Extended Sick Leave and Workers' Compensation Reimbursement Agreement

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Morris Library

Form Title: Extended Sick Leave and Workers' Compensation Reimbursement Agreement

Description: Agreement to reimburse extended sick leave benefits if sick leave was used prior to approval of workers' comp claim or occupational disease payments.

Usage Notes: This form is an agreement to repay the sick leave in the event the worker's comp or occupational disease payments are made to employee. Cannot use both.

Use Documentation: None available

To be used by: Campus Use

Posted on: 27 Aug 2014

Posting by: Human Resources

Author: Clay Cochran

Author's email: claytonc@siu.edu

Form ID: hro1059