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common forms ALL FORMS Benefits Enrollment/Change Form (FT/PT) CBSA DCRA Claim Form Disability Self-Identification - Employees Disability Self-Identification - Students EBDS Claim Form FMLA Leave Application ID Cards for Family Members Request New SRA Salary Reduction Agreement Performance Improvement Plan Performance Review Form Position Description Guidelines SRA Online Student Certification/Verification TIAA-CREF GRA Enrollment Application TIAA-CREF GSRA Enrollment Application Tuition Benefits for Children Application Tuition Benefits for Staff Application Vanguard Enrollment/Change Form Workers' Comp Supervisor Injury Report

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  Benefits Information & Guidelines
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• Benefits - Work/Life Benefits
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  • Paid Time Off & Holidays
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Leaves of Absence

There are many reasons for an employee being absent from work. Carnegie Mellon has many different types of leaves to help people accommodate their needs. The eligibility requirements, levels of compensation and benefits available during the various forms of leave differ.

Types of Leave

• Disability Leave (Short-Term and Long-Term)
• Workers' Compensation (for work-related illnesses and injury)
• Family and Medical Leave
• Personal Leave
• Military Leave
• Jury Duty Leave
• Bereavement Leave
• Faculty Professional Leave
• Faculty Parental Leave

Note: Maternity leave after the birth of a child is covered concurrently under Short Term Disability and FMLA for staff, or as a Faculty Parental Leave for faculty.

Check the Using Your Leave Benefits to Balance Your Work and Family chart to see which leave is most appropriate for your situation and the Leaves of Absence Chart to see the requirements, benefits and compensation afforded under each kind of leave.

Disability Leaves (Short Term and Long Term)

If you are/will be absent from work in excess of seven (7) consecutive calendar days due to a non-occupational illness or injury or childbirth, you may be eligible for Short-Term Disability, administered through MetLife. In order to receive benefits, you must report your STD claim by calling the MetLife Disability Claims Center using the Disability Telephone Reporting Procedure (.pdf):

• US-based employees should call 1-800-858-6506.
• Those working in an international (non-US) location should call 315-738-3215

	Short-Term Disability	Long-Term Disability
Who is Eligible?	Full-time benefits-eligible employees	Full-time benefits-eligible employees. A one-year waiting period is applied, which may be reduced by previous LTD coverage.
How Enroll	Automatic.	Basic plan - automatic. Enhanced - enroll during Open Enrollment, at initial benefits-eligibility, or upon a status change.
Benefit	60% of pay.	60% of pay. (Cost of living adjustments of 5% per year for up to 10 years are provided under the Enhanced LTD plan.)
Duration of Benefit	Injuries or illnesses resulting in disability lasting up to 25 weeks.	Injuries or illnesses resulting in continuous disability of at least 6 months up to the maximum duration of benefit (up to age 65 if less than age 60 when disability began; reduced if age is 60 or higher.
Conditions covered	Non-work related illnesses and injuries, including pregnancy and childbirth (runs concurrently with FMLA). See the STD Frequently Asked Questions.	Illnesses and injuries resulting in disability of more than 6 months. LTD benefits are generally a continuance of an STD-covered condition.

• Work-related illnesses or injuries should be handled through Workers' Compensation rather than STD.
• If the absence is also covered under the Family and Medical Leave Act policy, FMLA leave will run concurrently with the STD leave.
• Members of Local 95 should view information about the Sick and Accident Program, rather than the STD program. MetLife administers the short-term Sick and Accident policy, while Jefferson Pilot Financial administers their long-term program. See the Local 95 Benefits page for more information.
• Once you have exhausted your STD benefits, MetLife will automatically contact you to determine your eligibility for continuation of benefits through the Long Term Disability program.

Family and Medical Leave (FMLA)

Staff Handbook - Family and Medical Leave Information

Under the Family and Medical Leave Act (FMLA), Carnegie Mellon provides eligible employees up to 12 weeks of unpaid, job-protected leave for certain family and medical reasons (up to 26 weeks to care for a military servicemember injured in the line of duty). Employees who have worked at least 1,250 hours in the previous 12 months are eligible for FMLA coverage. Some qualifying reasons for taking an FMLA leave include: caring for a newly born or adopted child, caring for yourself or a family member experiencing a serious injury or illness, caring for a member of the military injured in the line of duty, or exigency arising out of a family member being called to active duty. See the Department of Labor's FMLA page at http://www.dol.gov/esa/regs/statutes/whd/fmla.htm for more information.

Staff members wishing to apply for a leave under this policy should complete an Application and Medical Certification Form. If possible, the form should be completed and submitted to the immediate supervisor who will forward it to Benefits thirty days in advance of the effective date of the leave. When unforeseen events occur that require a leave under this policy, staff members should provide this notice as soon as possible.

To apply for FMLA leave:

1. Complete the Application for Family and Medical Leave of Absence form (.pdf)
   1. If you are taking the leave to care for your own medical condition, complete the Medical Certification form (.pdf)
   2. If you are taking the leave to care for a seriously ill family member, complete the Physicians Certification form (.pdf)
2. Give the materials to your manager at least 30 days before the leave is to begin (for anticipated absences).
3. Your manager should then return the materials to the Benefits Office.
4. Inform your manager of your intended date of return to work.

Faculty are covered under a separate Faculty Parental Leave Policy upon the birth or adoption of a child.

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Related forms:

• Application for Family and Medical Leave of Absence form (.pdf)
• Physicians Certification form (.pdf) - when caring for a seriously ill family member
• Medical Certification form (.pdf) - when requesting time for one's own medical condition
• Return To Work Certification Form (.pdf)

For more information:

• Staff Handbook - FMLA Detailed Information
• FMLA Information sheet for Staff and Faculty (.doc)
• FMLA Information sheet for employees represented by Local 95 (.doc)
• Short-Term Disability Telephone Reporting Procedure (.pdf) - for faculty and staff
• Sick & Accident Program Telephone Reporting Procedure (.pdf) - for Local 95 Union Employees
• Short-Term Disability Frequently Asked Questions (.pdf) - Answers to the most common questions about the benefit and STD procedures for faculty and staff .
• Sick & Accident Program Frequently Asked Questions (.pdf) - Answers to the most common questions about the benefit and STD procedures for Local 95 Union Employees.

© Carnegie Mellon Human Resources 2004