FMLA Info & Short-Term Disability Forms


On February 1, 2020, VZ changed the FMLA and Leave of Absence administrator to Sedgwick.
Sedgwick already administers Verizon’s disability claims.


For open FMLA claims filed through January 31, 2020: 

  • Effective February 1, submit paperwork to Sedgwick; prior to this follow the current process 
  • The current fax number will be offline effective February 1, 2020
  • Claims will be automatically transferred to Sedgwick 
  • Sedgwick will send you a letter outlining any actions you might need to take 


For new FMLA claims beginning February 1, 2020

  • Requirements for initiating an FMLA claim remain the same, beginning with a call-out to your supervisor or absence administrator 
  • New FMLA forms will come from Sedgwick upon claim initiation and will be barcoded to provide faster claim review. Discard any prior FMLA forms. 
  • Use the new fax number for supporting FMLA documents: (859) 264-4384 


Short Term Disability Forms (for any absence more than 7 calendar days)

You will need to bring to your doctor:

Sedgewick Attending Physicians Statement (for accident/illness)


Sedgewick Attending Physicians Statement (for Behavioral Health Services)



Sedgewick Short Term Disability Authorization to Disclose Medical Info