DCH Health System
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Employee Checklist for Managing Leave
  • Request leave with your manager and the Leave Management Representative as soon as the need for leave is known or may be necessary (at least 30 days prior to the start of leave). NOTE:  Intermittent Leave is not processed until the first day of missed work. Your request for leave will be processed and required documentation will be mailed to you.
  • Be familiar and follow the call-in attendance policies in your area. Call your manager each time you miss work. Failure to follow this step of the policy and procedure will cause your absence to be coded as an incidence of absence and may result in disciplinary action and/or separation from employment.
  • Maintain open communication with your manager to ensure our organization is staffed appropriately to provide the care and services that our patients and communities expect and deserves
  • Carefully review all documents received related to your leave request. Hint:  Keep a file with all your Leave information.
  • For FMLA, return the completed Certification of Health Care Provider form (provided in your packet) within 15 days from your request for leave (it’s the date on your Conditional Letter). Ensure completion and delivery of the form to your Leave Management Representative within the required time frame.  Failure to return the forms may result in your leave being denied. Follow the approved Certification specifications to incidence of  absence per the DCH Attendance Policy.
  • For Military Leave, complete a Military Leave Request Form, to access click here along with a copy of your military orders.
  • Contact the Leave Management Representative  to discuss your return to work as soon as a date is known. Obtain a release to return to work from your healthcare provider.
  • All employees on a continuous medical leave for their own illness must be cleared through Employee Health before returning to work. Bring your written “Return to Work” medical release, which must specify “no restrictions” or give specific guidelines and timeframes for any restrictions listed, with you to Employee Health. If you are on intermittent Leave and miss more than 3 consecutive work days, your leave will become continuous, and you will need a doctor’s note to return to work.
  • Ensure your licensure (if applicable) is current before returning to work.
  • Be prepared to pay any missed benefit premiums; once you return to work and start receiving a DCH paycheck, any missed premiums will be deducted from your paychecks until all premium payments have been collected. 



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