Equal Employment Opportunity (Eeo) Policy And Program Administration Form Sample Page 34
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54VA MEDICAL CENTER
POLICY MEMORANDUM 00-304
BRONX, NEW YORK 10468
July 31, 2003
application shall be accompanied by the following information concerning each
potential leave recipient: (1) The name, position title, and grade or pay level of the
potential leave recipient; (2) The reasons transferred leave is needed, including a brief
description of the nature, severity, and anticipated duration of the medical emergency,
and if it is a recurring one, the approximate frequency of the medical emergency
affecting the potential leave recipient; (3) Certification from at least one physician, or
other appropriate experts, with respect to the medical emergency; and
(4) Any
additional information that may be required by the Human Resources Management
Officer to support the individual application.
(b) Leave Donor: An employee may submit a voluntary written request to transfer
a specified number of hours (or days, in the case of certain Title 38 employees) from
his or her annual leave account to the annual leave account of a specified VA leave
recipient.
This request will be submitted on VA Form 0239, Leave Transfer
Authorization (Attachment 2), through the Human Resources Management Officer to
the Fiscal Officer. The minimum amount of annual leave that may be transferred
from a Title 5 employee, or a Title 38 employee who is charged in hours, is four (4)
hours; for a Title 38 employee charged leave in whole day increments, the minimum
amount is one (1) day. The maximum amount that an employee may donate is one-
half the amount of annual leave the donor would accrue during the Leave Year the
donation is made. A leave donor who is projected to have annual leave subject to
forfeiture at the end of the Leave Year (i.e., use or lose annual leave) may donate no
more than the lesser of (1) one-half the amount of annual leave the donor would accrue
during the Leave Year the donation is made; or (2) the number of hours or calendar
days remaining in the Leave Year, as of the date of the transfer, for which the leave
donor is scheduled to work and receive pay. However, the Medical Center Director
may waive these limitations on maximum individual donations on a case-by-case basis
upon written certification by the Human Resources Management Officer and the Fiscal
Officer that the available donations are insufficient to remedy the income loss of the
employee experiencing the medical emergency. The Director’s waiver must be in
writing.
(c) Recipient’s Supervisor: Supervisors are responsible for continuously monitoring
the status of the leave recipient’s medical emergency to assure that the employee is
still affected by it and for promptly notifying the Human Resources Management
program of any changes in the employee’s status be in writing
7. REFERENCES: 5 U.S.C. Ch. 63
5 CFR Part 630, 810
VA HANDBOOK 5011, PART III
8. RECISSION:
Policy Memorandum 00-304, dated July 31, 2000
9. POLICY FORMULATION: Human Resources Management Program (05)
10. REVIEW DATE:
12
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