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    Leaves of absence / On the job injury

    To apply for a leave of absence please review the documents and applications below then complete the appropriate forms and submit to: Human Resources Leave Office, P.O. Box 34165, MS 33-380, Seattle, WA 98124-1165.  OR Fax to: 206-252-0021 OR scan and email to


    picture of LisaLisa Garberg, Human Resources Manager


    Leave Processing Analysts

    BrookLast name begins with A - K
    Brook Leighton, Leave Analyst

    CorineeLast name begins with L - Z
    Corinne Ross, Leave Analyst


    On the Job Injuries and Ergonomic Assessment

    Gretchen Helling, Injury Management and Prevention Administrator

    To Report an On the Job Injury

    ​Frequently Asked Questions about Leaves

    Employee Health Leave pdf icon Applying for your own health leave

    Family Health Leave or Parental Leave pdf icon Applying for leave to care for a covered family member or a newborn, newly adopted or placed child

    Childbearing Leave pdf icon Applying for maternity leave

    Please review the following Benefits Helpline Advisers to understand how your benefits may be affected by any type of leave of absence.

    For more detailed information regarding how benefits are affected by Leave, call the Benefits Helpline (206)957-7066.  Benefits Website

    Leave forms

    Employee Leave Request (login required) pdf icon Completed by an employee when applying for Health Leave OR to care for a Family Member OR for Childcare Leave. The Employee Leave Request form must be forwarded to Human Resources with the appropriate Health Care Provider Certification (see below).

    Health Care Provider Certification - Employeepdf icon Completed by the employee's physician when the employee is applying for Health Leave.

    Health Care Provider Certification - Family pdf icon Completed by the family members' physician when the employee is applying for leave to care for a family member.

    Medical Authorization to Return to Work (login required) pdf icon Completed by the employee and their physician when returning to work from a long-term health leave.

    SEA Certificated and Classified Long Term Leave Without Pay Application (login required) pdf icon To be used when applying for an annual unpaid leave for study, travel, or other reasons approved by Human Resources. Applications for leave for the 2018-2019 school year will be accepted January 2, 2018 through 5 p.m. on March 1, 2018. Guidelines

    Long Term Disability Salary Replacement

    Benefit eligible employees who will be disabled for more than 45 calendar days may qualify for Long Term Disability Salary Replacement. Please contact the Benefits Helpline (206)957-7066 or visit the Benefits website to obtain the LTD application form.

    LTD and Work Related Disabilities FAQpdf icon

    Instructions for submitting LTD forms: Employee completes the Employee Statement and Part 1 of the Physician Statement. Physician completes their portion of the Physician Statement.

    Employee sends the complete packet (including the employee form, the physician form, and the incomplete Employer Statement) to:

    Sprague Israel Giles Inc.
    ATTN: Employee Benefits 
    1501 Fourth Ave, Suite 730 
    Seattle WA 98101-1637

    SIG will complete the Employer Statement and submit forms to Standard Insurance.

    Leave Sharing

    Both parts I and II must be submitted to determine eligibility. Eligibility requirements

    Request for Professional Leave form is an accounting form. It can be found on the staff portal (login required) under Travel and Expense Reimbursements on the Business and Finance Forms webpage.

    Please contact Accounts Payable if you have questions about the Request for Professional Leave form.