COVID-19 Employee Information

The Communication to Employees Regarding COVID-19 Exposure contains steps employees will need to take to address COVID-19 Exposures.   

All employees are required to complete the self-certification through the myCSUDH portal. An employee may be excused from the vaccine requirement in the COVID-19 Vaccination Interim Policy. 

• Employees requiring a medical exemption must complete the Medical Exemption Certification Form
• Employees requiring a religious exemption must complete the Certification of Religious Belief Form

Complete the self-certification through the myCSUDH portal and upload the completed exemption document(s) to the following Dropbox folder: HR- Medical and Religious Exemptions.

In the rare event that you have partially completed the vaccination process for a two-dose vaccine, you must complete the Employee Certification of Pending COVID Vaccination Form and agree to upload to the secure Dropbox the following:

1. a signed copy of this form
2. a copy of your vaccination card 

Please upload the completed document(s) to the following Dropbox folder: HR- Employee Certification of Pending COVID-19 Vaccination.

A leave of absence is defined as any time away from work (excluding vacation), either paid or unpaid anything over 5 days or if hospitalized.  

An employee must complete the Leave of Absence Request Form by following the steps below and obtain the appropriate signatures prior to beginning a leave of absence. In the event the employee is unable to complete the form, an authorized representative (i.e., employee’s appropriate Administrator) must be elected to complete this procedure. 

Step 1. Notification: After completing the first three sections (Employee Information, Purpose of Leave, and Dates of Leaves), the employee signs and gives the form to his/her appropriate Administrator. The Appropriate Administrator must sign and date the form, indicating acknowledgement of employee’s intent to request a leave of absence. The form must be signed and returned to the employee within 5 days of receipt by the Appropriate Administrator. The leave is not approved at this point. 

Step 2. Payroll Services and Benefits: The employee must contact the Benefits Manager who will complete the Available Leave Credits section indicating the amount of available leave credits (sick, vacation and PH) and indicate the appropriate pay period and discuss any impact the leave will have on the employee’s benefits coverage. The Benefits Manager will determine which leave credits are available for the employee to use, will make the appropriate notation on the form, estimate the leave without pay date and approve the leave. 

Step 3. Completed form: The Benefits Manager will provide a copy of the completed form to the employee and Payroll Services. The appropriate Administrator will be notified by the Benefits Manager to indicate how to record the use of the employee’s leave credits. 

Leave of Absence Request Form

If employees do not have accrued leave available, they must apply for Family Medical Leave to be able to utilize vacation, CTO, or Personal Holiday while out on medical leave or to care for an “immediate family member” as defined in the applicable MOU.

Family Medical Leave (FML) is 12 weeks of benefits coverage available to an eligible employee for his/her own serious illness. FML can also be used by an employee to care for his/her child, spouse, or parent with a serious illness. FML begins the day after the employee’s last day worked, and runs concurrent with the use of accumulated leave credits. The CSU will continue to pay its portion of the employee’s benefits during the 12 week period, including any unpaid portion of FML. 

Family Medical Leave (FML) may be used intermittently up to 480 hours in a 12-month period, based upon full-time work status, for an eligible employee’s own illness or to care for his/her child, spouse or parent with serious illness.  

For maternity leave only, FML coverage will be assigned as follows. If the employee utilizes Non-Industrial Disability Insurance (NDI), FML will begin after NDI has ended. If NDI is not used, FML will begin 6-8 weeks after the birth of the baby and runs concurrent with the use of paid parental leave. 

Employees must contact the Benefits Manager to discuss eligibility and documentation required prior to taking the leave.  Employees must submit a completed Leave of Absence Request Form and Certification of Health Care Provider Form for Employee or Certification of Health Care Provide Form for Family Member (FMLA Forms) 5 days prior to the start of the leave.  If the medical leave is unforeseeable, the Leave of Absence and FMLA form must be submitted within 10 days from the start of the leave.  Failure to submit required form and documentation within timeframe may result in denial or termination of leave request. 

Other programs, such as Nonindustrial Disability Insurance (NDI) and/or Catastrophic Leave, may be utilized based upon eligibility and type of leave.

The Non-Industrial Disability Insurance (NDI) Program is a wage continuation program administered by the Employment Development Department (EDD) for eligible employees that have suffered loss of wages due to a disability or injury that is not work related. 

The NDI program defines “disability” as “mental or physical illness and mental or physical injury, including any illness or injury resulting from pregnancy, childbirth or related medical condition”.  An employee is deemed disabled on any day in which, because of physical, mental or medical condition, he/she is unable to perform his/her regular or customary work. An attending physician must verify the disability.   An employee is not eligible to apply for NDI to care for a family member. 

Eligibility

Full-time, permanent or probationary employees, who are members of the California Public Employees’ Retirement System (CalPERS) or State Teachers’ Retirement System (STRS) and who are in compensated employment, are eligible to apply for NDI benefits when disabled from work due to illness or physical injury which is not work related. 

Part-time employee who are members of CalPERS or STRS may be eligible if they are appointed half time or more for one year of service or one academic year or more. 

The employee must have a disability which has been verified and accepted by the Employment Development Department and submits to a medical examination. 

Benefits

Eligible employees may receive benefit payments up to 26 weeks (182 calendar days) for any one disability period in an amount equal to one-half pay, not to exceed the specified weekly amount based on the employee category. NDI benefits may not exceed six (6) months for any one incident. 

NDI Weekly Benefit Amounts per Employee Category:  

Filing a Claim

A claim form must be obtained by Benefits Services and submitted to your physician for completion prior to submission to the EDD office by your physician’s office.

• Benefits Services completes part A
• Employee completes part B
• Attending physician completes part C
• Attending physician submits completed form to EDD 

Waiting Period

The general waiting period is seven (7) calendar days.  The waiting period or any unserved portion may be waived if hospitalization is required. 

Payment Process

The EDD Office determines the period of eligibility and authorizes claims. Once Payroll Services receives the authorization of approved NDI days, the request for payment is made to the State Controller’s Office. Payment is prepared on a monthly basis through Payroll Services and distributed by the individual department. Employees may request Payroll Services to send the payment directly to their home address.

Disability Determination Summary

All full-time employees are eligible for sick leave at a rate of 8 hours per month. Part-time employees accrue sick leave on a prorated basis. Employees may be required to provide a physician’s statement for absence charged to sick leave.

• Once sick leave is exhausted, employees may be eligible to receive NDI benefits for a maximum duration of 6 months.
• Once NDI benefits are exhausted, employees who are disabled may be eligible for a leave of absence without pay. Employees may also apply for disability retirement benefits if accumulated service credits equals 5 years or more.
• During and after receipt of NDI benefits, employees may receive benefits from other voluntary disability plans if enrolled prior to the onset of disability.
• Employees shall provide their supervisor written authorization form their personal physician for return to work.
• Should an employee wish to return to work, but the condition of the disability prevents this return to his/her previous classification, an evaluation of reasonable accommodation will be implemented.

Based upon the employee’s collective bargaining language, an employee may request an unpaid leave of absence for a duration of time.   

The employee must obtain all required signatures on the Unpaid Leave of Absence Request Form before meeting with the Benefits Manager.  

The employee’s Appropriate Administrator, Department Administrator/Dean and Vice President must approve the request for an unpaid leave. The employee must schedule a meeting with the Benefits Manager to discuss how the unpaid leave will affect benefits coverage.  Once an employee is placed on unpaid leave, the employee is responsible for sending monthly premium payments directly to the insurance carrier(s) for continuation of coverage. 

Direct premium payment(s) will be requested when an employee is not on regular pay status for a full pay period or more, and wishes to continue their health, dental, vision, life and/or long-term disability coverage.  Once an employee is in “non-pay status,” and in order to continue your coverage during the absence, the employee will need to make monthly premium payments directly to the insurance carrier(s) for coverage as early as the following month. 

The direct pay notice and paperwork will be mailed to the employee upon being placed on unpaid leave.  The employee will complete and mail the paperwork directly to the carrier(s) with payment to maintain continuation of coverage while on unpaid leave.  Employees must pay the premium for the pay period in which they return to work. If the premium rates change while paying directly, the new premium amount must be paid to continue the coverage.   

Informal Telecommuting is available for temporary telecommuting, for eligible personnel during the COVID-19 situation that prevents California State University, Dominguez Hills personnel from being physically present on-site to perform their job responsibilities. The critical consideration is to ensure that the University maintains its ability to efficiently and effectively execute its core services in various work units, while protecting the health and safety of staff. The Telecommuting Guidelines in place are not intended to replace any guidance under normal University business operations. These guidelines are subject to change and revised when necessary. Please request approval from your Appropriate Administrator if you believe you are well enough to telecommute during your isolation or quarantine period.

The Benefits Resources to Assist CSU employees (COVID-19) information provide connection to CSU employees medical, financial and well-being benefits. Employees may find wellness assistance by going to the CSUDH Benefits page. Coming soon, an employee may also connect to the CSUDH Employee Total Wellness page for additional wellness support.  Additional information will be communicated once the page is accessible.