FMLA / Family Care Leave (FCL) / Absence Reporting Guidelines
Please Note – As of February 1, 2020, VZ has changed the administrator for FMLA & Leave of Absence to Sedgewick. Sedgewick is also the Short Term Disability administrator.
1) Absence Notification- Day One Through Day Seven (for FMLA)
Call your immediate supervisor or absence administrator, as applicable for your workgroup. Please make this call prior to the start of your scheduled work time to let them know you will not be at work due to illness or injury.
Provide the following information when you call:
Whether your absence is a new absence or is related to a previously approved intermittent certification. (Note: Please provide the FMLA certification start date if there are multiple certifications.)
Sedgewick will be notified of your absence by your supervisor. A letter to either confirm or deny your administrative eligibility for FMLA (worked 1250 hours in the previous 12 months) will be put in the mail to your home address within two (2) business days. You will receive an FMLA Medical Certification form which will be barcoded to provide faster claim review. Discard any prior FMLA forms. All FMLA paperwork will come from Sedgewick. It is imperative that you send the completed forms to Sedgewick within 25 days of the 1st day of your absence.
Guidelines for Filing FMLA Forms
- Have your health care provider complete the FMLA forms. The completed forms must be received by Sedgewick within 25 days of the 1st day of absence.
- If Sedgewick determines your forms are incomplete, and you are within the 25 day period to submit the forms, Sedgewick will return the forms to you with the incomplete sections highlighted and instructions for what needs to be completed. The corrected forms must be received by the Sedgewick within 25 days of the 1st day of absence.
- If forms are incomplete and 25 day period has expired, Sedgewick will return the forms and send a denial letter with instructions for requesting an Administrative Review.
- You will have 14 days from the date of the denial letter to request an administrative review. All corrections must be initialed and dated by your healthcare provider. The corrected forms AND A WRITTEN REQUEST FOR ADMINISTRATIVE REVIEW must be received by Sedgewick within 14 days of the date of the denial letter.
Advocate for yourself – call Sedgewick (800) 638-4228 to verify your forms were received.
2) Absences Beyond Seven Calendar Days (for Short Term Disability – STD)
Call the VZ Short Term Disability vendor Sedgewick at (800) 638-4228 on or before the 8th calendar day if your illness or injury continues for more than seven calendar days (or, you suffer a relapse within 14 calendar days of returning from a previous disability absence). This call should be made on or before the eighth calendar day of your absence. If your absence is a relapse within 14 calendar days of a previous disability, you need to call Sedgewick immediately. If you do not call Sedgewick there may be a delay in your pay.
Please be sure YOU do the following:
You must stay in constant contact with the Sedgewick case manager. The best way to do this is to call Sedgewick at (800) 638-4228 and request a call back from your case manager. The case manager must return call within 2 hours if you call before 3 PM.
Questions to ask:
1 week prior to the expiration of Sedgewick approval, contact case manager and ask for detailed info that your doctor needs to provide to extend your short term disability claim.
You must ask your doctor to provide all the requested info to Sedgewick.
If possible fax the forms to Sedgewick (859-264-4384) yourself and get a confirmation sheet that has the phone number of the fax you sent it from. If not, make sure you get the fax number from your doctor’s office. Call Sedgewick to verify they received all of the faxes. By giving the fax number to the Sedgewick case manager it enables verification of receipt of your fax.
Short Term Disability (STD) situations to be aware of:
- If you return to work from a short term disability absence, and you go back out sick/injured within 2 weeks of returning to work, you must call Sedgewick, as this is considered a continuation of the STD absence.
- If you return to work from a short term disability absence, you must remain working a minimum of 13 weeks before the STD clock resets.
YOU NEED TO BE AN ADVOCATE FOR SEDGEWICK AND YOUR DOCTOR
For assistance please contact the IBEW Benefits Coordinator at 800-320-0778