Work Leave and Accommodations

Below you will find information on:


 

Family and Medical Leave Act (FMLA)

The Family and Medical Leave Act (FMLA) covers leave for your absence from work due to your own care or to care of an eligible family member or loved one under state and/or federal law. Refer to your employer for details on your organization’s policies on timing for requesting FMLA.

Continuous: For example, you are absent from work for more than 3 consecutive days (e.g. 10 days in a row).

Intermittent: for example, chronic flare-ups of a condition result in several absences from work over the course of a month.  You will need to provide details of the episodes related to your condition.

Recertification: If you need either of the above leave types recertified or renewed please contact the Release of Information department to initiate your request.

Complete the following:

Intake form to initiate your FMLA request.
— Authorization must be provided on the intake form in order to release records to anyone other than you, the patient. If the authorization is not signed, the completed form will be sent to the patient.
— IF you are also submitting a disability request, follow instructions and complete all fields on the intake form for both FMLA and short-term or long-term disability, as applicable to you request.
— IF you are also submitting a disability form, please enter the claim number on the intake form.

Forms submitted with incomplete information will significantly delay processing of your request.

For the fastest service, scan your completed form(s), attach to an email and send to nw.roi@kp.org

Or you can:
Mail: Release of Information
Kaiser Permanente HIM
10220 SE Sunnyside Road
Clackamas, OR 97015

If your employer requires a Return to Work release click here for information on how to obtain that release.

If any of the above requests need to be modified after they have already been approved, please contact your clinical team to have your work status updated.

 

Short-term Disability (STD) and Long-term Disability (LTD)

Short-term and long-term disability coverage protect employees when they are off the job for a period of time due to illness or injury. Some employers may require you to apply for FMLA at the same time as STD or LTD (please consult your employer for details). These plans pay you a portion of your income for a short period, which is defined by your disability plan. Benefits are provided through your employer, and Kaiser Permanente supports authorization of these benefits. Please refer to your employer for additional details.

Complete the following:

— Submit the form provided to you by your disability carrier,
— INCLUDE a completed Intake form to initiate your STD/LTD request.
— Authorization must be provided on the intake form in order to release records to anyone other than you, the patient. If the authorization is not signed, the completed form will be sent to you, the patient.
— Be sure to enter the disability claim number on the Intake form.
— IF you are also submitting a FMLA request, follow instructions and complete all fields on the intake form for both FMLA and STD/LTD as applicable for your request.

Forms submitted with incomplete information will significantly delay processing of your request.

For the fastest service, scan your completed form(s), attach to an email, and send to nw.roi@kp.org

Or you can:
Mail: Release of Information
Kaiser Permanente
10220 SE Sunnyside Road Clackamas, OR 97015

If you your employer requires a Return to Work release click here to information on how to obtain that release.

If any of the above requests need to be modified after they have already been approved, please contact your clinical team to have your work status updated.

 

Work Accommodations

Under the Americans with Disabilities Act (ADA) employers are required to provide reasonable accommodations to qualified employees with disabilities, unless doing so would pose an undue hardship.

A reasonable accommodation is defined as assistance or changes to a position or workplace that will enable an employee to do his or her job despite having a disability.

If you require an accommodation, please complete the following steps:

— Contact your employer, who will either provide a document for your clinical team to complete or direct you on next steps.

— If you are given a form by your employer, use kp.org to email your clinical team or call them (obtain their phone number via kp.org or by calling 503-813-2000 or 800-813-2000) for further instructions.

  • In some cases, you may need to schedule an appointment.

Do not send these forms to the Release of Information department as that will delay your request.

 

Return to Work release

If you are on leave for a continuous period of time (Example FMLA, STD, LTD) you may need medical clearance from your Clinician before you return to work. If you require a release to return to work, please complete the following steps:

Use kp.org to email your clinical team or call them (obtain their phone number via kp.org or by calling 503-813-2000 or 800-813-2000) for further instructions.
— In some cases, you may need to schedule an appointment.
— If a visit is required or already scheduled, please request from your Clinician a Return to Work note.

  • In this Work Status report, your Clinician may specify any potential limitations you may require during your transition to regular duties.

— The documentation for Return to Work is provided by your treating clinician. You will need to make arrangements with your Clinician’s office to obtain this return to work release. Return to Work information cannot be sent directly to your employer by your clinical team.¬† You are¬†responsible for providing your release to your employer.

Do not send these forms to the Release of Information department as that will delay your request.

 

Paid Family and Medical Leave (Washington)

— Members who work in Washington state may qualify for the new Paid Family and Medical Leave (PFML) Program.

— To apply for this benefit, upload an electronic (PDF) copy of your Kaiser FMLA medical certification form to the Washington State online portal. No other form is required.

— To receive a PDF version of your FMLA form, request this at the time you apply for FMLA.

— If you are not requesting FMLA protection but wish to claim benefits under the PFML program, follow the same process as for requesting medical certification for FMLA.

 

Still have questions?
Click here to contact the Release of Information department for additional assistance.