№ files_lp_4_process_1_37476
Structured form for employees to request catastrophic leave and document eligibility, approvals, and anticipated leave details.
Year: 2022
Institution: University of Wisconsin-Madison
Department: Office of Human Resources – Workforce Relations
Document Type: Form
Policy: Catastrophic Leave Policy
Target Audience: Faculty, Academic Staff, University Staff, Limited Appointments
Purpose: Requesting extended unpaid leave due to catastrophic illness or injury
Eligibility Criteria: Exhausted all paid leave, not receiving other salary replacement income, sufficient medical documentation provided
Approval Authorities: Divisional Disability Representative, HR Office, Supervisor, Dean/Director/Designee
Date of Issue: October 2022
Sections: Recipient Information, Leave Details, Salary Replacement Income, Signatures, Payroll Office Use
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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