Anderson County Schools
Sick Leave Bank
Enrollment Application
c Certified Employee c Classified Employee
Name: ______
SS#: ______School: ______
I hereby apply for membership in the Anderson County Schools Sick Leave Bank. I agree to abide by all the rules and regulations as stated in the Tennessee Code Annotated (TCA 49-5-801).
WITH THIS APPLICATION, I AGREE TO HAVE TWO DAYS TAKEN FROM MY SICK LEAVE TOTAL AND DEPOSITED INTO THE SICK LEAVE BANK.
______
Signature Date
NOTE: The Business Office will send a letter to you through the
inter-school mail confirming your membership. This letter will
be sent after the October 31st deadline.
Your application can be sent through the school mail or you can mail your application to:
Anderson County Schools
101 S. Main Street, #507
Clinton, TN 37716
SEE BACK OF PAGE FOR A CONDENSED VERSION OF THE RULES.
A COMPLETE SET OF RULES & REGULATIONS IS AVAILABLE AT EACH SCHOOL.
Sick Leave Bank Usage
1. Sick Leave Bank days may be granted only for instances of disabling illness, injury or quarantine of the individual member. Grants of sick leave from the Bank shall not be made to any member on account of elective surgery or the illness of any member of the participants family or during any period the member is receiving disability benefits from Social Security or the State or Local Retirement Plan or while receiving payments under Worker’s Compensation. Disability benefits from individually purchased policies shall not affect eligibility to draw from the Bank.
2. A participant shall not receive any sick leave from the Bank until after having exhausted all accumulated sick leave, personal leave and vacation leave (if applicable), including all Board paid extensions.
3. There shall be a waiting period of ten consecutive duty days (excluding extensions for the same illness or injury) following the exhaustion of all available “paid leave” before days from the Bank may be used.
4. Members of the Bank shall be eligible to make application to the Bank for sick leave only after having been a member of the Bank for thirty calendar days.
5. All requests to draw upon the Bank must be made upon a Sick Leave Bank Request Form and submitted to the Trustees within thirty calendar days (the completed form should be turned into the Business Office). In extreme and unusual circumstances, exceptions may be approved.
6. A member drawing on the Bank may be required at any time to undergo, at their own expense, a medical review by a physician approved by the Trustees.
7. Leave grants from the Bank, recommended by the Board of Trustees, shall be in units of no more than twenty consecutive days for the individual applicant. Applicants may submit requests for extensions of such leave grants before their prior grants expire. The maximum number of days any participant may receive in any fiscal year is sixty days. The maximum number of days any participant may receive as a result of any one or the same illness or accident is ninety days.
8. In the event a member is physically or mentally unable to make a request to the Trustees for the use of sick leave days, a family member or agent may file the request.
9. Members may receive benefits from the Bank only for their annual payroll period of employment.
10. Sick leave granted a member from the Bank need not be repaid by the individual except in circumstances as stated in the Membership Provision rule number five.
11. A member shall lose the right to obtain the benefits of the Sick Leave Bank by:
a. Resignation or termination of employment.
b. Cancellation of participation which is effective on June 30th of each fiscal year.
c. Refusal to honor such assessment as may be required by the Trustees.
d. Being on approved leave of absence with the exception of personal illness or disability leave.
e. Retirement.
f. Refusal to comply with the guidelines set forth in the Rules and Regulations of the Bank.
12. All requests to draw from the Bank must be accompanied by a statement on the Medical Certification Form certifying that leave is medically required by the specified illness or disability. Such form must be signed by the physician.