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A hiring department may only require a PEM examination or make a medical inquiry of a job applicant after a bona fide conditional employment offer has been made and prior to the commencement of employment duties.
Have the employee's health care provider complete this medical certification as needed. This form is used for employee's taking leave under the Family and Medical Leave Act (FMLA) and California Family Rights Act (CFRA) for their own serious health condition or that of a family member.
To find publications, please visit our Publications page. Your personnel office can provide paper copies of many of these forms. Please note: Some forms can't be filled out on your computer. You'll need to print them and fill them out by hand. Forms that can be filled out on your computer generally can't be saved.
The employee has requested leave under the Federal and/or California family and medical leave statutes for his or her own serious health condition. Thank you for your assistance.
The purpose of this section is to provide guidance, information and resources available on how to handle situations where an employee is no longer able to perform the duties of his/her position and it is suspected that this inability is due to a medical condition.
• If supervisor doubts whether employee’s condition is related to employment, he/she should so indicate on Form CA-16. • When there is no time to complete Form CA-16, supervisor may authorize medical treatment by telephone and send completed form to medical facility within 48 hours.
California State employees are eligible for several types of time off, including the leave benefits below. Consult your supervisor or personnel office for details. Review the applicable Memorandum of Understanding (MOU) for rank-and-file employees.
