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SCJBJI::C`I"'; F'AM:ILY MEDICAL LEAVE ACT IN) PAGE 3 ~, , p? <br />PAGE 8 nF 19 <br />vacation, and/or other leave during your FMLA absence. 'T'his <br />means that you will receive your paid leave and the leave will <br />also be considered protected F'MLA leave and taunted aclainst youx: <br />FMI.,A levave entitlement. <br />Due to your status within Cass County, you are considered a "key <br />employee" as defined in the FMLA. As a "key employee" <br />restoration to employment may be denied following FMLA leave aza <br />the rlrounds that such restoration will cause substantial arzd <br />grievous economic injury to us. We have/ have not <br />determined that restoring you to emplayznent at the conclusion <br />of FMLA leave will cause substantial and grievous economic harm <br />to gas . <br />While an leave you will be required to fuxnish us with per.iadir. <br />reports of your status and intent to return to wank every <br />(indicate ,interval of periodic re,orts, _as approprxate far the <br />particular leave sa.tuation). <br />If the circumstances of your leave change, and you are able to return to <br />work. earlier than the date indicated on this form, you will be required <br />to notify ua at least two workdays prior to the date you intend to <br />report for work. <br />If your leave does qualify as FMLA leave, you will have the fa7.lowi.ng <br />rights while on FMLA leave; <br />• You have a right under the FM[".~A .for u <br />in a 1~-month period calculated as <br />measured backward from the date. of any <br />+ You have a >.:ight under the FM1.,A far u <br />in a single I2-month period to cars <br />with a serious injux:y or illness. <br />cotnmenced on <br />• Your health benefits must be maintained during any period of <br />unpaid leave under the same Conditions as if you Continued to <br />work. <br />• You must be reinstated to the same or an equivalent job with the: <br />same pay, benefits, and terms and conditions of employment on youx <br />return from FMLA-protected leave. tIf your leave extends beyond <br />thc~ end of your FMLA entitlement, you do not have return right:; <br />under FMLA.) <br />• If yo~.a do not return to wank following E'MLA leave far a reason <br />other than: I.) The continuation, recurrence or onset of a <br />serious health Condition. which would entitle you to FM:LA leave; ~') <br />the continuation, recurrence, ar• onset of a Caverer~ <br />serv.icernemt~er's serious injury or illness which would entitle you <br />FMLA Leave; or 3) other circumstances beyond year control, you may <br />p to 1.'. weeks of i.z.npaid Leave <br />a "rolling„ 12.-rrzonth period <br />FMLA leave usage. <br />p t:o 26 wee{cs of unpaid leave: <br />for a covered servicemembex: <br />This single I~-month. period <br />