Conn. Agencies Regs. § 31-51rr-40 - Certification for leave taken because of a qualifying exigency (29 CFR Section 825.309)
(a)
Active
Duty Orders. The first time an employee requests leave because of a
qualifying exigency arising out of the covered active duty or call to covered
active duty status or notification of an impending call or order to covered
active duty of a military member, an employer may require the employee to
provide a copy of the military member's active duty orders or other
documentation issued by the military which indicates that the military member
is on covered active duty or call to covered active duty status, and the dates
of the military member's covered active duty service. This information need
only be provided to the employer once. A copy of new active duty orders or
other documentation issued by the military may be required by the employer if
the need for leave because of a qualifying exigency arises out of a different
covered active duty or call to covered active duty status or notification of an
impending call or order to covered active duty of the same or a different
military member;
(b)
Required
information. An employer may require that leave for any qualifying
exigency specified in section
31-51rr-13 of the Regulations of
Connecticut State Agencies be supported by a certification from the employee
that sets forth the following information:
(1) A statement or description, signed by the
employee, of appropriate facts regarding the qualifying exigency for which FMLA
leave is requested. The facts shall be sufficient to support the need for
leave. Such facts shall include information on the type of qualifying exigency
for which leave is requested and any available written documentation which
supports the request for leave; such documentation, for example, may include a
copy of a meeting announcement for informational briefings sponsored by the
military, a document confirming an appointment with a counselor or school
official, or a copy of a bill for services for the handling of legal or
financial affairs;
(2) The
approximate date on which the qualifying exigency commenced or will
commence;
(3) If an employee
requests leave because of a qualifying exigency for a single, continuous period
of time, the beginning and end dates for such absence;
(4) If an employee requests leave because of
a qualifying exigency on an intermittent or reduced schedule basis, an estimate
of the frequency and duration of the qualifying exigency;
(5) If the qualifying exigency involves
meeting with a third party, appropriate contact information for the individual
or entity with whom the employee is meeting (such as the name, title,
organization, address, telephone number, fax number, and email address) and a
brief description of the purpose of the meeting; and
(6) If the qualifying exigency involves
Rest and Recuperation leave, a copy of the military member's
rest and recuperation orders, or other documentation issued by the military
which indicates that the military member has been granted rest and recuperation
leave, and the dates of the military member's rest and recuperation
leave.
(c) The United
States Department of Labor has developed an optional form (Form WH-384) for
employees' use in obtaining a certification that meets FMLA's certification
requirements. (The employer may use the form referenced in Appendix A). This
optional form reflects certification requirements so as to permit the employee
to furnish appropriate information to support his or her request for leave
because of a qualifying exigency. Form WH-384, or another form containing the
same basic information, may be used by the employer; however, no information
may be required beyond that specified in this section.
(d)
Verification. If an employee
submits a complete and sufficient certification to support his or her request
for leave because of a qualifying exigency, the employer may not request
additional information from the employee. However, if the qualifying exigency
involves meeting with a third party, the employer may contact the individual or
entity with whom the employee is meeting for purposes of verifying a meeting or
appointment schedule and the nature of the meeting between the employee and the
specified individual or entity. The employee's permission is not required in
order to verify meetings or appointments with third parties, but no additional
information may be requested by the employer. An employer also may contact an
appropriate unit of the Department of Defense to request verification that a
military member is on covered active duty or call to covered active duty status
or has been notified of an impending call or order to covered active duty; no
additional information may be requested and the employee's permission is not
required.
Notes
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