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Labor&PolicyTeave of Absence Medical—William Hicks—8-6-12
RESOLUTION AUTHORIZING UNPAID MEDICAL LEAVE OF ABSENCE
FOR WILLIAM HICKS
RESOLUTION NO.: ,2012
INTRODUCED BY:
WHO MOVED ITS ADOPTION
SECONDED BY:
WHEREAS, William Hicks, an employee in the Town of Queensbury Building and
Grounds Department, is recovering from a serious illness, and
WHEREAS, Mr. Hicks has requested Town Board approval to take an unpaid medical
leave of absence as set forth in Warren County Civil Service Rule XIX, and
WHEREAS, Mr. Hicks has submitted medical documentation supporting a need for
medical leave, and
WHEREAS, the Town's Facilities Manager has recommended that the Town Board grant
Mr. Hicks such unpaid medical leave with an effective date of July 22nd, 2012 extending through
the earlier of
I. January 22nd, 2013, with the opportunity to extend such leave at 90 day
increments; or
2. Certification of his physical qualification for return to work, documented by his
physician in form satisfactory to the Town; and
WHEREAS, in accordance with Warren County Civil Service Rule XIX, Town Board
approval is discretionary and necessary before an employee may take such leave, and
WHEREAS, the Town Board has carefully considered the circumstances of Mr. Hicks'
request and the recommendation of the Facilities Manager,
NOW, THEREFORE, BE IT
RESOLVED, that the Queensbury Town Board hereby authorizes and grants an unpaid
medical leave of absence to William Hicks with an effective date of July 22nd, 2012 extending
through the earlier of
1. January 22nd, 2013, with the opportunity to extend such leave at 90 day increments; or
2. Certification of his physical qualification for return to work, documented by his
physician in form satisfactory to the Town; and
BE IT FURTHER,
RESOLVED, that Mr. Hicks shall provide the Town with a status report from his
physician regarding his ability to return to work and must notify the Town Board in writing by
December 22nd, 2012 of his intention to return to work or request further unpaid medical leave
and supply supporting documentation if he wishes to request additional unpaid leave beyond
January 22nd, 2013, and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Town Supervisor,
Facilities Manager and/or Town Budget Officer to take any action necessary to effectuate the
terms of this Resolution, and
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BE IT FURTHER,
RESOLVED, that this Resolution will not have any impact or create any inference as to
any determination of entitlement to Disability or Workers' Compensation Benefits.
Duly adopted this 6t''day of August,2012,by the following vote:
AYES
NOES
ABSENT :
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