Houston Fire Department Unscheduled Leaves and Absences (PDF)

HOUSTON FIRE DEPARTMENT SUBJECT: UNSCHEDULED LEAVES AND ABSENCES VOLUME NO. I ALL COMMANDS REFERENCE NO. I-22 (B) SECTIONS 1.00-6.08K / APPENDIX B 1.0...

HOUSTON FIRE DEPARTMENT SUBJECT: UNSCHEDULED LEAVES AND ABSENCES VOLUME NO. I ALL COMMANDS REFERENCE NO. I-22 (B) SECTIONS 1.00-6.08K / APPENDIX B 1.00 PURPOSE 1.01 To ensure compliance with The Family and Medical Leave Act (FMLA) which entitles employees to take job-protected leave to receive care for an employee’s own, or provide care for an employee’s specific family member’s, serious health condition. 1.02 To establish a policy to allow employees to utilize sick leave in accordance with the City of Houston Code of Ordinances, Chapter 14, Article III et seq. and all relevant federal and state laws. 1.03 To establish the process of managing the return of employees to productive work through a temporary medical assignment while recovering from a short or long-term non- occupational injury or illness. 1.04 To provide wage replacement and medical benefits to employees injured during the course and scope of employment. 2.00 OBJECTIVES 2.01 To define clear expectations and guidelines for when an employee requests leave, or an absence related to: A. Emergency Leave B. FMLA C. Funeral Leave D. Resignation/Retirement E. Severe Weather F. Sick Leave G. Temporary Medical Condition H. Workability 2.02 To establish procedures for members requesting Family and Medical Leave. 2.03 To distinguish the management and control of the misuse of sick leave. 2.04 To establish guidelines for temporary duty assignments if the employee is unable to perform regularly assigned duties due to a non-occupational illness, injury, disease, or other medical condition. 2.05 To establish procedures to assist recovering employees while recovering from injuries that occurred in the course and scope of employment. 3.00 DEFINITIONS 3.01 Absence Without Leave: Absences or tardiness without proper notification shall be considered as an AWOL and the offender shall be disciplined accordingly. 3.02 Act (The Act): The Texas Workers’ Compensation Act as it exists or may be amended hereafter and otherwise found in Title 5, Subtitle A, Chapter 401 et al, Texas Labor Code. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 1 of 30 3.03 Assessment Meeting: A meeting to discuss an employee’s medical status, as it relates to his/her ability to perform essential job functions, based on the medical questionnaire and evaluation provided by the treating physician. 3.04 Benefit Year: The 12-month period beginning September 1st and ending August 31st. 3.05 Bona Fide Offer of Employment: A written offer of a transitional duty assignment that abides by requirements set by TDI that contains work restrictions given by the approved City of Houston and TDI medical provider. 3.06 Calendar Year: The period beginning on January 1st and ending December 31st of each year. 3.07 Continuing Treatment: A period of incapacity of more than three (3) consecutive full calendar days combined with at least two visits to a health-care provider or one visit and a regimen of continuing treatments, or incapacity due to pregnancy, or incapacity due to a condition that is chronic, permanent, long-term, or requiring multiple-treatments. 3.08 Covered Active Duty: The duty of a member of the regular or the reserve component of the Armed Forces of the United States (U.S. Armed Forces) during deployment to a foreign country or order to active duty. 3.09 Covered Servicemember: A current member of the U.S. Armed Forces, including a member of the National Guard or Reserves, who: A. Incurs a serious injury or illness in the line of active duty that may render the servicemember medically unfit to perform his/her duties for which the servicemember is undergoing medical treatment, recuperation, or therapy for the serious injury or illness; B. Is in outpatient status; C. Is on the temporary disability-retired list; D. Is a veteran who was discharged within five years of the date on which the veteran undergoes the medical treatment, recuperation, or therapy. 3.10 Covered Servicemember Leave: Leave made available to eligible employees who are the spouse, son, daughter, parent, or next of kin of the service member; employees may take up to twenty-six (26) weeks of leave to care for a covered servicemember during a single 12-month benefit year. 3.11 Disabling Occupational Injury: An illness or injury occurring in the course and scope of employment which prevents the employee from returning to regularly assigned duties on the next scheduled workday following the date of the injury or thereafter. Lost time is recorded beginning on the next scheduled workday. 3.12 Eligible Employees: Any employee who has worked for the City for at least one year and who has been physically at work at least 1,250 hours during the previous twelve- month period, as determined from the date the proposed leave is to begin. 3.13 Emergency Leave: Leave granted by the Fire Chief or designee at his/her discretion, to allow employees to attend personal matters of an emergency nature without the requisite advance notice. 3.14 Employee: All individuals engaged in the performance of duties for, or on behalf of, the City of Houston, whether hired, appointed, full time, part time, temporary or permanent including classified as well as non-classified employees. 3.15 Employee Relations: An employee assigned to HFD Human Resources General Relations who is responsible for administration of the Temporary Medical Condition (Non-Occupational Injury) section of the guidelines. 3.16 Family Member: Spouse, child or step-child, or parent or step-parent of the employee. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 2 of 30 3.17 FMLA Coordinator: An employee assigned to HFD Human Resources Shared Services who is responsible for notifying employees of their FMLA eligibility status, rights and responsibilities for FMLA Leave, and the designation and processing of FMLA leave in accordance with City of Houston A.P. No. 3-2. 3.18 FMLA Increments of Leave: Approved leave may be taken in periods of whole weeks, single days, or hours. 3.19 FMLA Leave: Paid or unpaid leave for eligible employees that may be taken under certain conditions. 3.20 Form 48: The HFD form used for health care provider verification of an employee’s bona fide non-occupational illness, disease, or injury or wellness care appointment. To be considered valid the Form 48 must: A. Have Sections 1 and 2 completed (if for employee’s family member’s condition); B. Have Sections 1, 2 and 3 completed (if for employee’s own condition); C. Cover all dates of absence; D. Be signed by a health care provider as defined in Appendix A; E. Be submitted within ten (10) calendar days (excluding the initial date of requested leave) and every thirty (30) calendar days thereafter for the duration of the bona fide non-occupational illness, disease, or injury. 3.21 Full Duty: The position with all essential functions required to be performed by an employee on a full-time basis. 3.22 Health Care Provider: A Doctor of Medicine or Osteopathy who is authorized to practice medicine or surgery by the state in which the doctor practices, or any other person determined by the Secretary of Labor to be capable of providing health-care services. (See Appendix A) 3.23 Immediate Family: Includes the father or father-in-law, mother or mother-in-law, sister, brother, spouse, child or step-child, grandparent and grandchild. 3.24 Injured Leave: Leave authorized by Section 14-226 of the Code of Ordinances and accorded to a recovering employee who sustains an injury or illness in the course and scope of his/her employment. 3.25 Injury: The damage or harm to the physical and/or neurological structure of the body and those diseases, conditions, or infections naturally resulting from damage or harm. The term also includes occupational illness that is a bodily injury or health impairment resulting from exposure to conditions of the recovering employee’s physical environment and/or work area. 3.26 Maximum Medical Improvement (“MMI”): The earliest date after which, based on reasonable medical probability, further material recovery from or lasting improvement to an injury can no longer reasonably be anticipated; or the expiration of 104 weeks from the date on which income benefits begin to accrue. 3.27 Medical Advisor: A qualified, licensed physician retained by the City to perform medical reviews, assessments, evaluations of recovering employees for placement in transitional duty assignments, and other duties as requested by the Director of HR. 3.28 Medical Questionnaire: A document used to query a treating physician, psychiatrist, or psychologist regarding the medical status of a recovering employee as it relates to the performance of essential job functions. 3.29 Medical Separation: Non-punitive, non-disciplinary process of removing a recovering employee from the position of employment with the City pursuant to Section 14-185 of the Code of Ordinances or Section 143.1115 of the Texas Local Government Code. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 3 of 30 3.30 Military Family Leave: Leave made available to eligible employees with a spouse, son, daughter, or parent on active duty or call to active duty status in the U.S. Armed Forces, National Guard or Reserves in support of a contingency operation; employees may use the 12-week leave entitlement to address certain qualifying exigencies. 3.31 Non-Disabling Occupational Injury: An illness or injury occurring in the course and scope of employment from which the employee, although receiving medical treatment, is not prevented from returning to the full performance of his/her regularly assigned job or duties on the next scheduled workday. 3.32 Non-Occupational Injury: An illness or injury not occurring in the course and scope of employment with the City of Houston which prevents an employee from returning to full duty on his/her next scheduled workday. 3.33 Occurrence: An unscheduled absence, excluding VACU and AWOL, of one duty shift or any portion thereof (based on an employee’s assignment) during a 12-month period beginning with the date of the initial unscheduled absence. 3.34 Overpayment: Any payment of salary continuation, accrued leave balances, City funds or benefits which, when added to workers’ compensation benefits paid, results in the recovering employee being paid more than the established salary continuation percent of the recovering employee’s regularly paid wage/salary with longevity and/or a payment of benefits or City funds for which the recovering employee was either not eligible or paid in error. 3.35 Parent: A biological mother or father, or an individual who stood in loco parentis to an employee when the employee was a child. The term does not include a parent-in-law. 3.36 Personal Leave: Hours of leave with pay granted to eligible employees based on sick leave usage (SICK, SFAM, FMLS) during the previous benefit year. 3.37 Place of Recovery: One of the locations described below, at which an employee shall reside and be available for contact on his/her assigned workday while on sick and/or injured leave. A. The address and telephone number listed in departmental records, including the electronic member profile; B. The hospital at which the employee is confined; C. Any other temporary address specifically approved by the employee’s supervisor. 3.38 Qualifying Exigencies: The attending of certain military events, arranging for alternative childcare, addressing certain financial and legal arrangements, attending certain counseling sessions, or attending post-deployment reintegration briefings. 3.39 Recovering Employee: An employee who suffered an on-the-job injury in the course and scope of his/her employment while furthering the affairs of the City of Houston. There are two classifications of service workers within the City: municipal and classified. Classified employees are defined by Chapter 143 of the Texas Local Government Code. 3.40 Return-to-Work Drug Test: An employee in a safety impact position must successfully pass a controlled substance test, by receiving a negative test result, before assuming the duties of a safety impact position, when the employee has not worked in more than thirty (30) consecutive calendar days. 3.41 Risk Management Office: An office located within the HFD Human Resources Department that is responsible for administration of the Work Ability (Occupational Injury) section of the guidelines. 3.42 Salary Continuation: The sum of money, before withholdings and deductions, paid by City funds in conjunction with indemnity benefits to recovering employees who meet the salary-continuation program requirements. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 4 of 30 3.43 Serious Health Condition: An illness, injury, impairment, or physical or mental condition that involves an overnight stay in a medical care facility or continuing treatment by a health-care provider. 3.44 Sick Leave: Time off authorized at the discretion of the Fire Chief or his/her designee, for an employee’s own bona fide illness, disease, or off-duty injury or to allow the employee to consult with or receive testing or treatment of the bona fide illness, disease or off-duty injury (SICK). Sick leave shall also mean time off authorized at the discretion of the Fire Chief or his/her designee to care for a family member due to the family member’s bona fide illness, disease, or injury (SFAM). 3.45 Sick Leave Coordinator: An employee assigned to the HFD Human Resources Division who maintains all submitted Form 48’s and manages the department’s sick dock program in accordance with City of Houston A.P. No. 3-11. 3.46 Sick/Injured Liaison: An employee assigned to the HFD Emergency Response Division who coordinates the placement of sick or injured employees, who have been released to restricted duty by their treating physician, into available transitional duty or temporary medical assignments. The Sick/Injured Liaison also serves as the point of contact for employees who have not been released to work in any capacity, or whose medical restrictions cannot be accommodated in any available transitional duty or temporary duty assignment, and have been transferred to calling-in daily. 3.47 Son or Daughter: A biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person standing in loco parentis, who is under age 18; or who is age 18 or older and incapable of self-care because of a mental or physical disability. 3.48 Spouse: A husband or a wife as defined or recognized under state law. The State of Texas recognizes a common law marriage but does not recognize a domestic partnership. 3.49 Temporary Medical Assignment: A temporary duty location to allow an employee with a temporary medical condition who has been released to work with medical restrictions, the opportunity to work within those restrictions while recovering from an injury/illness that occurred outside the course and scope of employment. 3.50 Temporary Medical Condition (TMC): A non-occupational bona fide illness, injury, disease, or other medical condition. 3.51 Texas Department of Insurance (TDI): The Division of Workers’ Compensation that oversees the administration and operation of the Texas workers’ compensation system by monitoring compliance and taking enforcement action when necessary, to ensure laws and other regulations regarding workers’ compensation are implemented and enforced. 3.52 Texas Workers’ Compensation Work Status Report (DWC073 Form): A medical report summary completed by the occupationally injured employee’s treating physician that describes the employee’s injury, medical treatment, work status for possible return to work, and work restrictions. 3.53 Third Party Administrators (TPA): Independent administrator contracted by the City to be responsible for the adjudication of workers’ compensation claims including payments to recovering employees and health care providers in compliance with the law. 3.54 Transitional Duty Assignment: A work assignment allowing a recovering employee with restrictions, from an occupational injury, to return to gainful employment with the goal of returning to full duty. 3.55 Transitional Duty Letter: A document used to query a treating physician regarding the recovering employee’s ability to return to gainful employment. 3.56 Treating Physician: An individual, group or facility authorized by the City and TDI to direct the medical treatment of a recovering employee. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 5 of 30 3.57 Unscheduled Absence: Any leave, including but not limited to sick leave (SICK), sick family (SFAM), emergency leave (VACU), or vacation or holiday in lieu of sick leave (VLIEU or HLIEU), requested without advance notice as required by the department. 3.58 Vacation and/or Holiday In Lieu of Sick Leave: Accrued vacation and/or holiday balances used to compensate an employee on authorized Sick Leave for a non- occupational injury, illness, disease, or other medical condition after all sick leave has been exhausted (VLIEU or HLIEU). 3.59 Veteran: A person who served in the active U. S. military, naval, or air service, and who was discharged or released under conditions other than dishonorable. 3.60 Workability Referral Program (WRP): Administered by the Selection Services Division of HR, WRP coordinates and refers recovering employees for interviews and consideration of vacant City positions for permanent placement in jobs for which a recovering employee may qualify by experience and education, and allow for his/her medical restrictions, but with no guarantee of appointment or placement. 4.00 SCOPE 4.01 This policy applies to all full-time employees in the classified or unclassified service of the Houston Fire Department. 5.00 RESPONSIBILITIES 5.01 All responsibilities are outlined within the context of this guideline. 5.02 All areas that identify District Chief responsibilities or notification requirements shall also mean a supervisor of equivalent rank for an employee’s assigned work location where a District Chief is not assigned. 6.00 GUIDELINES 6.01 Emergency Leave: A. Requesting emergency leave: 1. An employee requesting this leave shall contact his/her immediate supervisor at or before his/her scheduled report time, by telephone or in person, and shall: a. State the reason or event necessitating the leave; b. Request the approximate duration of leave needed to manage the emergency and report to work; c. When the duration is initially unknown, the employee will provide an updated request by contacting his/her immediate supervisor if the duration is expected to exceed 12 hours; d. Update his/her supervisor once the emergency is managed and provide an estimated time the employee will arrive at his/her work location; e. Report to work as soon as possible after the emergency is managed. 2. The immediate supervisor shall notify the District Chief: a. Of the employee’s initial request for this leave; b. All information provided by the employee relating to the request; c. Any updates received from the employee; d. The time the employee arrived at the designated work location. B. Approving requests for emergency leave: I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 6 of 30  1. District Chief’s may approve up to twelve (12) hours of emergency leave and: a. Shall only approve leave for the time reasonably necessary to address the employee’s emergency and report to the designated work location; b. Shall enter the leave as unscheduled vacation, Code VACU, for purposes of timekeeping, not to exceed one (1) duty shift for employees assigned to a 24- hour shift; c. Shall submit the request by email to the Shift Commander for approval, if the employee initially requests more than twelve (12) hours of this leave, or it extends beyond twelve (12) hours. d. Shall submit an email to the Shift Commander if more than one (1) request for emergency leave is approved in the district on the same calendar day. 2. The Shift Commander, or equivalent supervisor, may approve requests for this leave beyond twelve (12) hours, not to exceed twenty-four (24) hours total. 3. The immediate supervisor will notify the employee if the request is approved. C. Denying requests for emergency leave: 1. The District Chief or Shift Commander/equivalent supervisor, based on the information received, may deny the request for emergency leave for the following reasons: a. Failure to provide sufficient information regarding the nature of the situation; b. Nature and/or justification given is not deemed an emergency; c. Request is for an employee’s or an employee’s family member’s illness or injury; d. Request is in conjunction with previously scheduled leave to enable the employee to be off the entire duty shift and the member has or will be scheduled a Step II, or greater, Attendance Review. 2. The immediate supervisor of the requesting employee shall be advised of the denial and shall notify the requesting employee of and who made the decision. 3. The employee shall be coded as AWOL until the employee arrives at the scheduled work location or until a substituting employee, approved by the employee’s immediate supervisor, arrives. 6.02 Family and Medical Leave Act (FMLA): A. Employees shall familiarize themselves with City of Houston A.P. No. 3-2, Family and Medical Leave. B. Department Responsibilities: 1. Each department shall post on its premises a notice explaining the FMLA’s provisions and providing information concerning the procedure for filing complaints with the Department of Labor (DOL) Wage and Hour Division. The notice shall be posted prominently where it can be readily seen by employees and applicants for employment. 2. Each department shall also include the notice in the employee handbook or written guidance to employees concerning employee benefits or leave rights, if such material exists, or distribute a copy of the general notice to each new employee upon hire. C. Maintenance of Health Benefits: 1. During any FMLA leave, the City shall maintain the employee's coverage under any group health plan on the same conditions as coverage would have been provided if the employee had been continuously employed during the entire leave period. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 7 of 30  2. If an employee fails to return to work after FMLA leave has been exhausted or expires, the City may recover from the employee the City's share of health plan premiums during the employee's unpaid FMLA leave, unless the employee's failure to return is due to one of the reasons identified in FMLA regulations. D. Eligible employees shall inform their supervisor and FMLA Coordinator of the need to take FMLA leave for up to 12 weeks (480 hours) of job-protected leave for the following qualifying reasons: 1. Incapacity due to pregnancy, prenatal medical care or child birth, limited to a single 12-month period. 2. Because of the birth, or to care for the employee's child after birth, or placement of a child with the employee for adoption or foster care, limited to a single 12- month period. 3. Care for the employee's spouse, son or daughter or parent, who has a serious health condition, during the benefit year. 4. A serious health condition that makes the employee unable to perform the employee's job, during the benefit year. 5. Military family leave, limited to a single 12-month period. E. Eligible employees shall inform their supervisor and FMLA Coordinator of the need to take FMLA leave for up to 26 weeks of leave for Covered Servicemember Leave. F. Employee Notice: 1. When an employee provides notice of the need for FMLA leave, the employee shall state a qualifying reason for the leave and satisfy the requirements for notice of foreseeable or unforeseeable leave, below. The employee does not need to expressly mention FMLA. 2. When an employee provides notice of the need for FMLA leave, the employee shall inform the FMLA Coordinator if the employee's spouse is also an employee of the City. 3. If an employee does not comply with usual notice and procedural requirements, and no unusual circumstances justify the failure to comply, FMLA leave may be delayed or denied. G. Foreseeable Leave: 1. An employee shall provide at least 30 calendar days advance notice to his/her immediate supervisor and the FMLA Coordinator before FMLA leave is to begin if the need for leave is foreseeable based upon: a. An expected birth; b. Placement for adoption or foster care; c. Planned medical treatment of the employee, a family member; or d. Planned medical treatment of a covered servicemember. 2. When planning medical treatment, the employee shall consult with the department and make a reasonable effort to schedule the treatment so as not to unduly disrupt the department's operations, subject to the approval of the health care provider. H. Unforeseeable Leave: 1. When the approximate timing of leave is not foreseeable, an employee shall provide notice to the FMLA Coordinator as soon as practicable under the facts and circumstances of the particular case, and within the time prescribed by the department's usual and customary notice requirements applicable to such leave. 2. When an employee requests to use Sick Leave, the immediate supervisor or supervisor receiving the notification shall: I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 8 of 30  a. Offer the employee FMLA and direct the employee to contact the FMLA Coordinator when appropriate; b. Document on the employee’s Form 42 that FMLA was offered – “FMLA YES”; c. If the employee requests FMLA, notify the employee’s District Chief. 3. For Military Family Leave due to a qualifying exigency, the employee shall provide notice as soon as practicable, regardless of how far in advance the leave is foreseeable. I. Eligibility Notice: 1. When an employee requests FMLA leave, or when the department acquires knowledge that an employee's leave may be for an FMLA qualifying reason, the FMLA Coordinator shall notify the employee of the employee's eligibility for FMLA leave. 2. If the employee is not eligible for FMLA leave, the notice shall state at least one reason why the employee is not eligible. 3. Absent extenuating circumstances, the FMLA Coordinator shall provide the eligibility notice within five (5) business days in writing. J. Certification of Leave: 1. The department shall require that an employee's FMLA leave be supported by certification. 2. The FMLA Coordinator shall give notice of a requirement for certification each time certification is required. 3. At the time the FMLA Coordinator requests certification, the FMLA Coordinator shall advise the employee of the consequences of failure to provide adequate certification. 4. Absent extenuating circumstances, the FMLA Coordinator shall request certification by providing the employee with a Family and Medical Leave (FMLA) packet: a. At the time the employee gives notice of the need for leave or within five (5) business days thereafter; b. Or in the case of unforeseen leave, within five (5) business days after the leave commences. 5. The employee shall provide the requested certification to the FMLA Coordinator within 15 calendar days after the department's request, unless it is not practicable to do so despite the employee's diligent, good faith efforts. 6. The FMLA Coordinator may request certification at a later date if the department has reason to question the appropriateness of the leave or its duration. 7. The FMLA Coordinator shall advise an employee if he/she finds a certification incomplete or insufficient and shall: a. State in writing the additional information necessary to make the certification complete and sufficient; b. Provide the employee 15 calendar days to submit the additional information. 8. If the employee fails to provide the FMLA Coordinator with a complete and sufficient certification or fails upon request to provide necessary information to make the certification complete and sufficient, the FMLA Coordinator may deny FMLA leave. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 9 of 30  K. Medical Certification of a Serious Health Condition: 1. When leave is taken for the serious health condition of an employee or of a family member, the FMLA Coordinator shall require the employee to obtain a medical certification from a health care provider. 2. An employee may choose to comply with the certification requirement by providing the department with an authorization, release, or waiver allowing the department to communicate directly with the health care provider. a. To make such contact, the department shall use a health care provider, a human-resources professional, a leave administrator, or a management official. b. The employee's direct supervisor shall not contact the employee's health care provider. L. Certification of Covered Servicemember Leave: 1. When an employee takes covered servicemember leave, the FMLA Coordinator shall require the employee to obtain certification completed by an authorized health care provider of the covered servicemember, and a confirmation of a covered family relationship to the seriously injured or ill covered servicemember. 2. The FMLA Coordinator shall accept as sufficient certification invitational travel orders or invitational travel authorizations issued to any family member to join an injured or ill servicemember at his or her bedside. 3. The FMLA Coordinator may seek authentication or clarification of the certification but may not seek a second opinion, third opinion, or recertification. M. Certification of Qualifying Exigency for Military Family Leave: 1. Eligible employees shall notify the FMLA Coordinator of the need for Military Family Leave for one or more of the following qualifying exigencies: a. To address any issues arising from the military member’s short-notice deployment. b. To make or update financial and legal arrangements arising from the military member’s covered active duty. c. To attend counseling for the employee, the military member, or the child of the military member. d. To attend military events and related activities. e. To spend up to fifteen (15) calendar days with a military member who is on Rest and Recuperation leave during covered active duty. f. To address certain childcare and related activities concerning the military member’s child that arise from the military member’s covered active duty. g. To attend post-deployment activities for up to 90 days following the termination of the military member’s covered active duty. h. To address certain activities related to the care of the military member’s parent who is incapable of self-care. i. Any other event that you and your employer agree is a qualifying exigency and agree to the timing and duration of the leave. 2. The first time an employee requests military family leave because of a qualifying exigency, the FMLA Coordinator shall require the employee to provide certification by providing a copy of the military member's covered active duty orders or other documentation issued by the military. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 10 of 30  3. This certification or other document must indicate that the military member is on covered active duty or call to active duty status in support of a contingency operation, and the dates of the military member's covered active duty service. N. Designation Notice: 1. When the FMLA Coordinator has sufficient information to determine whether leave is being taken for a FMLA qualifying reason, he/she shall notify the employee whether the leave will be designated as FMLA leave. 2. If the leave will not be designated as FMLA qualifying, the FMLA Coordinator shall notify the employee of that determination. 3. Absent extenuating circumstances, the FMLA Coordinator shall provide the designation notice within five (5) business days in writing. 4. The FMLA Coordinator may retroactively designate leave as FMLA leave with appropriate notice to the employee if the department's failure to timely designate leave does not cause harm or injury to the employee. 5. The department and an employee may agree that leave will be retroactively designated as FMLA leave. O. Authentication and Clarification: 1. If an employee submits a complete and sufficient certification signed by the health care provider, the FMLA Coordinator shall not request additional information from the health care provider; however, a. The department may contact the health care provider for purposes of clarification and authentication of the certification after the department has given the employee an opportunity to provide additional information as set forth above. i. To make such contact, the department shall use a health care provider, a human-resources professional, a leave administrator, or management official. ii. The employee's direct supervisor shall not contact the employee's health- care provider. P. Recertification: 1. The FMLA Coordinator shall not request recertification less than every thirty (30) calendar days unless the employee's condition changes. The employee must be allowed fifteen (15) calendar days to provide recertification. 2. As part of the recertification for leave taken because of a serious health condition, the department may provide the health care provider with a record of the employee's absence pattern and ask the health care provider if the serious health condition and need for leave is consistent with such a pattern. Q. Intent to Return to Work: 1. An employee on approved continuous FMLA leave shall update his/her immediate supervisor every two (2) weeks regarding his/her status and intent to return to work. 2. Prior to returning to duty, the employee shall contact his/her immediate supervisor and the FMLA Coordinator. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 11 of 30  R. Fitness for Duty Certification: 1. As a condition of restoring an employee who took FMLA leave, which was not on an intermittent or reduced schedule and was due to the employee's own serious health condition, the FMLA Coordinator shall require certification (FMLA Form J) from the employee's health care provider confirming that the employee is able to resume work, including the employee's ability to perform essential job functions. 2. An employee on FMLA Leave due to his/her own serious health condition, who is released to work with medical restrictions, shall request a work schedule and assignment from the Sick/Injured Liaison. S. Return-to-Work Drug Test: 1. An employee who has been absent for more than thirty (30) consecutive calendar days shall successfully pass a Return-to-Work Drug Test before working in a safety impact position. 2. The District Chief shall ensure an employee returning to duty (full or restricted) from FMLA leave has received and passed a Return-to-Work Drug Test, if applicable. T. Length and Duration of Leave: 1. Except in the case of covered servicemember leave, an eligible employee's FMLA leave is limited to a total of 12 workweeks (480 hours) during a benefit year for any one or more of the qualifying reasons. 2. Spouses who are employed by the City shall be limited to a combined total of 12 weeks of FMLA leave during the 12-month period if leave is taken for the birth of a son or daughter, the placement of a child for adoption or foster care, or to care for a parent with a serious health condition. U. Intermittent or Reduced Leave Schedule: 1. FMLA leave may be taken intermittently or on a reduced leave schedule under certain circumstances: a. Intermittent leave is FMLA leave taken in separate blocks of time in increments of whole weeks, single days, or hours, due to a single qualifying reason; b. A reduced leave schedule is a leave schedule that reduces an employee's usual number of working hours per workweek, or hours per workday. 2. A medical need for leave that can be best accommodated through an intermittent or reduced leave schedule must exist for such leave taken because of: a. The employee's own serious health condition; b. To care for a parent, son, or daughter with a serious health condition; c. Covered servicemember leave. 3. Military family leave due to a qualifying exigency may also be taken on an intermittent or reduced schedule basis. 4. When leave is taken after the birth of a healthy son or daughter or placement of a healthy child for adoption or foster care, an employee shall not take leave intermittently or on a reduced leave schedule for bonding purposes. V. Paid Leave Requirement: 1. The City requires the employee to use accrued paid leave for FMLA leave before using unpaid leave. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 12 of 30  a. The employee may choose the order in which type of paid accrued leave, consistent with the terms and conditions of the department's normal leave policy. b. If the employee chooses to use sick leave, it may only be used for the employees own serious health condition or for the care of the employee's spouse, son or daughter or parent, who has a serious health condition. 2. Wellness, Holiday, or Floating Holiday leave shall not be used for FMLA leave. 3. If a City approved holiday occurs during an employee's paid FMLA leave, the holiday is considered observed and that day's absence shall not be charged against the paid leave. 4. If a City approved holiday occurs during an employee’s unpaid FMLA leave: a. The holiday shall be without pay; however; b. For purposes of determining the amount of FMLA used by an employee when the day preceding and the day following the holiday are FMLA, the holiday is counted as a FMLA holiday in the week of FMLA leave. W. FMLA and Workers’ Compensation: 1. An absence covered by workers' compensation for an injury that also qualifies as a serious health condition for an eligible employee, shall also be counted as an FMLA absence. 2. Compensation for the absences covered by both workers' compensation and FMLA will be paid by workers' compensation benefits until such benefits are exhausted. Thereafter, the employee shall use accrued paid leave and then unpaid leave for the remaining period. 3. If the department offers a transitional duty assignment to the employee whose absence is covered by both workers' compensation and FMLA, and the employee refuses the offer, the employee may be denied further workers' compensation payments and salary continuation benefits; however, the employee remains on FMLA leave until the employee's FMLA leave is exhausted. X. Employee Restrictions: 1. Employees shall not work outside employment or overtime while on Family Medical Leave Sick (FMLS). Such activity shall be grounds for disciplinary action. 2. Family Medical Leave Sick (FMLS) hours will be used to determine an employee’s eligibility for Personal Leave. 6.03 Funeral Leave: A. Requesting funeral leave: 1. Members requesting funeral leave shall notify their immediate supervisor of their request as soon as reasonably possible and provide: a. The relationship of the member to the deceased; b. The anticipated length of funeral leave needed; c. Any extenuating circumstances (requires traveling out of state or country). B. Death of an employee’s immediate family member: 1. Up to three (3) calendar days (three 12-hour workdays for employees assigned to 24-hour shift) of approved paid leave may be granted to employees, code DFAM. 2. If requested by the employee, the Fire Chief or his/her designee may grant additional time for cases that involve extenuating circumstances or extreme travel distances. If additional time is granted, the employee’s accrued benefit leave shall be used (e.g. vacation or holiday time). I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 13 of 30  C. Requests for persons other than an immediate family member: 1. Funeral leave due to the death of a relative may be approved if, in the opinion of the Fire Chief or his/her designee, the employee’s presence would be appropriate given the nature of the individual relationship. 2. The Fire Chief or his/her designee may allow an employee to use accrued leave for funeral attendance in cases of the death of a co-worker, friend, associate, etc. 3. Employees shall make these requests with as much notice as possible. 6.04 Resignation/Retirement: A. An employee who decides to voluntarily leave the City’s employment for any reason shall notify his/her immediate supervisor of his/her intention to resign or retire. 1. The supervisor shall direct the employee to contact the Department’s Human Resources Management Office to schedule an appointment to complete all necessary forms. 2. Supervisors will collect all personnel records regarding the employee and forward to HFD HR. B. Any employee who voluntarily resigns shall forfeit any and all rights otherwise reserved under Civil Service statutes and is subject to re-employment only in the manner prescribed by the policies governing employment in effect at the time of rehire. C. Employees shall not “ride out” sick, vacation, or holiday leave, prior to resignation or retirement. 6.05 Severe Weather and Emergency Conditions: A. Per City of Houston A.P. No. 2-3, unless otherwise directed by the Mayor, all city employees are expected to be at work as scheduled regardless of weather conditions or other emergency situations. B. In cases of emergency, the Mayor may determine that some or all non-essential City services will be suspended, requiring the presence of only designated employees. If conditions are severe enough to suspend non-essential City services, a public announcement will be made by the Mayor on local radio and/or television stations and department directors will be notified. C. City employees should monitor the Houston radio and television stations for communications issued by the Mayor and their department to determine whether to report to work. Employees must contact their immediate supervisor if they have any questions or need clarification of their responsibilities. D. The authority to suspend non-essential City services and to direct or advise City employees not to report to their regular work location as a result of emergencies shall rest solely with the Mayor. Only the Mayor shall issue a proclamation directing City employees to work from their residence, as their temporary work location, during emergencies. E. The Fire Chief has the responsibility to designate employees as Tier I, Tier II, or Tier III employees and shall submit a report indicating such designations to the Office of Emergency Management (OEM) and the City HR Department on the first business day of May each year. 1. Tier I employees: a. Include all classified employees assigned to Emergency Response, or any other employee designated by the Fire Chief as Tier I. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 14 of 30  b. Presence at their assigned posts is mandatory at the appointed time(s) and for required duration(s). Employees may be assigned to their usual duty stations, other duty stations, or other locations as determined by Chief Officers. c. When advance warning exists, will be given city business (code CBUS) as required, to personally prepare for and prepare or evacuate others for whom they are responsible. These employees may not be free to perform these duties during or in the immediate aftermath of the emergency. After these preparations are complete, these employees shall report for duty. d. Are responsible for contacting their immediate supervisor or manager in their chain of command if they are physically prevented by circumstances beyond their control from reaching their assigned posts. These employees must follow instructions from their supervisor or manager. e. Failure to report and carry out assigned duties in the absence of prior approvals by their department directors or designees will result in disciplinary action up to and including indefinite suspension. 2. Tier II employees: a. Include all other classified employees not designated as Tier I and any non- classified employees designated as Tier II by the Fire Chief. b. When advance warning exists, will be allowed to leave work prior to the emergency, once released by an authorized supervisor, in order to personally prepare for and prepare or evacuate those for whom they are responsible. After such preparations are complete, Tier II employees shall be available for duty at the discretion of their chain of command. c. Must be prepared to report to work when and where directed, as instructed by their supervisor or other authorized departmental officials. d. Failure to report and carry out assigned duties in the absence of prior approvals by their department directors or designees will result in disciplinary action up to and including indefinite suspension. 3. Tier III employees: a. Include any non-classified employees of HFD not designated as Tier II by the Fire Chief. b. When advance warning exists, will be released by an authorized supervisor prior to the emergency, to prepare. c. Shall follow emergency instructions given by the civil authorities (including evacuation orders). d. Are subject to recall to duty (including those who may have evacuated the Houston area). These employees are required to remain available for recall, return to work as instructed, and remain at work until released from duty. e. Once the City’s Emergency Operations Center determines the emergency has subsided, all employees, unless otherwise directed by their supervisor, or other departmental official, must report to their regular scheduled work assignment and location. F. Reporting to Work: 1. While conditions may make it difficult for an employee to report in a timely manner to his/her regular work location, all employees must report to work as soon as possible. 2. An employee should exercise his/her best judgment regarding his/her individual situation, making every reasonable effort to report to work. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 15 of 30  3. In all cases, an employee shall notify his/her immediate supervisor as soon as possible of his/her situation and make every attempt to arrive at his/her designated work location. If conditions are such that the employee is unable to make it to the designated location, the employee shall try to arrive at the earliest possible opportunity: a. To a fire station within the assigned district; b. To a fire station closest to his/her assigned district; c. To any HFD fire station. 4. In situations where employees arrive to a work location other than their assigned station, they shall notify their immediate supervisor and report to the on-duty supervisor at that location. 5. If an employee has satisfied his/her supervisor that weather conditions or circumstances beyond his/her control have prevented him/her from reaching his/her scheduled work location, the employee’s District Chief may allow the employee to use accrued paid leave time. In no case shall sick leave benefit time be used to cover the amount of time absent or tardy. 6. If an employee does not satisfy his/her supervisor that an emergency prevented him/her from reaching his/her scheduled work location, he/she may be subject to disciplinary action up to and including indefinite suspension. 7. In conditions where the Mayor has issued a directive suspending non-essential City services and directing a designated City employee not to report to his/her regular work location: a. All Tier I and Tier II employees must still report to work as soon as possible, unless specifically designated by the Mayor’s directive. b. The City’s Director of Administration and Regulatory Affairs shall provide departments with the appropriate emergency paid leave code and instructions on its application. 6.06 Sick Leave: A. Sick leave is a paid absence from duty that is a privilege, and it is in the employees’ best interest to manage their sick leave usage appropriately. 1. Eligible employees shall be entitled to accrue and may use their sick leave in accordance with the City of Houston Code of Ordinances, Chapter 14, Article III (Sick Leave and Injury) and any other applicable department-specific mandates. 2. Deduction of approved leave: a. Employees working an averaged 46.7-hour workweek in Emergency Response (including Special Operations) shall be charged 8-hours of sick time for each twelve (12) hours off (1.5 hours off for each scheduled work hour). b. Employees working a 42-hour workweek in OEC shall be charged 10.5 hours of sick time for each twelve (12) hours off. c. All other employees shall be charged sick leave on an hour-for-hour basis. 3. Employees are responsible for monitoring and being aware of their sick leave balances. If an employee does not have a sufficient sick leave balance to cover all hours the employee is absent in a scheduled workday: a. The employee may request holiday or vacation in lieu of sick leave (Code HLIEU or VLIEU). b. If all leave balances (sick, holiday, and vacation) are inadequate to cover the hours the employee is absent; the employee will be coded as OUT. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 16 of 30  c. Failure to have a sufficient “bank” of accrued sick leave hours may result in unpaid leave. B. Sick leave usage: 1. An employee shall not engage in any outside employment on any day for which the employee has requested and received paid or uncompensated sick leave or intermittent FMLS. a. Approval of outside employment pursuant to applicable civil service regulations and department policies shall not be construed as authorizing an exception to the foregoing prohibition. b. A violation of this provision may be grounds for appropriate disciplinary action, up to and including indefinite suspension or termination. 2. To utilize paid sick leave, an employee is required to notify his/her immediate supervisor at or before his/her scheduled report time and: a. Unless incapacitated, an employee shall personally make the notification to his/her immediate supervisor by a direct telephone call. i. Other forms of notification, including but not limited to text messages, emails, voice messages, or leaving a message with any other person who is not a supervisor DO NOT comply with this policy without expressed written approval from management or department policy (except as identified in 6.06B.2.b.i.). ii. A telephone call from someone other than the employee does not comply with this policy, except in emergency situations, excluding incarceration. b. If an employee is unable to reach his/her immediate supervisor, the employee shall: i. Continue up the chain-of-command until able to personally notify a supervisor. ii. If all supervisors in his/her chain of command are unavailable, the employee shall notify OEC of the situation and then make attempts later to contact his/her immediate supervisor. c. Notification by an employee will include the recovery location, a good contact number for the employee, and the estimated duration of sick leave or sick family leave needed, if known. i. The employee shall contact his/her immediate supervisor at or before his/her scheduled report time each additional workday absent to provide an update on the recovery status, anticipated return to work date, and/or to request additional leave or FMLA. ii. If proper notification is not made by the employee, the employee will be coded as AWOL and may be subject to disciplinary action, up to and including indefinite suspension. 3. When an employee gives proper notice to his/her immediate supervisor and requests to use Sick Leave, the supervisor receiving the notification shall: a. Offer the employee FMLA; b. Notify the employee’s District Chief of the sick leave request; c. Document the leave usage in the members electronic personnel file (Form 42). 4. The District Chief will: a. Enter code SICK or SFAM in DC Staffing, based on the information given by the requesting employee; I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 17 of 30  C. Whenever an employee exceeds thirty (30) consecutive calendar days of leave due to a non-occupational injury: 1. The employee’s District Chief shall notify the Staffing Chief in Emergency Response by email. 2. For administrative purposes, the employee shall be transferred to a five (5) day, forty (40) hour workweek under the Emergency Response Division and shall report daily via phone to the Sick/Injured Liaison, Monday through Friday between 0800 and 0830 hours (See Temporary Medical Condition, Section 6.07). D. Submitting forms: 1. Employees shall be responsible for submitting all forms as outlined in this policy. a. When an employee is required to submit a Form 48, the form must be submitted in person, via fax, or via email: i. To the employee’s immediate supervisor or a higher-ranking supervisor in the employee’s chain of command (if the immediate supervisor is unavailable); ii. Within ten (10) calendar days following the initial date of requested leave; iii. With the healthcare provider clearly indicating on the form whether the employee is released to full duty or has any medical restrictions. b. Employees who submit a Form 48 via fax or email, shall maintain a copy of the fax confirmation or sent email showing the form was submitted within the required time frame. c. Employees may send a Form 48 from a personal email address; however, employees shall email a Form 48 to their immediate supervisor’s (or higher- ranking supervisor’s) City email address. d. A valid Form 48 is required to be submitted and must cover all dates of requested sick leave when: i. An employee has exceeded a total of 64 hours of sick leave usage during the benefit year (96 hours for members assigned to a 24-hour shift); ii. An employee has a subsequent request for sick leave usage in the same benefit year after exceeding 64 hours of sick leave (96 hours for members assigned to a 24-hour shift); iii. An employee is transferred to the Emergency Response Division after exceeding leave of thirty (30) consecutive calendar days due to a non- occupational illness or injury and shall continue to submit a valid Form 48 every thirty (30) calendar days thereafter for the duration of the illness or injury; iv. An employee requests sick leave on the day before, the day of, or the day after a city designated holiday; v. A supervisor requests an employee to provide a Form 48 to determine that an absence for a non-occupational injury is bona fide, regardless of whether an employee is within 64 hours of usage. e. Failure to submit a valid Form 48 when required may result in the employee’s paycheck being permanently docked. f. After ninety (90) consecutive calendar days of non-occupational injury leave, Employee Relations will issue an employee a medical questionnaire that is to be completed by his/her treating physician and returned by fax, mail, or in person. 2. When a supervisor receives a submitted Form 48, that supervisor shall: I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 18 of 30  a. Complete Section 4 and provide the employee with a copy of the acknowledged form immediately (if employee is present) or when the employee returns to duty; b. Place the original in the employee’s station file; c. Email or fax the acknowledged Form 48 to the Sick Leave Coordinator; d. Document submission of the Form 48 in the member’s electronic Form 42. E. Attendance Review: 1. When an employee exceeds four (4) occurrences in the preceding 12-month period, his/her attendance will be reviewed. a. The purpose in each step of the review shall be to determine if and/or what contributing and/or mitigating factors are affecting the employee’s attendance and to assist the employee in improving their attendance. b. Each review step shall consider the employee’s work environment, work demand, stress factors, overall fitness/health of the employee, usage of unscheduled leave, outside employment, as well as any other factors that may have contributed to the need for sick leave usage. 2. Step I Review: a. The employee’s District Chief and Station Officer will meet with an employee who exceeds four (4) occurrences in the preceding 12-month period. The District Chief will: i. Review and discuss the employee’s attendance, ii. Ensure the employee understands how to request FMLA, iii. Attempt to identify if contributing or mitigating factors may be affecting the employee’s attendance and developing into patterns iv. Offer recommendations and solutions to improve the employee’s attendance and/or if needed may create and implement an attendance improvement plan, v. Explain the next step of the review process if the employee’s attendance declines to the point the employee exceeds six (6) occurrences, vi. Document the Step I Review by describing the outcome of the meeting on the employee’s electronic Form 42; including any factors, recommendations, solutions, and/or an improvement plan. vii. Request a Step I letter to be sent to the employee 3. Step II Review: a. The employee’s Deputy Chief, or equivalent rank in a support area, and District Chief will meet with an employee who exceeds six (6) occurrences in the preceding 12-month period. The Deputy Chief will: i. Review and discuss the employee’s attendance, documentation from the Step I Review, and any other pertinent documentation, ii. Attempt to identify if contributing factors, mitigating factors, or developing patterns have led to the member’s poor attendance, iii. Offer recommendations and solutions to improve the employee’s attendance and/or if needed may formalize and enforce an attendance improvement plan, iv. Have autonomy to implement solutions and/or remove previously approved privileges to assist in correcting the employee’s poor attendance, v. Explain the next step of the review process if the employee’s attendance declines to the point the employee exceeds eight (8) occurrences, I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 19 of 30  vi. Document the Step II Review by describing the outcome of the meeting on the employee’s electronic Form 42; including any factors, recommendations, solutions, privileges removed, and/or an improvement plan. 4. Step III Review: a. In all cases, prior to an employee being scheduled for a Step III Review, the employee must have already met with the Deputy Chief for a Step II Review. b. The District Chief shall request, through the chain of command, a Step III Review when an employee exceeds eight (8) occurrences in the preceding 12- month period. c. A review board, consisting of the employee’s Assistant Chief, Deputy Chief, and District Chief, shall convene and meet with the employee. The review board will: i. Review all documentation of the employee’s Step I and II Reviews, and any other pertinent documentation, ii. Review and discuss the employee’s continued poor attendance, iii. Focus on the individual and his/her ability to function in their regularly assigned capacity, iv. Forward to the Fire Chief or designee a report of the meeting with recommendations and/or implementation of corrective measures, not limited to: 1. Requirement to enter a medical surveillance program, 2. Temporary Duty Assignment, 3. Referral to the Employee Assistance Program (EAP), 4. Overtime eligibility, 5. Outside employment. v. Document the Step III Review by describing the outcome of the meeting on the employee’s electronic Form 42, including any corrective measures. 5. Step IV Review: a. Prior to an employee being scheduled for a Step IV Review, the employee should have already met with the review board for a Step III Review, unless there are extenuating circumstances. b. The District Chief shall request, through the chain of command, a Step IV Review when an employee exceeds (10) occurrences in the preceding 12- month period. c. The Fire Chief or designee will meet with the employee and will: i. Review all documentation of the employee’s Step I, II, and III Reviews and any other pertinent documentation, ii. Review and/or implement additional recommendations from the Step III Review. F. If at any time a supervisor determines that an employee is abusing any provision set forth in the guideline, the supervisor may file a complaint with the Professional Standards Office. 6.07 Temporary Medical Condition (Non-Occupational Injury): A. Employees may contact the FMLA Coordinator and request Family Medical Leave for any non-occupational serious health condition. B. Employee Restrictions: I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 20 of 30  1. Employees who have not received a medical release to return to full duty, with no restrictions, by their treating physician: a. Shall not work any outside employment. b. Shall not apply for, accept, or work any overtime assignment. c. Shall not attend any educational classes or other training without written authorization from the Fire Chief or his/her Designee. This restriction does not include safety classes or other authorized job-related classes. d. Shall not leave the place of recovery during their scheduled work hours, without proper notification and approval from their immediate supervisor. 2. Violation of these restrictions shall be grounds for disciplinary action. C. Employee Requirements: 1. To ensure HIPAA compliance, the employee shall submit any required medical documentation only by mail, fax, or hand delivery. 2. Shall notify the immediate supervisor, or supervisor he/she is temporarily assigned to report to, when released to full duty, and shall provide a valid Form 48 that indicates the date of release with “no medical restrictions” prior to resuming a full duty assignment. 3. Shall complete a Return-to-Work Drug Test and receive a negative test result prior to resuming any safety impact position when the employee has not worked in over thirty (30) consecutive calendar days. D. An employee who exceeds thirty (30) consecutive calendar days of leave due to a temporary medical condition, shall be transferred to a five (5) day, forty (40) hour workweek reporting in by telephone to the Emergency Response Division. Such an employee shall: 1. Submit a Form 48 to the Sick Leave Coordinator upon receiving the transfer and every thirty (30) calendar days thereafter for the duration of the temporary medical condition. 2. Report in via telephone Monday through Friday between 0800 and 0830 hours to the Sick/Injured Liaison. 3. Remain at the place of recovery during his/her scheduled work hours, unless obtaining prior approval from the immediate supervisor. 4. If needing to leave the place of recovery during scheduled work hours, notify his/her immediate supervisor of the reason, time of departure, and time of return. After proper notification, employees may leave the place of recovery to attend: a. Court. b. Federal, State, County, and Local voting. c. Medical appointments, including obtaining prescribed medications. d. Religious services. e. Treatment regimens, including outdoor activity, as prescribed by the employee’s treating physician in writing. E. It is the policy of the City of Houston to provide opportunities for a recovering employee to return to productive work, as soon as it is practicable, by allowing an employee to work within the medical restrictions determined by the employee’s treating physician. F. Temporary Medical Assignments: 1. To be eligible, an employee: a. Shall have obtained a release to return to work with medical restrictions identified by his/her treating physician; I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 21 of 30  b. Shall submit a valid Form 48 to the Sick Leave Coordinator and Sick/Injured Liaison which lists all medical restrictions; c. Must contact the Sick/Injured Liaison and request a temporary medical assignment. 2. Process for receiving an assignment: a. When an employee has met all eligibility requirements, the Sick/Injured Liaison will attempt to identify an assignment to accommodate the employee’s documented medical restrictions and meet the needs of the department. b. If an assignment is identified, the Sick/Injured Liaison will notify and offer the recovering employee the temporary assignment. c. The employee will be offered only one temporary assignment, which he/she may accept or decline. i. If declined, the employee will be required to utilize benefit leave until released to full duty. ii. If accepted, the member will be issued a transfer to the agreed upon temporary assignment. d. All temporary medical assignment schedules will be on a forty (40) hour workweek, working eight (8) hours a day, five (5) days a week. e. Supervisors shall ensure employees work within the medical restrictions indicated by their treating physician on the Form 48. f. Employees shall submit a valid Form 48 every thirty (30) calendar days for the duration of the temporary assignment. g. An employee must notify his/her immediate supervisor and submit a valid Form 48 when the employee has received a release to full duty with no medical restrictions. 3. Time limits: a. Non-Classified employees, who have been on temporary medical assignment for 90 calendar days, may request up to an additional 90 calendar days of temporary duty based on medical documentation. The Fire Chief or designee may approve this request for additional time up to a maximum of 180 days. b. Classified employees, who have been on temporary medical assignment for one (1) year, will be contacted by Employee Relations and: i. Informed in writing of available options; ii. Issued a medical questionnaire to be timely completed by the employee’s treating physician and returned; iii. Scheduled an initial assessment meeting with the Assistant Chief of Human Resources or designee upon receipt of the completed medical questionnaire. c. Classified employees, may request up to an additional one (1) year of temporary medical assignment, which may be granted based on medical questionnaire documentation. The Fire Chief or Designee may grant up to one (1) year of additional temporary medical assignment to help facilitate the employee’s return to full duty, for a combined maximum of two (2) years. d. When an employee is unable to return to full duty within the maximum time allowed for temporary medical assignment, Employee Relations will: i. Inform the employee in writing of available options, I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 22 of 30  ii. Issue the employee a medical questionnaire, to be timely completed by the employee’s treating physician and returned, iii. Schedule an assessment meeting to review and discuss any additional or updated information based on the medical documentation. G. Any classified employee, who is absent from his/her field assignment in Operations for 180 days or longer for any reason, shall refer to I-47 Classified Training for the Re-Orientation Program (ROP) requirements. H. If a recovering employee is assessed discipline, less than an indefinite suspension, for conduct or infractions occurring before the injury, the employee will be informed of the discipline, but it will not be imposed until after the recovering employee has returned to work. Any delay in the imposition of discipline, less than an indefinite suspension, caused by the recovering employee being on temporary medical leave, should be reflected in the documentation of the discipline, and such delays should not affect the discipline imposed. I. A recovering employee may be subject to possible loss of City of Houston authorized benefits and/or disciplinary action up to and including indefinite suspension for any of the following: 1. Failure to report to full duty and/or a temporary medical assignment. 2. Failure to notify the department of any medical status changes. 3. Failure to timely and fully cooperate with a request for additional documentation or testing. 6.08 Work Ability (Occupational Injury) A. Employees shall comply with all City of Houston, Houston Fire Department, and Texas Workers’ Compensation usual and customary notice and procedural requirements for reporting an occupational injury. If an employee does not comply with the usual notice and procedural requirements, and no unusual circumstances justify the failure to comply, compensation may be delayed or denied. B. Process for reporting an occupational injury: 1. An employee who suffers an occupational injury shall notify his/her supervisor immediately following the injury. a. If an injury is not reported on the actual date of occurrence, it shall be reported to the immediate supervisor no later than thirty (30) days from the date of occurrence, accompanied by a detailed written report. b. The report shall include the date, time, location, nature of the injury, and description of how the injury occurred and any applicable witness statements regarding the incident. 2. After receiving the initial report of an injury, the supervisor must assess the situation, obtain pertinent information, and determine whether the employee requires immediate medical attention. a. If an employee needs to be transported for treatment or evaluation, the member shall be transported as soon as possible, and OEC will notify a Senior EMS Supervisor to report to the medical facility where the employee is transported to complete the documentation and reporting of the injury claim. i. Employees may seek emergency medical treatment from the nearest medical facility capable of handling the injury. Emergency medical care does not require approval from the City or TDI. ii. When the medical condition is stable and follow-up treatment is required, the recovering employee must seek medical treatment with a City and I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 23 of 30  TDI-approved medical provider. Failure to treat with an approved medical provider may make the recovering employee ineligible for benefits under the Texas Workers’ Compensation Act. b. If an employee does not require transportation for treatment or evaluation, the supervisor receiving the report of injury will complete the required documentation with the employee. 3. When the situation is stable, or it is determined that the injured member will be transported: a. The supervisor shall notify the District Chief and the on-duty Chief or Senior Communications Officer at OEC of: i. The employee’s name, employee number, station, and type of injury; ii. Whether the employee will be transported and/or where the employee is transported; iii. Whether the employee will be remaining on duty. b. When a disabling occupational injury occurs, OEC shall notify an Incident Safety Officer (ISO) to respond to the scene to investigate. The ISO shall take possession of any equipment suspected of failure for further investigation as deemed necessary by the Fire Chief. c. OEC shall follow current protocols in making any additional notifications. 4. Documentation Required for Initial Report of Injury: a. The supervisor completing and assisting the employee with documenting the injury shall ensure: i. The HFD Form WB 51 - Supervisors Accident Packet is completed in entirety (no blank boxes/lines). The packet includes: 1. The Accident Report; 2. On the Job Reference Sheet; 3. Authorization for Disclosure of Protected Health Information. ii. The supervisor’s portion is completed and reviewed with the injured employee to ensure accuracy. iii. The employee reviews, acknowledges, signs, and obtains copies of all documents related to the incident. iv. Employee is informed of the need to seek medical treatment with a City and TDI-approved medical provider if the employee is not transported. v. Only the nature of the incident is documented in the employee’s electronic Form 42. 5. Reporting the Injury Claim: a. After completing all injury paperwork, the supervisor shall report the employee’s injury claim within 24 hours: i. By telephone to the TPA and receive a reference number. ii. In person or by telephone to the Risk Management Office. When calling outside business hours, leave a detailed voicemail concerning the incident, and include the employee’s name, payroll, and contact number. b. The Accident Report and employee’s written statement shall be faxed, and the originals sent by inter-office mail, to the Risk Management Office. 6. Follow-Up Report: a. The employee’s on-duty immediate supervisor shall complete a Supplemental Report of Injury (HFD Form 52), fax the completed form, and send the I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 24 of 30  original by inter-office mail to the Risk Management Office, when an injured employee: i. Experiences lost time due to the reported injury (1st occurrence of lost time after the date of injury); ii. Returns to full duty or a transitional duty assignment (1st day of return); iii. Experiences an exacerbation or recurrence of a previous occupational injury. 7. District Chiefs shall ensure results of a Return-to-Work Drug Test have been received for employees returning to full duty, if applicable. If an employee returns after an absence of more than thirty (30) consecutive calendar days who has not completed a Return-to-Work Drug Test, the District Chief shall: a. Authorize the drug test; b. Direct the employee to contact the Risk Management Office; c. Not allow the employee to perform in a safety impact position prior to receiving a negative test result. C. Requirements while on Injured Leave or Transitional Duty Assignment: 1. Employees SHALL: a. Attend all scheduled physician office visits and/or physical or occupational therapy, and follow all directives outlined in the treatment regimen. Failure to comply may result in disciplinary action or loss of benefits. b. Review Parts I-IV of the DWC073 with their treating physician for accuracy and completion. c. After every physician visit: i. Contact the adjuster assigned by the TPA, ii. Submit a DWC073 Form within five (5) calendar days to the Risk Management Office by fax, mail, or in person, d. Submit a DWC073 Form every thirty (30) calendar days thereafter. Failure to submit a DWC073 Form may result in the cessation of benefits and/or disciplinary action. e. In a timely manner, complete and return via mail, fax, or in person, any Medical Questionnaire (MQ) issued to the employee by the Risk Management Office. f. Contact the Risk Management Office and their immediate supervisor when released to full duty. 2. Employees SHALL NOT: a. Work any outside employment. Such activity will be grounds for disciplinary action. b. Apply for, accept, or work any overtime assignment prior to returning to full duty without restrictions. c. Attend any educational courses or other training without written authorization from the attending physician, TWC claim adjuster, Fire Chief or designee, and Risk Management Office. This does not include safety classes, voluntary meetings with the TPA, or other authorized job-related classes. D. Returning to full duty: 1. When released to full duty, the employee shall provide a copy of the DWC073 Form indicating the date of release with “no medical restrictions” to the Risk Management Office. I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 25 of 30  2. Any classified employee, who is absent from his/her field assignment in Operations for 180 days or longer for any reason, shall refer to I-47 Classified Training for the Re-Orientation Program (ROP) requirements. 3. Upon returning to the assigned work location, the employee shall present a copy of the DWC073 Form indicating the date of release with “no medical restrictions” to the on-duty immediate supervisor. E. Transitional Duty Assignment: 1. It is the policy of the City of Houston to provide opportunities for a recovering employee to return to productive work, as soon as it is practicable, by working within the medical restrictions determined by the employee’s treating physician. 2. The DWC073 Form will be the official form used to initiate: a. Workers’ Compensation coding for lost time, b. The Bona Fide Offer of Employment letter, c. Placement of an injured employee into a transitional duty assignment. 3. Transitional duty assignments will be granted at the discretion of the Fire Chief and based on the needs of the department at the time of the request. 4. When an employee is released to duty with medical restrictions indicated on the DWC073 Form, the Risk Management Office will submit a request to the Sick/Injured Liaison for a transitional duty assignment. Upon approval of transitional duty placement, the employee shall: a. Be notified to sign and accept a transitional duty assignment using the Transfer and Bona Fide Offer of Employment letter. b. Work within the medical restrictions identified and refrain from strenuous activity (other than prescribed exercise or therapy). c. Obtain and forward a completed DWC073 listing current medical restrictions every thirty (30) calendar days, by fax or in person, to the immediate supervisor, the Risk Management Office, and the Sick/Injured Liaison. d. Familiarize themselves with Mayor’s E.O. No. 1-33, Work Ability Guidelines. 5. Time limits: a. Non-Classified employees, who have been on transitional duty for 90 calendar days, may request an additional 90 calendar days of transitional duty based on medical documentation. The Fire Chief or designee may approve this request for additional time up to a maximum of 180 days. b. Classified employees, who have been on transitional duty for one (1) year, will be contacted by the Risk Management Office and: i. Informed in writing of available options, ii. Issued a medical questionnaire to be timely completed by the employee’s treating physician and returned, iii. Scheduled an initial assessment meeting with the Assistant Chief of Human Resources or designee upon receipt of the completed medical questionnaire. c. Classified employees may request up to an additional one (1) year of transitional duty, which may be granted based on medical questionnaire documentation. The Fire Chief or designee may grant up to one year of additional transitional duty assignment to help facilitate the employee’s return to full duty, for a combined maximum of two (2) years. d. When an employee is unable to return to full duty within the maximum time allowed for transitional duty, the Risk Management Office will: I-22 (B) Unscheduled Leaves and Absences REVISED 12/30/2019 REVIEWED 6/22/23 Page 26 of 30  i. Inform the employee in writing of available options, ii. Issue the employee a medical questionnaire, to be timely completed by the employee’s treating physician and returned, iii. Schedule an assessment meeting to review and discuss any additional or updated information based on the medical documentation. F. Emergency Response Daily Call-In: 1. Employees exceeding ninety (90) consecutive calendar days of injured leave shall: a. Be transferred to a five (5) day, forty (40) hour workweek under the Emergency Response Division for administrative purposes; b. Be issued a medical questionnaire to be timely completed by the treating physician and returned to the Risk Management Office. 2. An employee on injured leave whose injury, based on the documentation provided by the employee’s treating physician, prevents him/her from reporting to either full duty or a transitional duty assignment shall: a. Report by telephone on scheduled work days to the Sick/Injured Liaison between 0800 and 0830 hours. b. Remain at the place of recovery during his/her scheduled work hours, unless obtaining prior approval from his/her immediate supervisor. c. If needing to leave the place of recovery during scheduled work hours, notify his/her immediate supervisor of the reason, time of departure, and time of return