work. To register you will need: o Work email address o Last four digits of your social security number o Date of Birth o Employee ID number If you have trouble registering, have previously registered and forgot your password, or need to change your work email to personal email, please contact: Qcera Support at 310-473-7988 or Email: support@leavesource.com |
Step Three | Upload required documentation Depending on your leave type, you may be required to upload additional documentation (i.e., doctor’s note, Certification of Healthcare Provider form, or verification of birth). If you are extending your original LOA - please upload an updated doctor’s note to Qcera/Leavesource and enter a new leave date within 3 (three) calendar days. |
Step Four | Return to work to return to work, you must provide a doctor’s note indicating your release and go to the Employee Health Department (EHD) to be cleared, prior to your return. Your doctor’s note must identify: • The date of your return • Whether you are “Return to work with no restrictions” or “full duty” • If restrictions apply, your doctor’s note must state those restrictions and how long they will be in place (i.e. no lift/push/pull) Failure to provide a return to work release at the end of your approved leave may result in the appropriate level of disciplinary action being applied, up to and including termination. If you have questions or would like to provide your doctor’s note, contact: Employee Health Department 909-920-6210 Fit for Duty Hours are 7:30am to 3:30pm (Monday –Friday) No appointment needed |
Pay During Your FMLA Leave/PDL/ADA Leave
Paid Time Off (PTO) is mandatory for the first 24 hours of your leave of absence, followed by ESL. • ESL and PTO will be automatically coordinated with State Disability (SDI) on the 8th day of your leave. • If you exhaust ESL, you can request to use PTO for the remainder of your LOA. • Please complete the “Payroll Notification Form” and return to Martha Salcedo, in Employee Health via fax or email. • Apply for State Disability (SDI) online www.edd.ca.gov or via paper application, please ask EHD. o SDI – you cannot apply before your leave begins, 7-day waiting period (approximately 50% of your income)
Pay During A Bonding Leave (CFRA) Or for FMLA/Family To Care For an Ill Family Member
PTO is mandatory for the first 24 hours of your leave of absence, followed by ESL. • ESL will be paid (maximum of ½ of what you accrue annually). Example, if the maximum accrual is eight (8) days per year, then you can only use four (4) days of ESL. • PTO and ESL will be automatically coordinated with Paid Family Leave (PFL) on the 8th day of your leave. Please complete the “Payroll Notification Form” to authorize PTO/ESL and return to Martha Salcedo, in Employee Health via fax or email. • Apply for Paid Family Leave (PFL) online www.edd.ca.gov or via paper application, please ask EHD, benefits can be paid up to 8 weeks of leave (approximately 60-70% of your income)
Pay During A Bonding Leave (CFRA) Or for FMLA/Family To Care For an Ill Family Member
PTO is mandatory for the first 24 hours of your leave of absence, followed by ESL. • ESL will be paid (maximum of ½ of what you accrue annually). Example, if the maximum accrual is eight (8) days per year, then you can only use four (4) days of ESL. • PTO and ESL will be automatically coordinated with Paid Family Leave (PFL) on the 8th day of your leave. Please complete the “Payroll Notification Form” to authorize PTO/ESL and return to Martha Salcedo, in Employee Health via fax or email. • Apply for Paid Family Leave (PFL) online www.edd.ca.gov or via paper application, please ask EHD, benefits can be paid up to 8 weeks of leave (approximately 60-70% of your income)
Benefits During Your Leave
While on a paid leave, your share of insurance premiums will continue to be deducted from your paycheck. • Once your PTO/ESL benefits have been paid out and exhausted and you no longer receive a paycheck from the hospital, you are considered to be on an unpaid leave. You will be required to pay your share of the insurance premiums directly to SARH in order to keep your coverages in effect during your unpaid leave. • The maximum time that your share of premiums will continue at active rates is six (6) months. If your leave continues beyond six (6) months, your share of premiums will be increased to COBRA premium level by the start of the 7th month. • The Benefits Department will mail you communication regarding your benefits.
For further information, please go to sarhconnection.org
Martha Salcedo, Senior LOA/Work Comp Specialist at 909-920-4713 or email msalcedo@sarh.org
Karen Long, LOA/Work Comp Specialist at 909-920-6814 or email klong@sarh.org
Payroll Department 909-920-4881