Application to Use Sick Leave Bank. A member of his/her designee must complete the Brimfield C.U.S.D. #309 Catastrophic Sick Leave Bank Application for leave and submit it to the Superintendent. Application must be accompanied by the Brimfield C.U.S.D. #309 Catastrophic Sick Leave Bank Physician’s Statement from a licensed health care provider. Requests should indicate the estimated number of sick days required and information related to any pending disability claims.
Application to Use Sick Leave Bank. A member or his/her designee must complete the Elmwood C.U.S.D. #322 Catastrophic Sick Leave Bank Application for leave and submit it to the Superintendent. Applications must be accompanied by the Elmwood C.U.S.D. #322 Catastrophic Sick Leave Bank Physician’s Statement from a licensed health care provider that includes the beginning date of the condition, a description of the illness or injury, and a prognosis for recovery. Requests should indicate the estimated number of sick days required and information related to any pending disability claims.
Application to Use Sick Leave Bank. Only current members may apply for sick/catastrophic leave days. Members can only request days from the Bank for use after all of his/her accrued sick/personal/vacation days have been used, but should apply for days from the Bank in a reasonable period of time before their use is needed if possible. A member or his/her designee must complete the Catastrophic Sick Leave Bank Application for leave and submit it to the Committee. The Committee may request a physician's statement from a licensed health care provider indicating the estimated number of sick days required and information related to any pending disability claims. Only one request will be considered per incident or illness, even if the incident/illness spans more than one year. Only one request may be made per twelve month period, which begins on the day of any leave approved under a prior request.
Application to Use Sick Leave Bank. Per Section 6.1.4 of the Negotiated Agreement between the Ashland County Board of Developmental Disabilities and the Ashland County Developmental Disabilities Education Association, each bargaining unit and management member of the Sick Leave Bank may apply and be awarded a maximum of twenty (20) sick days if he/she meets the Committee’s qualifications for eligibility. Once eligibility is determined and after the initial twenty (20) days are awarded, the employee may apply to the Bank for an additional (15) days if unable to return to work. Date of Request: Employee Name: Dates Requested: Start Date: End Date: Must provide a medical statement from a licensed physician with application. Employee Signature Date Date Application Received: Application Received By: Sick Leave Bank Committee: Employee a Member of the Bank: Yes No Medical Verification Provided: Yes No Approved/Disapproved: Approved/Disapproved: Approved/Disapproved: Approved/Disapproved: Reason for Disapproval: 1/1/2023 APPENDIX C
