Last Chance Memorandum Of Agreement Sample (Page 3 of 4) in pdf

SAMPLE

rehabilitation program, the Employee must be able to demonstrate

participation and progress in the referral program. Failure to demonstrate

active participation and/or acceptable levels of progress in an approved

rehabilitation program will result in immediate removal from federal

employment as determined in the original decision letter.

(ix) The Employee expressly acknowledges that he is required to comply with

any and all medical guidance issued to him as part of his participation in an

approved rehabilitation program. The Employee also expressly authorizes

that the Agency’s Director of Psychological Health to discuss his participation

and rehabilitative progress with administrative and clinical staff of the

approved rehabilitation program. The Agency is also authorized to obtain,

under the authority of this Agreement and upon request, copies of the

Employee’s rehabilitation program records.

(x) The Employee will agree to sign an authorization to release information

pertaining to his rehabilitation to the Agency’s Director of Psychological

Health, Sean Wood. This authorization is to be signed and submitted within

10 calendar days of the date of this agreement.

b. The Agency understands and agrees to comply with the following terms,

conditions, responsibilities and duties:

(i) Retain a position in the federal technician service at an appropriate pay

grade and duty description for the Employee

(ii) The Agency agrees to hold the pending removal action in abeyance until

the Employee completes the 12-month abeyance period. Upon satisfactory completion of

the 12-month abeyance period, the Agency will revoke the removal action and the

original memorandum agreement will be destroyed. Note, however, that the Agency

does not have authority to remove certain file records and that all current and future NGB

Form 904 entries will remain as part of the Employee’s file.

(iii) The Agency will allow the Employee to take annual leave, sick leave, or

leave without pay (LWOP) in accordance with OPM, agency and local regulations and

guidance as modified in this Agreement.

4. Both the agency and the Employee believe that this Agreement provides the Employee

with a reasonable accommodation to his acknowledged problems. This agreement

provides the Employee with an opportunity to demonstrate that he is willing to

rehabilitate the problems that are interfering with his federal technician position and

resume his employment as a dependable and productive employee.

5. NOTE: The Employee must satisfy this Agreement and the Rehabilitative

Program or be considered a rehabilitative failure under the conditions imposed by

this Agreement. If the Employee fails to satisfactorily complete the rehabilitative

Last Chance Memorandum Of Agreement Sample Page 3