Nashville APWU FMLA

FMLA

FMLA Forms

APWU FMLA Form 1 (Revised 5/24/12) [PDF]

* Certification by a Health Care Provider for the Employee’s Own Serious Illness
APWU FMLA Form 2 (Revised 5/24/12) [PDF]

APWU FMLA Form 3 (Revised 4/30/09 [PDF]
* Certification by Employee of Qualifying Exigency for Military Family Leave

APWU FMLA Form 4 (Revised 4/30/09) [PDF]
* Certification by a Service Member’s Health Care Provider for Caregiver Military Family Leave

These forms are compliment of your National APWU Industrial Relations Team
For more information go to APWU.org (Industrial Realtions)

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If you have a condition that may be covered under the Family Medical Leave Act you should submit the medical certification. Certification must be in conjunction with an absence for a covered condition. The Union has a one page form that can be used instead of the three page form the Postal Service sends you. Certifications are frequently returned because of missing information so you must be persistent. You can reach the FMLA office at (901)521-2375 if you have questions about what information is needed on a certification. Anthony Graham is the FMLA Coordinator for your local Union and he can be reached at 589-2617.
If you are injured at work or have an occupational disease you should file a claim under OWCP. You should notify your supervisor immediately if you are injured at work or feel you have an occupational disease such as carpal tunnel. Your supervisor should give you a form CA-1 or CA-2 depending on what type of injury you have. Parts of the form must be completed by your supervisor, your doctor, and yourself. If approved, OWCP will pay for medical treatment, mileage and lost wages depending on the condition. You may also be eligible for other compensation including schedule award payment if you have lost use of part of your body or have a permanent disability. OWCP is administered by the Department of Labor and can be complicated. Ron Peaks is the OWCP Coordinator for the Nashville Local of the APWU and can be reached at 885-2833 or 262-7036.

To Contact the USPS FMLA Office, Call 901-521-2375	FMLA FMLA Forms APWU FMLA Form 1 (Revised 5/24/12) [PDF] * Certification by a Health Care Provider for the Employee’s Own Serious Illness APWU FMLA Form 2 (Revised 5/24/12) [PDF] APWU FMLA Form 3 (Revised 4/30/09 [PDF] * Certification by Employee of Qualifying Exigency for Military Family Leave APWU FMLA Form 4 (Revised 4/30/09) [PDF] * Certification by a Service Member’s Health Care Provider for Caregiver Military Family Leave These forms are compliment of your National APWU Industrial Relations Team For more information go to APWU.org (Industrial Realtions) _______________________ If you have a condition that may be covered under the Family Medical Leave Act you should submit the medical certification. Certification must be in conjunction with an absence for a covered condition. The Union has a one page form that can be used instead of the three page form the Postal Service sends you. Certifications are frequently returned because of missing information so you must be persistent. You can reach the FMLA office at (901)521-2375 if you have questions about what information is needed on a certification. Anthony Graham is the FMLA Coordinator for your local Union and he can be reached at 589-2617. If you are injured at work or have an occupational disease you should file a claim under OWCP. You should notify your supervisor immediately if you are injured at work or feel you have an occupational disease such as carpal tunnel. Your supervisor should give you a form CA-1 or CA-2 depending on what type of injury you have. Parts of the form must be completed by your supervisor, your doctor, and yourself. If approved, OWCP will pay for medical treatment, mileage and lost wages depending on the condition. You may also be eligible for other compensation including schedule award payment if you have lost use of part of your body or have a permanent disability. OWCP is administered by the Department of Labor and can be complicated. Ron Peaks is the OWCP Coordinator for the Nashville Local of the APWU and can be reached at 885-2833 or 262-7036.
APWU Forms Available for FMLA Medical Certification here