Our GuidanceResources platform fully integrates EAP, behavioral health, wellness and absence management services. 1-866-4-USWAGE The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. (1-866-487-9243), U.S. Department of Labor San Diego, CA 92101, 619-557-5110 Employees who have been denied compensation under the CT Paid Leave Insurance Program, or any person who has been assessed a penalty by the CT Paid Leave Authority, may file an appeal with the Connecticut Department of Labor (CTDOL) Appeals Division. P: 800.872.1414 (US, Canada, Puerto Rico, Bermuda, US Virgin Islands) P: 609.986.1234 (All other countries - collect calls accepted) Send a Message. 1001 Executive Center Drive, #103 Atlanta, GA 30303, (678) 237-0521 (1-866-487-9243), U.S. Department of Labor B-7 Tabonuco St If your employer denies the privileges guaranteed to you under the Family and Medical Leave Act (FMLA), you may be able to file a claim for . Suite 10058 .manual-search-block #edit-actions--2 {order:2;} 1-866-4-USWAGE Written Correspondence: The Hartford, c/o EthicsPoint P.O. An official website of the United States government. If you work in Northern Virginia, see Baltimore District Office. (1-866-487-9243), U.S. Department of Labor ]]>*/, Americans with Disabilities Act (ADA) General information, Americans with Disabilities Act (ADA) Federal contracting, Black Lung Benefits Act (Title IV of the Mine Act), Board of Alien Labor Certification Appeals, Bureau of International Labor Affairs (ILAB), Economic Dislocation and Worker Adjustment Assistance Act (EDWAA), Employees' Compensation Appeals Board (ECAB), Employee Retirement Income Security Act (ERISA) (EBSA), Federal Contract Compliance Programs (OFCCP), Federal Employees Compensation Act (FECA), Federal Mine Safety and Health Act (the Mine Act), Fraud, Waste, and Abuse (1-800-347-3756) (OIG), Hotline to Report Fraud, Waste, and Abuse in DOL Programs, Job Openings at the U.S. Department of Labor, Labor Management Relations Act (LMRA, or Taft-Hartley Act), Labor Management Reporting and Disclosure Act (LMRDA), Labor Relations Recordkeeping and Reporting, Mine Safety and Health Administration (MSHA), Occupational Safety and Health Administration (OSHA), Office of Administrative Law Judges (OALJ), Office of Disability Employment Policy (ODEP), Office of Federal Contract Compliance Programs (OFCCP), Office of Labor-Management Standards (OLMS), Office of Small and Disadvantaged Business Utilization (OSDBU), Office of Trade Agreement Implementation (ILAB), Office of Workers' Compensation Programs (OWCP), Rehabilitation Act of 1973 (Section 503) General information, Rehabilitation Act of 1973 (Section 503) Federal contracting, Rehabilitation Act of 1973 (Section 504) General information, Rehabilitation Act of 1973 (Section 504) Federal contracting, Safety and Health Regulations Inspections/Citations/Penalties, Safety and Health Regulations Recordkeeping, Statistics Collective Bargaining Agreements, Statistics Personal Consumption Expenditures, Uniformed Services Employment and Reemployment Rights Act (USERRA), Union Reports (LM-1, LM-2, LM-3, and LM-4) (OLMS), Veterans' Employment and Training Service (VETS), Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), Whistleblower Protection Safety and Health, Worker Adjustment and Retraining Notification Act (WARN), Workers Compensation Longshore and Harbor Workers, Workforce Investment and Opportunity Act (WIOA), 200 Constitution AveNW CTDOL Leave complaints are filed below after January 15th. Submit claims, check status of disability or leave, and see payments. 1-866-4-USWAGE (1-866-487-9243), U.S. Department of Labor Suite 5710 1-866-4-USWAGE White Plains, NY 10601, 914-682-6348 @media (max-width: 992px){.usa-js-mobile-nav--active, .usa-mobile_nav-active {overflow: auto!important;}} Wage and Hour Division #views-exposed-form-manual-cloud-search-manual-cloud-search-results .form-actions{display:block;flex:1;} #tfa-entry-form .form-actions {justify-content:flex-start;} #node-agency-pages-layout-builder-form .form-actions {display:block;} #tfa-entry-form input {height:55px;} 1-866-4-USWAGE ]]>*/, Some offices may have limited hours for in-person visits, please contact your local office to learn more. 202-693-0103. The .gov means its official. 1-866-4-USWAGE Oklahoma City, OK 73102, 405-231-4158 135 North Pennsylvania Street, Suite 700 Susan Spivak BernsteinSenior Vice President Shreveport, LA 71101, 318-676-4025 An employee is entitled to be reinstated to the employees same position or, if the same position is no longer available, to an equivalent position upon returning from CTFMLA leave. By outsourcing your Absence Management program with us, your employees will have access to robust digital tools to start and manage their claim with ease: The Hartford Financial Services Group, Inc., (NYSE: HIG) operates through its subsidiaries, including underwriting companies Hartford Life and Accident Insurance Company and Hartford Fire Insurance Company, under the brand name, The Hartford, Employee Benefits Help Give You the Power to Prevail, Review Status Updates & Receive Text Alerts. Hartford Fmla Forms Pdf Paid Family and Medical Leave (PFML) programs can vary depending on location. Northeast Area HRSSC FMLA NORTHEAST PO Box 970901 Greensboro NC 27497-0901 . 230 S. Dearborn Street Suite 304 At The Hartford, we've spent nearly 20 years perfecting an Absence Management experience that helps simplify administration while supporting your employees and improving your workplace practices and programs. We can help you get the right coverage with an online quote. (1-866-487-9243), 1 Church St Wage and Hour Division Wage and Hour Division #views-exposed-form-manual-cloud-search-manual-cloud-search-results .form-actions{display:block;flex:1;} #tfa-entry-form .form-actions {justify-content:flex-start;} #node-agency-pages-layout-builder-form .form-actions {display:block;} #tfa-entry-form input {height:55px;} .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} 1-866-4-USWAGE Note: An employee can request this leave for a family member only after the employee has entered the FMLA disability status on a certified medical certificate with his/her supervisor. Long Term and FMLA claims . You can watch ourInformational webinarand review ourPowerPointslideshow for more detailed information about the Connecticut Family & Medical Leave Act. @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} 1-866-4-USWAGE Birth of a child and care for the child within the first year after birth; The placement of a child for adoption or foster care and care for the child; Care for a family member with a serious health condition; Because of an employees own serious health condition; To serve as an organ or bone marrow donor; To address qualifying exigencies arising from a spouse, son, daughter or parents active-duty service in the armed forces; and. .manual-search-block #edit-actions--2 {order:2;} 10810 Executive Center Dr U.S. Department of Labor Workers who have been denied paid leave may file anappeal, regular Plan work coverage. .manual-search ul.usa-list li {max-width:100%;} Donations to Hartford HealthCare are managed by the Hartford Hospital Department of Philanthropy, a Connecticut tax-exempt organization under section 501(c)(3) of the IRS code (E.I.N. .agency-blurb-container .agency_blurb.background--light { padding: 0; } Please check your spelling or try another term. (1-866-487-9243), 770 The City Drive S Orlando, Florida 32803, (407) 648-6471 1-866-4-USWAGE We sent a one-time security code to {#maskedTwoFactorEmail}. (1-866-487-9243), 60 E South Temple St Phoenix, AZ 85003-1725, 602-514-7100 Learn more. West Palm Beach, FL 33401, (561) 640-0474 (1-866-487-9243), U.S. Department of Labor Note: All requests for Family and Medical Leave for a child or for adult dependents must be made within three (3) years of leaving the employee's employment. .usa-footer .grid-container {padding-left: 30px!important;} In addition, youll need to plan for the impact on your budget and the rest of your workforce. (1-866-487-9243). If no handbook or written leave materials exist, the employer must distribute this general notice to new employees upon hire. 395 W Spruce Ave (1-866-487-9243), U.S. Department of Labor 721 19th Street, Suite 114 5700 Crooks Road An agency within the U.S. Department of Labor, 200 Constitution Ave NW .manual-search ul.usa-list li {max-width:100%;} San Antonio, TX 78216, 210-308-4515 If you add or remove an attorney or representative, please notify us immediately at DOL.CTFMLA@ct.gov or (860) 263-6400 to ensure timely receipt of all communications, which may have time-sensitive deadlines. 1-866-4-USWAGE (1-866-487-9243), U.S. Department of Labor Wage and Hour Division Wage and Hour Division Mar 2016 - Dec 20204 years 10 months. Other Points of Contact Media Inquiries: Communications Director, Jesse.Imse@ct.gov (860) 604-7497 John.McKay@ct.gov (860) 713-5197 Links to: Freedom of Information requests Employee Search Agency Directory. Last 4 digits of Social Security #: Relation to Employee: Child Parent Employee #: Relation to Employee: Spouse Age: Enter the range of numbers between 13 and 25 to indicate the age of the family member. 26 Federal Plaza Employers may use Form WH-382, which is available at no cost from the WHD website at www.dol.gov/agencies/whd/fmla, to provide this designation notice. Room 607 . #block-googletagmanagerheader .field { padding-bottom:0 !important; } Telephone: (860) 263-6970 Fax: (860) 706-5767. If you do not have internet access or need assistance filing an appeal, please contact the CTDOL Appeals Division at 38 Wolcott Hill Road, Wethersfield, CT 06109. .manual-search ul.usa-list li {max-width:100%;} The site is secure. Phone Number; Fair Labor Standards Act (FLSA) 1-866-487-9243* Family Medical and Leave Act (FMLA) 202-693-0066. At this time, there are no federal or state laws that require an employer to pay an employee for an absence due to COVID. 600 Dr. Martin Luther King Jr. Place (1-866-487-9243), U.S. Department of Labor Clovis, CA 93611, 559-487-5317 Portland, OR 97205, 503-326-3057 Contact us Problems? 1-866-4-USWAGE Suite 112 Employer Identification Number: Employee #: Relation to Employee: Employee name is not part of the Employer's identification number. HRSSC FMLA CAPITAL METRO PO Box 970903 Greensboro NC . (1-866-487-9243), 710 Locust St 100 S Clinton St 1-866-4-USWAGE 1-866-4-USWAGE 606 N Carancahua St Special rules apply to employees of local education agencies. According to EEOC statistics, the average cost of defending an FMLA lawsuit is $78,000. This publication is for general information and is not to be considered in the same light as official statements of position contained in the regulations. Room 7M10 700 Ygnacio Valley Road 300 Fannin Street Room 525 1-866-4-USWAGE If you work in Clark or Spokanecounty, see Portland District Office. 1-866-4-USWAGE 1-866-4-USWAGE Prior to January 15th, file your complainthere. /*-->*/. F. Edward Hebert Building Birmingham, AL 35203-3711, 205-536-8570 1-866-4-USWAGE Las Vegas, NV 89101, (702) 388-6001 Wage and Hour Division (1-866-487-9243), U.S. Department of Labor For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Wage and Hour Division For a sick/disability absence involving more than seven calendar days, employees must call Hartford, our STD insurance carrier, at (866) 548-3101. Tampa, FL 33607, (813) 288-1242 (1-866-487-9243), U.S. Department of Labor FMLA Poster Wage and Hour Division (1-866-487-9243), U.S. Department of Labor St. Louis, MO 63103-2830, (314) 539-2706 Columbia, SC 29201-9863, 803-765-5981 The CT Paid Leave Authority provides Connecticut's workforce access to paid family and medical leave benefits . Law360 interviewed Mederic Daigneault for its article, "Carlton Fields Adds Financial Regulatory Pro in Hartford."The article discusses Med, a financial regulatory veteran with over 20 years' experience, joining Carlton Fields as a shareholder in the Hartford office. /*-->*/. Massachusetts. 11A Clinton Ave @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} You are about to be logged out due to inactivity. Wage and Hour Division FMLA FMLA Medical Certificate FAQs-Full Time Employees FAQs-Part Time Employees OSHA Retiree Resources SEC-1 (Workplace Violence Incident Report Form) Workers Compensation. 903 San Jacinto Blvd Room 423 Tucson, AZ 85001-1390, 520-449-8450 Guaynabo, PR 00968, 787-775-1947 Washington, DC 202101-866-4-US-WAGE1-866-487-9243, Administrator Interpretations, Opinion and Ruling Letters, Resources for State and Local Governments. Covered employers must provide employees with certain critical notices about the FMLA. (1-866-487-9243), U.S. Department of Labor 1-866-4-USWAGE Wage and Hour Division And if you're found guilty of wrongful termination, damages can range from $87,500 to $450,000. English: 1-877-238-4373 for Paid Family Leave Claim and General Information. Have multiple employers? Your ill or injured employee's first point of contact is with a nurse who conducts an in-depth interview to capture a comprehensive understanding of their medical . 1-866-4-USWAGE Wage and Hour Division 215 Dean A McGee Ave The employee must have worked for their covered employer for at least one year to be eligible to apply for FMLA. p.usa-alert__text {margin-bottom:0!important;} PO Box 7245 Before sharing sensitive information, make sure youre on a federal government site. (1-866-487-9243), U.S. Department of Labor US Department of Labor Serving Kern, Santa Barbara, San Luis, Obispo, and Ventura counties and portions of Los Angeles county: U.S. Department of Labor Computershare Call the Wage and Hour Division's toll-free help line: 1-866-4-USWAGE (1-866-487-9243) Monday to Friday 8:00 a.m. to 4:30 p.m. local time. Federal government websites often end in .gov or .mil. 1-866-4-USWAGE (1-866-487-9243), U.S. Department of Labor Supported 800 number incoming call volume as well as internal customers . Whether an employee has worked the minimum 1,250 hours of service is determined according to FLSA principles for determining compensable hours or work. U.S. Cincinnati, OH 45202, 513-684-2908 Tallahassee, FL 32303, (850) 942-8341 If the employee requests leave for a different qualifying reason in the same leave year and the employees eligibility status has changed, the employer must notify the employee of the change in eligibility status within five business days. Comments and Help with hartford fmla application Age of Family Members (if applicable): Enter one: Number of Family Members (if applicable): Enter the range of numbers and the numbers should be between 1 and 4 if possible. to work and should be uploaded in LeavePro or your healthcare provider can fax to HR Leave Administration via the fax number on the form. Always login to the portal from this page or the log in page linked above. Jackson, MS 39269. Although the Department of Labor makes every effort to provide quality information, it makes no claims, promises or guarantees about the accuracy or completeness of the information contained herein. If you work in South Dakota, see Denver Colorado District Office. Courthouse B-58 You can also contact us by email by visiting WHD online at https://webapps.dol.gov/contactwhd. 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