Common use of Application for and Approval of Job Incurred Disability Leave Without Pay Clause in Contracts

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to receive job incurred disability leave without pay an eligible worker must submit a request on the prescribed form to his/her department head describing the illness or accident and all information required for the department head to evaluate the request. The worker must attach a statement from a physician certifying as to the nature, extent, and probable period of illness of disability.

Appears in 6 contracts

Samples: Memorandum of Understanding, Memorandum of Understanding, Memorandum of Understanding

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Application for and Approval of Job Incurred Disability Leave Without Pay. In order to receive job incurred disability leave without pay an eligible worker employee must submit a request on the prescribed form to his/her department head describing the illness or accident and all information required for the department head to evaluate the request. The worker employee must attach to the request a statement from a physician certifying as to the nature, extent, and probable period of illness of disability.

Appears in 5 contracts

Samples: Memorandum of Understanding, Memorandum of Understanding, Memorandum of Understanding (Mou)

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to receive job incurred disability leave without pay pay, an eligible worker unit member must submit a request on the prescribed form to his/her department head the appointing authority describing the illness or accident and all information required for the department head appointing authority to evaluate the request. The worker unit member must attach to the request a statement from a physician certifying as to the nature, extent, extent and probable period of illness of or disability.

Appears in 4 contracts

Samples: Memorandum of Understanding, Memorandum of Understanding, Memorandum of Understanding

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to To receive job incurred disability leave without pay an eligible worker employee must submit a request on the prescribed form to his/her department head the appointing authority describing the illness or accident and all information required for the department head appointing authority to evaluate the request. The worker employee must attach a physician's statement from a physician certifying as to the nature, extent, extent and probable period of illness of or disability.

Appears in 4 contracts

Samples: Memorandum of Understanding, Memorandum of Understanding, Memorandum of Understanding

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to To receive job incurred disability leave without pay an eligible worker employee must submit a request on the prescribed form to his/her their department head describing the illness or accident and all information required for the department head to evaluate the request. The worker must attach a request with an attached physician's statement from a physician certifying as to the nature, extent, extent and probable period of illness of or disability.

Appears in 4 contracts

Samples: Memorandum of Understanding, Memorandum of Understanding, Memorandum of Understanding

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to receive job incurred disability leave without pay an eligible worker nurse must submit a request on the prescribed form to his/her the department head describing the illness or accident and all information required for the department head to evaluate the request. The worker nurse must attach a statement from a physician certifying as to the nature, extent, extent and probable period of illness of or disability.

Appears in 3 contracts

Samples: Memorandum of Understanding, Memorandum of Understanding, Memorandum of Understanding

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to receive job incurred disability leave without pay an eligible worker employee must submit a request on the prescribed form to his/her department head the appointing authority describing the illness or accident and all information required for the department head appointing authority to evaluate the request. The worker employee must attach a physician's statement from a physician certifying as to the nature, extent, and probable period of illness of or disability.

Appears in 3 contracts

Samples: Memorandum of Understanding, Memorandum of Understanding, Memorandum of Understanding

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Application for and Approval of Job Incurred Disability Leave Without Pay. In order to receive job incurred disability leave without pay an eligible worker employee must submit a request on the prescribed form to his/her their department head describing the illness or accident and all information required for the department head to evaluate the request. The worker employee must attach to the request a statement from a physician certifying as to the nature, extent, and probable period of illness of disability.

Appears in 1 contract

Samples: Memorandum of Understanding

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to To receive job incurred disability leave without pay an eligible worker employee must submit a request on the prescribed form to his/her department head describing the illness or accident and all information required for the department head to evaluate the request. The worker employee must attach to the request a statement from a physician certifying as to the nature, extent, extent and probable period of illness of or disability.

Appears in 1 contract

Samples: Memorandum of Understanding

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to receive job incurred disability leave without pay an eligible worker employee must submit a request on the prescribed form to his/her their department head describing the illness or accident and all information required for the department head to evaluate the request. The worker employee must attach a statement from a physician certifying as to the nature, extent, and probable period of illness of disability.

Appears in 1 contract

Samples: Memorandum of Understanding

Application for and Approval of Job Incurred Disability Leave Without Pay. In order to receive job incurred disability leave without pay an eligible worker employee must submit a request on the prescribed form to his/her department head describing the illness or accident and all information required for the department head to evaluate the request. The worker employee must attach to the request a statement from a physician certifying as to the nature, extent, extent and probable period of illness of or disability.

Appears in 1 contract

Samples: Memorandum of Understanding

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