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The County provides a Leave of Absence program that eligible employees may utilize foreseen and unforeseen events preventing an employee from coming to work for a designated period of time. There are many provisions involved with a Leave of Absence depending on the type of leave (paid or unpaid), the employee’s collective bargaining unit and legislation such as the Family Medical Leave Act (FMLA) and California Family Rights Act (CFRA) of 1991.

link dblArrowAbsence Management Program Handbook AcrobatReader
link dblArrowLeave of Absence Payroll Instructions Form AcrobatReader
link dblArrowLeave of Absence Request/Extension of Leave RequestAcrobatReader
link dblArrow2017 Coverage PeriodsAcrobatReader
link dblArrow2018-2019 Coverage PeriodsAcrobatReader
link dblArrowFEHC Certification of Health Care Provider (non-pregnancy disability leave) AcrobatReader
link dblArrowCertification of Health Care Provider for Pregnancy Disability Leave, Transfer, and/or Reasonable Accommodation AcrobatReader
link dblArrowAttending Physician Statement For Return To Work From Leave Of Absence AcrobatReader
link dblArrowMilitary Service Notification & Request for Military Leave Pay AcrobatReader
link dblArrowWaiver of Disability Benefits AcrobatReader
link dblArrowPregnancy Disability & Bonding Leave Checklist AcrobatReader

For questions regarding Leave of Absence, please contact:
Lula Trimble Absence Management Analyst - A-L Phone: 654-2780
Lula.Trimble@ventura.org Fax: 654-2665
Ophelia Rojo Absence Management Analyst - M-Z Phone: 654-3636
Ophelia.Rojo@ventura.org Fax: 654-2665

Long Term Disability

link dblArrow LTD Packet Instructions AcrobatReader
link dblArrow LTD Claim Form Employee Statement AcrobatReader
link dblArrow LTD Claim Form Physician Statement  AcrobatReader
link dblArrow Certificate of Insurance - Class 1 AcrobatReader
link dblArrow Certificate of Insurance - Class 2 AcrobatReader
link dblArrow Certificate of Insurance - Classes 3,4,5 AcrobatReader

For questions regarding Long-Term Disability, please contact:
Sara Long Disability Coordinator Phone: 654-2627
Sara.Long@ventura.org Fax: 654-2665

Wage Supplement Program

Employees are only eligible to enroll in the Wage Supplement Plan within the first 90 days of employment.

link dblArrow Enrollment Form/Brochure AcrobatReader

link dblArrow Claim Form AcrobatReader

For questions regarding Wage Supplement Plan, please contact:
Ophelia Rojo Disability Coordinator Phone: 654-3636
Ophelia.Rojo@ventura.org Fax: 654-2665

CEO Human Resources/Benefits
County of Ventura
800 South Victoria Ave #1970
Ventura, CA 93009
Phone: (805) 654-2570
Fax: (805) 654-2665
Benefits.ServiceRep@ventura.org

 

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