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EMPLOYEE COMPLETE the FOLLOWING Top of This Page Only 2015-2026

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Of page 2. FAX COPIES CANNOT BE ACCEPTED. HEALTH CARE PROVIDER COMPLETE THE FOLLOWING including PAGE 2 The Genetic Information Nondiscrimination Act of 2008 Title II GINA prohibits employers and other entities covered by GINA from requesting genetic information of an individual or family member except as specifically allowed by this law. A In-patient Hospitalized Care B Serious Incapacity causing Absence of more than 3 consecutive days Two Treatments C Incapacity causing Absence due to...

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Understanding the 8239 Form

The 8239 form, often referred to as the LAUSD Form 8239, is primarily utilized by employees within the Los Angeles Unified School District (LAUSD) to request leave under the Family and Medical Leave Act (FMLA). This form is essential for those needing to take time off for medical reasons or to care for family members. Understanding its purpose is crucial for employees who may need to navigate their leave options effectively.

Steps to Complete the 8239 Form

Completing the 8239 form involves several key steps to ensure all necessary information is accurately provided. Here’s a simple breakdown:

  • Begin by filling out your personal information at the top of the form, including your name, employee ID, and contact details.
  • Indicate the type of leave you are requesting, specifying whether it is for your own medical condition or to care for a family member.
  • Provide the dates for your requested leave, including the start and end dates.
  • Attach any required documentation, such as medical certifications, to support your leave request.
  • Review the completed form for accuracy before submitting it to your supervisor or HR department.

Legal Use of the 8239 Form

The 8239 form is legally recognized under the Family and Medical Leave Act (FMLA), which entitles eligible employees to take unpaid leave for specific family and medical reasons. It is crucial for employees to understand their rights under this law, including the protection against job loss during their leave. Properly completing and submitting the form ensures compliance with FMLA regulations and protects both the employee's rights and the employer's responsibilities.

Who Issues the 8239 Form?

The 8239 form is issued by the Los Angeles Unified School District (LAUSD). It is specifically designed for use by employees within this district, ensuring that the leave request process aligns with district policies and federal regulations. Employees should always obtain the most current version of the form directly from the LAUSD human resources department or its official website.

Required Documents for the 8239 Form

When submitting the 8239 form, certain documents may be required to validate the leave request. These typically include:

  • Medical certification from a healthcare provider, detailing the nature of the medical condition.
  • Any additional documentation that may support the leave request, such as proof of family relationship if caring for a family member.
  • Previous leave records, if applicable, to provide context for the current request.

Form Submission Methods

The 8239 form can be submitted through various methods, depending on the policies of the LAUSD. Common submission methods include:

  • Online submission through the district's employee portal, if available.
  • Mailing the completed form to the human resources department.
  • In-person submission at designated HR offices within the district.

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CA LAUSD/HR 8239 20154.8 Satisfied (175 Votes)
CA LAUSD/HR 8239 20064.8 Satisfied (938 Votes)
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