CHECKING ELIGIBILITY & SENDING

ACKNOWLEDGEMENTS SOP
Country: U.S.
Last Date Edited: 10/24/2022
Edited By: Rachel Soto

CONTENTS

Checklist.......................................................................................................................................................................................................4

Navigating Standard Operating Procedures (SOPS)....................................................................................................................................6

Process.........................................................................................................................................................................................................6

Step 1: Receiving Work............................................................................................................................................................................6

Step 2: One-Case: One-Claim Relationship..............................................................................................................................................6

A. RELATING CASES TO EACH OTHER.........................................................................................................................................7

B. One case one claim – copy documentation..........................................................................................................................7

Step 3: Initial Case/Claim Review............................................................................................................................................................8

A. Identifying AWS pregnancy and parental cases- Pilot...........................................................................................................8

B. Identifying Mental Health cases............................................................................................................................................9

C. Identifying Connecticut Paid Family Leave (CTPFML).........................................................................................................11

D. Reviewing the Case..............................................................................................................................................................12

E. Reviewing the Contact Record to Confirm the Employee is Not Terminated or Suspended.............................................12

F. Reviewing Case Notes..........................................................................................................................................................12

G. Reviewing Documentation..................................................................................................................................................13

H. Reviewing Absence Claim Intake.........................................................................................................................................13

I. Assessing Whether to Reopen an Existing Claim for Relapse, Withdrawing, and scheduling an Extension Requested Task
13

J. Reviewing Eligibility, Employment History, Reversing Eligibility Decisions, and Valdating Leave Plans.............................15

K. Ensuring Estimated Return to Work (ERTW) is Updated on the RTW Object.....................................................................19

L. Contagious Disease Protocol...............................................................................................................................................19

Step 4: Terminated or Suspended Employees & COVID Cases.............................................................................................................22

A. Terminated/Suspended Employees....................................................................................................................................22

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 B. Reviewing the Case/Claim for COVID..................................................................................................................................23

Step 5: Updating Leave Dates................................................................................................................................................................25

A. Checking MyTime................................................................................................................................................................25

B. Changing Leave Dates..........................................................................................................................................................25

C. Check the Leave Status Feed (LSF)......................................................................................................................................26

Step 6: Oregon family leave act (ofla) state of emergency updates.....................................................................................................27

Step 7: Military USERRA Cases..............................................................................................................................................................28

A. USERRA Overview................................................................................................................................................................29

B. Review Information with Employee Task............................................................................................................................29

C. Approve the Absence..........................................................................................................................................................29

D. Reviewing the Decision........................................................................................................................................................29

E. Sending Military Decision letter..........................................................................................................................................30

F. Editing L031.........................................................................................................................................................................30

G. Editing LO50.........................................................................................................................................................................31

H. Verify or Schedule an “EE Interview Needs to Be Completed” Task...................................................................................32

I. Completing the “Review Information with EmployeE” Task...............................................................................................33

J. Completing the “CM/AC Review” Task................................................................................................................................33

K. Create a Case Note..............................................................................................................................................................33

Step 7: Non-USERRA Cases – Acknowledgements................................................................................................................................33

A. Fmla Denials & Acknowledgements....................................................................................................................................33

B. Sending Acknowledgement Letters.....................................................................................................................................34

C. Complete Correspondence Ready to Send Tasks................................................................................................................37

D. Completing Review Information with Employee Task........................................................................................................37

E. Verify or Schedule a Follow-Up Task and Completing Duplicates.......................................................................................37

F. Create a Case Note..............................................................................................................................................................39

Example Letters.....................................................................................................................................................................................39

A. Editing Letter L001 - Acknowledgement – CFFM, Military exigency and Caregiver – EE....................................................39

B. Editing Letter- EOHC Acknowledgement Letter– EE............................................................................................................40

C. Editing Letter L002- Acknowledgement -Pregnancy...........................................................................................................46

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 D. Editing Letter L003 - Acknowledgement - Intermittent – EE (EOHC, CFFM, Crime, & DV).................................................48

E. Editing Letter L003 - Acknowledgement - Intermittent – EE (School Visitation)................................................................49

F. Editing Letter L004 - Acknowledgement - Leave Share - EE................................................................................................51

G. Editing Letter L005 – Acknowledgement – PLOA – NONNACF – EE....................................................................................51

H. Editing Letter L007 - Acknowledgement - Bonding, Small Necessities...............................................................................51

Appendix: Standard Case Management Processes...............................................................................................................................56

A. Sending Letters and Correspondence..................................................................................................................................56

B. Creating Case Notes.............................................................................................................................................................58

C. Withdrawing Claims.............................................................................................................................................................58

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CHECKLIST
Case Review
☐ The Case Manager will be notified of a new Case/Absence Claim by a “Correspondence Ready to Send” task for “L001, L002
(remember to choose the appropriate letter template, remove the L002 and double check the attachments added are
right), L003, L004, L005, L007, or Review information with Employee” tasks.
☐ If pregnancy or bonding case, review if the EE is part of AWS.
☐ Reviewing the Contact Record to confirm the employee is not terminated or suspended.
☐ Review the Case notes.
☐ Review Case documentation.
☐ Review Absence Claim intake.
☐ Was the correct Case/Absence Claim opened?
☐ Check the Absence Claim to see if the “Additional Claim Exists for Same Leave Reason in the Same Year. Please
Review.” Task populated. This is a marker of a possible relapse.
☐ Assess whether a new Case/Absence Claim was opened correctly,
☐ or if reopening an existing claim should have occurred,
☐ If a claim was reopened due to relapse, the Case manager will schedule an “Extension Requested” task for the Case
owner.
☐ Check leave dates to ensure accuracy.
☐ Review eligibility and employment history.
☐ Ensure the ERTW is added to the RTW Object.
☐ Report any identified contagious disesases.

Terminated/Suspended Employees
☐ Was the employee terminated/suspended?
☐ Verify the “Reinstatement Review” or “Term Review – Status Change” task populated.
☐ Complete the “Correspondence Ready to Send” or “Review Information with Employee Task” without taking action.
☐ Create a Case note documenting all actions taken.

COVID Cases
☐ Review Case & Claim for COVID indicators.
☐ Determine if the Case/Claim should have gone to the CRC Team.
☐ If this is a CRC Case/Claim, reassign to the CRC team.
☐ Update “Special Circumstances” to reflect “COVID Suspected.”
☐ Create a Case note documenting all actions taken.

Changing Leave Dates

☐ If at intake the employee advised to update dates in a Case/intake note, check to see if the employee is hourly or salaried.
☐ If the employee is salaried, proceed with updating the leave dates per the employee’s request.
☐ If the employee is hourly, verify dates in MyTime before changing the dates.
☐ If the employee worked after their requested LSD, change the LSD to the day after the LDW unless the employees LDW
was on or after the ERTW.
☐ Check the LSF.

Military USERRA cases

☐ Confirm the Case/Claim is for Military USERRA (for self)
☐ Confirm dates are provided at intake.
☐ For continuous requests, if dates were provided, approve the Absence Claim.
☐ Review the decision.
☐ Update the signature to the generic DLS signature.
☐ Send L050 to advise the employee of the decision.
☐ Ensure enclosre E008 is attached.
☐ For intermittent requests, approve the Absence based on the employees request up to 365 days (i.e. October 1, 2020 –
September 30, 2021), if frequency and duration were provided “add time” for the date provided. DALI will auto approve.
☐ Review the decision.
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 ☐ “Add Time” when applicable.
☐ Update the signature to the generic DLS signature.
☐ Send L031 to advise the employee of the decision.
☐ Ensure L005 & L008 are attached.
☐ If dates were not provided, proceed with next step.
☐ Verify/schedule an “EE Interview Needs to be Completed” task.
☐ Complete the “Review Information with Employee” task.
☐ Complete the “CM/AC Review” task.
☐ Create a Case note documenting all actions taken.
☐ Proceed to the next assigned task.

Non-Military USERRA cases

☐ Review the “Correspondence Ready to Send” task on the Case level.
☐ Select the appropriate letter from the Conga Composer dropdown.
☐ Select the Conga button for “EE Correspondence.”
☐ Review the letter to ensure all key items are pulled into the letter.
☐ Ensure the appropriate enclosures were added to the EOHC- Acknowledgement packet. Team should modify the letter and
include the deadline of the documentation
☐ For L007, edit based on the leave reason.
☐ Use the editing examples depending on the leave reason as L007 is edited differently than all other letters.
☐ Ensure the letter accurately reflects eligibility.
☐ Update the signature to the generic DLS signature.
☐ Send the letter.
☐ Complete the “Correspondence Ready to Send” task.
☐ Corp/CS PLOA Cases/Claims: Schedule a “Check for Site Response” follow-up task.
☐ Non-Military USERRA & Non-Corp/CS PLOA Cases/Claims: Verify/Schedule an “Employee Interview Needs to be Completed”
follow-up task.
☐ Complete the “CM/AC Review” task.
☐ Create a Case note documenting all actions taken.
☐ Proceed to the next assigned task.

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NAVIGATING STANDARD OPERATING PROCEDURES (SOPS)
The following tools are available to help users navigate throughout this SOP:

 Download the SOP from the DLS Portal but do not save. Using this SOP in the web browser view disables some
of the functionality listed below.
 The Table of Contents – The Table of Contents is hyperlinked to every heading in the document. Users can press
the CTRL button on your keyboard while simultaneously clicking the heading from the Table of Contents to drop
down to that section of the SOP.
 The Navigation Pane – Like the Table of Contents, the Navigation Pane allows users to jump through the
headers, however, using this option also allows users to jump back to the Table of Contents without scrolling
through the document. To access the Navigation Pane, press CTRL + F and select “Headings” located under the
Navigation tile in the top of the pane.
 Comments – When SOPs are updated, or there is a specific call out to a section, the SOP Owner may add a
comment to alert the user. To select through the comments, select “Review” from the task bar the top of the
page then select “Next” in the comments section.
 HypELRinks – When a section or process has already been defined, the SOP Owner will hypELRink the user back
to the original information. The user can use the Navigation pane or Table of Contents to return back to the
section they were reviewing.

PROCESS

STEP 1: RECEIVING WORK

Tech will run a daily batch at 5 AM PST and assign all in scope tasks to the Case Managers assigned to this team. This will ensure we
are not spending time manually pulling reports and assigning work. Additionally, leads/managers will look at the live report in DALI
after 5 AM PST and re-assign to Case Managers who are done with the tasks assigned to them during the tech daily batch. In scope
tasks include: “Correspondence Ready to Send” tasks for L001, L002 (EOHC Acknowledgement), L003, L004, L005, L007 and “Review
Information with Employee” for USERRA Cases/Claims.

A. Assigned tasks will be pulled by using the task list on the “Home” or by pulling the My Due Tasks and Activities report.

STEP 2: ONE-CASE: ONE-CLAIM RELATIONSHIP

DALI will enforce a strict one-case-one-claim relationship, with the exception of pregnancy claims that move to Bonding. What this
means is that you will not be able to create a new absence claim or a new accommodation request on a case that already has an
existing accommodation request or absence claim on it – if you attempt to do so, the system will require you to create a new case
first, and then step through the AR/AC creation process. If an employee is transitioning from one leave type to another without
returning to work, you will need to create a new case and claim. The same is true if an employee is on leave and wants to request an

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accommodation – a new case and claim will be required. If you need to ‘relate’ one case to another, there is new functionality to
allow us to do so.

A. RELATING CASES TO EACH OTHER

When you are creating a new case and claim from within an existing case, the existing case and the new case will be ‘related to’
each other automatically.

If you need to relate a case to another after intake, you can do it by clicking ‘edit’ on the case, and making a selection per the below.

This should be done in scenarios where the employee has moved from one leave type (Ex. PLOA) to another (Ex. MLOA) without
returning to work.

B. ONE CASE ONE CLAIM – COPY DOCUMENTATION

Situations (transition from leave to accommodation, transition from EOHC to PLOA, etc.) employees may request a leave which
shares documentation with another leave. In those instances, DLS Case Managers (and employees) should have to option to copy
the documentation on case A to case B.

1. Allow users to copy documentation on one case to another case

1. Given a document has been added to a case
2. When DLS Case Managers navigate to the 'View All' feature on the File object or Documentation tab
3. Then DLS Case Managers will see a "Copy File" button
1. This will appear for all Case Status types
4. And DLS Case Managers will see selecting check boxes next to each document and they will be able to select one or
many documents.

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 1.

2.
2. Selecting Copy File button
1. Given DLS Case Managers have selected one or several documents
2. When they will select the Copy File button
3. Then a pop up will display which allows me to relate the selected documentation to any other case related to the
Contact

3. Display confirmation message

1. DLS Case Managers have selected files on case X and the copy button
2. And populated a valid case number (Y)
3. Then select save
4. Then a confirmation message will display that says "You are copying {number of files} files from case X for contact Z
to case Y for contact A. Are you sure you want to continue?"
5. And if they select OK then the selected files will continue to appear under case X, and they will also appear under
the documentation tab on case Y
6. And if they select Cancel then the selected files will remain on case X but will NOT appear on case Y.

4. Document will be logged in S3 File History

1. Will not be visible on the Case UI
5. Tasks for Copied Documents
1. Tasks should not be created for Documents which are copied to another Case
2. The one exception is if a Document is copied to a Case which has a different Case Owner from the original Case -
then a Document Received task should be triggered to the Case
6. Duplicate Files Validation Message
1. If a duplicate file already exists on the Case which a user is attempting to copy to, the following validation message
will appear:

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 1. One or more duplicate file(s) already exist on the Case you are attempting to copy to. Please remove
duplicate file or contact your system administrator if the problem persists.
7. Accommodation Request File components
1. On an Accommodation Request, the File component which only pulls from Salesforce items should be
removed/hidden
2. The existing File component will be able to pull files from S3 and Salesforce, and should be the only object visible
on the UI

STEP 3: INITIAL CASE/CLAIM REVIEW

During the initial Case/Claim Review, the Case Manager will review the Case, Claim intake, Case notes, documentation, eligibility,
and updating estimated return to work (ERTW).

A. IDENTIFYING AWS PREGNANCY AND PARENTAL CASES- PILOT

The Elig&Ack team will not send any acknowledgment letters for AWS EEs.

To determine if the EE belongs to the AWS team follow the next steps:

I. Navigate to the Details tab on the Contact level

II. Under ‘Additional Information’, look for the ‘STeam Member Name’

III. If any of the following names show on that section, do not

‘Correspondence Ready to Send’ task or take any additional actions.

 Adam Selipsky
 Barbara Santana-Alvarez
 Brandy Morbeck
 Prasad Kalyanaraman
 Matt Garman
 Peter DeSantis
 Stephen Schmidt
 Werner Vogels
IV. Re-assign the ‘Correspondence Ready to Send’ task to the Case Owner and leave a note stating: "Reassigning task to
case owner as per PREG/PAR AWS pilot"
V. If a different name shows on that list, proceed to the standard process.

B. IDENTIFYING MENTAL HEALTH CASES

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 I. E105 Case Comment

Review the case intake, employee interview questionnaire and case notes/details to determine if the case is related to a
psychological/mental condition. If you determine the case is related to a mental health condition, you will have to add an ‘E105’ case
comment for all EOHC continuous cases (regardless of the employee class), in order for the acknowledgement letters to populate
information specific to mental health conditions.

1. Navigate the case level to the ‘Case Comments’ section.

2. Click ‘New’.

3. Enter the comment E105

4. Do not mark the ‘Public’ checkbox.
5. Click ‘Save’.

6. Go to the One Leave Content tool and send the acknowledgement letters.

II. Mental Health & Wellness Reassignment (F-R class)

The Elig&Ack team will need to review or request proper reassignment for identified Mental Health & Wellness cases. This
applies only to Continuous EOHC cases for F-R employees that do not have an Actual Return to work (ARTW). The only
exception to this is Fitness for Duty cases (FFD).

To determine if the case requires reassignment to the Mental Health & Wellness team:

a) For cases created through the ERC DLS Support team:

1. Navigate to the Case level
2. Scroll down to the Case Comments section and the case should include the following comment:

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 b) For cases created via MyHR, please review the intake form for the check box if the case is related to Mental
Health.

c) To confirm that the case has already been assigned to the correct Case Manager, please review following list of Case
Owner's Manager.

 Joe Walsh
 Jenn Estes
 Tony Michaud

d) If E&A team identifies the case is a MH&W case but it has not been properly reassigned, add ‘F99’ to the Case Comments
section and within the next hour DALI will reassign the case automatically. Once the case is assigned to the MH team, a new
Case Comment will show as “F99 – reassignment complete”. Note: you do not need to wait for reassignment in order to
send the acknowledgement letters and complete all your actions.

C. IDENTIFYING CONNECTICUT PAID FAMILY LEAVE (CTPFML)

The Eli&Ack Team will use a specific template for the pay benefits the employee is eligible for during Leave.

I. CT PFML Eligibility

The Cases that apply are the following:

 All employees associated with an account (work site) with a billing state of Connecticut.
 Claim includes dates that are on or after 01/01/2022. (Note: The claim can start before 01/01/2022 as long as the end date
of the claim is on or after 01/01/2022)

The Connecticut PFML should be present for CT Employees for the following leave reasons:

 Family Leave:
o Care for a family member who has a serious medical condition
o Bond with a newborn or child who has joined the family through adoption / foster care

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 o Military Caregiver – care for a family member (parent, spouse, child, or next of kin) who was injured during active duty
in the military
 Domestic (Family) Violence Leave (Personal Protected Leave)
 Medical Leave (Employee’s own health condition) – including pregnancy, organ donation, and bone marrow donation.

II. Editing Acknowledgments

Please review the type of leave and modify the ‘Pay during leave section’ inside the Conga composer as shown below:

Pregnancy, FR Bonding

 You can request to apply any accrued and available Sick, Personal, Floating Holiday, and/or Vacation pay.
 Employees who work in the state of Connecticut are required to apply for Paid Family Leave (PFL) to qualify for time
coverage and pay during leave. Apply at www.ctpaidleave.org
 You may be eligible for a pay benefit under Amazon’s Pregnancy and Parental Leave Plans. You may be eligible to receive up
to 100% of your base wages.
 We will deduct the amount you are eligible to receive from the state plan from your Amazon payment. Be sure to apply for
your state plan as soon as possible.
 Review all the enclosed information to learn about pay processes for employees on a leave of absence.

Statutory unpaid (CFFM, Domestic Violence, Personal Protected Leave)

 Your leave is unpaid.

 You can request to apply any accrued and available Sick, Personal, Floating Holiday, and/or Vacation pay.
 Employees who work in the state of Connecticut are required to apply for Paid Family Leave (PFL) to qualify for time
coverage and pay during leave. Apply at www.ctpaidleave.org
 Review all the enclosed information to learn about pay processes for employees on a leave of absence

D. REVIEWING THE CASE

Anytime a new Case is received, the Case Manager will review all Case level objects to determine if key information has been
provided. This information will help determine if the Case is in scope.

I. Review the “Case Information” object.

II. Review the “Notes” object.
III. Review the “Documentation” tab.
IV. Review the “Open Activities” and “Activities History” objects.
V. Review the “Leave Status Feed.”

E. REVIEWING THE CONTACT RECORD TO CONFIRM THE EMPLOYEE IS NOT TERMINATED OR SUSPENDED
Review the Contact Record to ensure the employee is not terminated or suspended. If the employee is terminated or suspended,
proceed to step 3.

I. Navigate to the Contact Record and check the “EMP Status Description.”

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F. REVIEWING CASE NOTES
Review Case notes to ensure there is no mention of COVID 19 or termination. If the Case is related to COVID 19 or the
employee is terminated or suspended, proceed to step 3.

Note: Do not send ACK letters on a new EOHC case for an employee who was previously confirmed for submitting fraudulent
documentation on an ELR or ELR extension. Consult with Sr. CM or DLS manager to confirm if case should be closed/cancelled.

I. From the Case, scroll to the “Notes” object on the right side of the screen.

G. REVIEWING DOCUMENTATION
Review documentation to ensure there is no mention of COVID 19 or termination. If the Case is related to COVID 19 or the
employee is terminated, proceed to step 3.

I. From the Case, click on the “Documentation” tab.

II. If there are documents uploaded, review to ensure there is no mention of COVID, termination, or supension.

H. REVIEWING ABSENCE CLAIM INTAKE

Review Claim intake to ensure there is no mention of COVID 19, termination, or suspension. If the Case is related to COVID 19 or
the employee is terminated or suspended, proceed to step 3

To review Absence Claim Intake:

a. From the Case level, click on the Absence Claim hypELRink.
b. From the Absence Claim, select the hypELRinked “Intake” number (i.e. CI-000091)

c. Review requested leave dates, intake notes, and the intake questions specific to the leave reason.

I. ASSESSING WHETHER TO REOPEN AN EXISTING CLAIM FOR RELAPSE, WITHDRAWING, AND

SCHEDULING AN EXTENSION REQUESTED TASK
Regardless of the request type, the Contact Specialist will either open a new Case and Claim or add time to an existing
Claim/Case. The Case Manager will review the new Claim and past Claims to determine if a new Case/Claim was appropriate or
if the new Case/Claim will be withdrawn and an old Case or Claim will be reopened.

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To see all Cases assigned to the employee, click on the “Contact Name.” This will take you to the Contact level. Click on the
“Cases” hypELRink.

If the new Case and Claim were opened correctly, proceed to step 4.

Unique situations:
 A Case created as a PLOA cannot have a MLOA claim added. A new Case would need to be opened. Likewise, if an employee
had a MLOA case and did not return to work and transitioned to a PLOA this would be a new case with a new absence
claim.
 An intermittent case cannot have a continuous Claim added. If an employee returns to work on a reduced schedule, a
separate case/claim will be created for that, apart from the continuous case/claim that already exists.
 If a Parental Leave Claim is directly following a pregnancy leave it must be on the same Case. Pregnancy-related / bonding
claims are the one exception to the one-case-one-claim rule.

I. Create a New Case & Absence Claim

A new Case and Absence Claim are appropriate when:
1. There are no open Cases or Claims and;
2. The prior Case was closed for 14 or more days from the RRTW*
*NOTE: If the prior Case had a STD claim, it must have been closed 14 days or more from the employee’s release
to return to work (RRTW)
Important: If the original case had any documentation, make sure to upload it in the new case. Visit the
‘Uploading Documentation’ section on the Case Management SOP for further details.
3. Or the prior Claim has been closed for 13 or less days but the request is due to a new condition or leave reason.
4. In this scenario, the Case Manager will proceed to step 4.

II. “Additional Claim Exists for Same Leave Reason in the Same Year. Please Review.” Task
Before we assess if reopening an old Case/Claim is required it is important to check for the “Absence Claim Exists for the
Same Year’ task. This task fires on all Claims, except PLOA, when a claim is created for a reason, for which another claim
already exists. When this task is present on the Absence Claim, the Case Manager will closely review the former Cases &
Claims for relapse. This task is not the only identifier of relapse. Review the following scenarios to determine the best
course of action:

 Reopening an Absence Claim on an Existing Case

 Reopen an Old Case & Claim

III. Reopening an Absence Claim on an Existing Case

An Absence Claim should have been reopened on an existing Case when:
 There is an open Case and;
 The employee requests an Absence Claim but a prior Claim, for the same reason, was closed 13 days* or less.
*NOTE: If the prior Case had a STD claim, it must have been closed 13 or less days* from the RRTW.
1. In this scenario, the Case Manager will complete all tasks that fired on the incorrectly opened Case/Claim,
withdraw the incorrectly created Case and associated
Claims.
2. Review intake from the withdrawn claim.
3. From the Case, navigate to the “Absence Claims” object.
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 4. Select the Absence Claim that needs to be reopened.
a. Select the dropdown arrow adjacent to “New Cash Out Request,” select “Close/Reopen” from the picklist.
b. Input the reopen reason.
c. Input the effective date.
d. Select “Reopen.”
5. Once the Absence Claim is reopened, schedule a manual “Extension Requested” task for the Case owner, due the
next business day.
a. Scheduling an “Extension Requested” task
i. To schedule an “Extension Requested” task, navigate to the Case level and scroll down to “Open
Activities”
ii. Click the adjacent dropdown arrow and select “Add New”
1). Subject: Select “Extension Requested” from the dropdown
2). Due Date: Next business day
3). Comments: Relevant comments and signature line (location/alias/date)
a). Example: “Employee relapsed. New Case and Claim were created at intake. I withdrew the new
Case/Claim. Please contact employee to go over extension timeline. LAS16/swillisa/22 Sept 20”
4). Related to: DALI requires the ‘related to’ field be completed with the related Case, Claims, or
Accommodation Request (AR).
a). An error will populate if you fail to relate your task to a Case/Claim/AR. The ‘related to’
Case/Claim/AR will be automatically added if the task is scheduled from the Case/Claim/AR.
5). Priority: “Normal”
6). Status: “Open”
7). Reminder Set: Leave blank
8). Select “Save”
6. Create a Case note documenting all actions taken.
7. Proceed to the next Case/Claim.

IV. Reopen an Old Case & Claim

An old Case and Absence Claim will be reopened when:
 The prior Case & Claim has been closed for 13 days* or less and is related to the same medical condition.
*NOTE: If the prior Case had a STD claim, it must have been closed 13 days or less from the RRTW.
1. In this scenario, the Case Manager will complete all tasks that fired on the incorrectly opened Case/Claim,
withdraw the incorrectly created Case and associated Claims.
2. Navigate to the Case, select “Edit” in the top right corner.
a. Status – Select “Open.”
b. Select “Save.”
3. Navigate to the Case, select “Edit” in the top right corner.
4. Once the Case is reopened, reopen the Absence Claim.
5. Once the Absence Claim is reopened, schedule a manual “Extension Requested” task for the Case owner, due the
next business day.
6. Create a Case note documenting all actions taken.
7. Proceed to the next Case/Claim.

J. REVIEWING ELIGIBILITY, EMPLOYMENT HISTORY, REVERSING ELIGIBILITY DECISIONS, AND VALDATING

LEAVE PLANS

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I. Reviewing Eligibility
DALI automatically completes eligibility and adds appropriate leave plans. The Case Manager will review eligibility before
navigating to Conga to send letters and correspondence. If an employee is denied due to eligibility, this information is
pulled into acknowledgement letters.

1. From the Absence Claim, click on “Absence” on the right sidebar.

2. Eligibility for each Absence Claim will populate under the Absence object. To view the details, click the associated
hyperlinks.
Note: In case the STD claim is not automatically generated the CM will follow the next steps:
a. Cancel the case via the Physician Statement (PS), select the status reason ‘cancelled- entered in error’.
At this moment, the STD benefit should appear on the case and CM should continue to the step c.
b. If the STD benefit does not appear after cancelling the AC, the CM should enter a new PS using the
‘pending – recertification’ reason with the dates in pending status which will trigger the STD benefit.
c. Create a new PS using the ‘pending – recertification’ reason with the same leave dates.
d. Once DALI automatically generates the STD claim, there is no need to send any additional letters or
create new cases.
3. Navigate to the “Eligibility Rules Results” object at the bottom of the screen. The eligible and ineligible results will
populate.
4. Case Managers will confirm eligibility results are reflected in acknowledgement letters.

II. Additional Claim Exists for Same Leave Reason Task

If two or more absence claims are created within 1 year for the same leave reason, the “Additional Claim Exists for the
Same Leave Reason” task will trigger on the newest claim. When this occurs, the DLS Case Manager will need to review
both claims.

If first claim is denied but the employee was eligible, and the additional claim is denied due to ineligibility, the task will fire.
In this scenario, the employee is still eligible for the additional claim.

The DLS Case Manager must reverse the eligibility decision on the additional claim before sending the acknowledgement
letter. The additional claim will continue to follow standard case management for leave adjudication.

NOTE: There is an exception when moving from pregnancy to bonding claims and bonding to pregnancy claims. The
“Additional Claim Exists for the Same Leave Reason” task will trigger and as referenced above, if the employee was eligible
for one leave reason within the same year, they will be eligible for the additional request.

III. Reversing Eligibility

In some scenarios, the DLS Case Manager may need to reverse the decision made by DALI. Possible scenarios include, an
extenuating circumstance after late filing. Another know scenario is when adding a Parental leave to an existing Pregnancy
leave case - the eligibility will re-run for the Parental leave, but when this in in the same case we need to look at the original
eligibility for any available leave laws.
1. To update the eligibility decision, navigate to the Absence Claim.

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 2. Select the hypELRinked leave plan that needs to be updated. The date range object will populate.
a. Click on the hypELRinked “Name” of the date range that needs to be edited.
b. The “Date Range” object will populate.
c. Navigate to the “Eligibility Rule Results” at the bottom of the screen. Check the results to determine if
eligibility needs to be updated.
d. To update eligibility:
i. Select the down arrow on the right side of the eligibility rule that needs to be updated.
ii. Select “Edit.”
iii. Select the “Passed” check box to mark the employee as eligible. If not eligible, unselect the “Passed”
check box.

iv. Select “Save.”

e. To update the leave decision, navigate to the “Dates” at the top of the date range object.
i. Select the dropdown arrow to the right of the date range that needs to be edited.
ii. Select the “Edit.”
iii. Update the status from “Denied” to “Pending.” Once the decision can be made, use the Physicians
Statement (Rationale Screen) to make the decision.

iv. Select “Save.”

3. Ensure the rationale for reversal decision is clearly documented in a case note.

IV. Reviewing Employment History Task

The DALI system utilizes the most recent hire date, which under some circumstances can cause an employee to not show as
eligible for Parental Leave, FMLA, and Leave Share. Under certain situations the “Review Employment History” task will
populate to alert Case Managers to verify the employment history to assure that the correct leave and benefit plans are in
place.

1. When the “Review Employment History” task populates, the Case Manager will use the team Chime to message
the manager, team lead, or senior to check PP to determine if the employee is actually eligible for the leave they
have applied for.
2. The manager, team lead, or senior will :
a. Navigate to People Portal.
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 b. Under search, enter Workforce Job Summary.
c. Enter the Employee ID.
d. Under the general tab, look at the job information to determine eligibility.
e. Navigate to the employees leave case and verify that eligibility and entitlements are correct.
i. General eligibility information is available in the Leave & Pay Benefits Overview SOP.
f. Report findings to the Case Manager.
3. If changes are needed, the Case Manager will proceed to reversing eligibility decisions.
4. If changes are not needed, the Case Manager will proceed to validating leave plans.

V. Reversing Eligibility Decisions

In some scenarios, the Case Manager may need to reverse the decision made by DALI. Possible scenarios include, an
extenuating circumstance after late filing. Another know scenario is when adding a Parental Claim to an existing Pregnancy
leave case - the eligibility will re-run for the Parental leave, but when this in in the same case we need to look at the original
eligibility for any available leave laws.
4. To update the leave decision, navigate to the Absence Claim.
5. Select the hypELRinked leave plan that needs to be updated. The date range object will populate.

f. Click on the hypELRinked “Name” of the date range that needs to be edited.
g. The “Date Range” object will populate.

v. Select the “Edit” button in the top right corner.

vi. Update the status from “Denied” to “Pending.” Once the decision can be made, use the Physicians
Statement (Rationale Screen) to make the decision.
vii. Select “Save.”

6. Ensure the rationale for reversal decision is clearly documented in a case note.

VI. Validating Leave Plans

Case Managers will validate the appropriate leave plans have been added to DALI.

1. From the Absence Claim, scroll to “Absences” on the right sidebar.

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 a. DALI will populate the correct plans. If the Case Manager identifies an error in the leave plans, notify a DLS
Manager immediately.
b. A Trouble Ticket will need to be created as this is a bug. CTI: HRIS > HR Systems > DALI > System Issues/Bugs.

K. ENSURING ESTIMATED RETURN TO WORK (ERTW) IS UPDATED ON THE RTW OBJECT

During the initial review, the Case Manager will verify the ERTW is added to the Return to Work Object on the Absence Claim.
This will ensure all letters sent pull in the estimated dates.

I. Navigate to Absence Claim, to the quick actions drop down in the top right corner of the screen.

II. Select "Work Status". The New Work Status Row will populate, select Estimated Return to Work.

III. Add the correct ERTW and click Save.

IV. The Case Manager will verify the ERTW was added.
1. If no date was added, add the day after the last day of the leave request into the “Estimated Return to Work” field.
This will populate the date in the ERTW field after the record is saved.
V. If there is not a known ERTW, input 30 days after the leave start date.

L. CONTAGIOUS DISEASE PROTOCOL

When DLS receives a report of time away from work due to a contagious disease claim, DLS will identify the contagious
disease during regular case management and notify our partner teams such as GSOC, WHS or EHS.

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I. Contagious Diseases
Here is a current list of reportable contagious diseases. If an employee reports a contagious disease that isn’t on this
list, work with your Sr. Case Manager or Manager to determine if the contagious disease should be reported. The
most common ICD codes are listed next to the contagious disease, please note this is not an exhaustive list.

Reportable Contagious Diagnosis List ICD 10 codes starting with

Conjunctivitis B30
Cholera A00
Cryptosporidiosis A07.2
Diphtheria A36
Ebola Virus Disease/EVD/EBOLA A98.4
Hepatitis B15, B16, B17, B18, B19
Flu / Influenza A, B J09, J10, J11
A39.0, A87, G00, G01, G02,
Meningitis / Meningococcal infection G03
MERS ( Middle Eastern Respiratory Syndrome) B34.2
Measles/Rubeola B05
Rubella/German Measles B06
Salmonella / Salmonellosis A02
SARS / Severe acute respiratory syndrome B97.21
Shigellosis A03
Small Pox B03
Tuberculosis A15
Varicella,Herpes Zoster, Shingle, Chicken Pox B01

II. Contagious Disease Confirmed by Employee

If the contagious disease is confirmed by the employee, but no medical records are given to confirm a contagious
disease, the DLS Case Manager will follow these steps:

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 1. Set a task for the clinical team to validate the diagnosis.
2. From the case level scroll down to “Open Activities”
3. Click the adjacent dropdown arrow and select “Add New.”
a. Subject: Clinical Review Requested
b. Assigned To: DLS Clinical Queue
c. Due Date: Next business day
d. Comments:
i. Employee reported (Name and/or ICD 10 Code of contagious disease)
ii. Date symptoms started if known
iii. Is there a medical appointment scheduled?
iv. Name of HCP, Phone of HCP (if available)
v. Employee contact info
e. Priority: “High”
f. Status: “Open”
g. Reminder Set: Auto populates
h. Select “Save.”
III. Contagious Disease Confirmed by Medical Professional
Once a contagious diagnosis information is identified by a DLS Case Manager and is deemed “confirmed contagious
diagnosis” (Contagious diagnosis confirmed from medical documentation), the DLS CM notifies GSOC POC via ad hoc
email through DALI with the details about the associate and the reportable contagious diagnosis. Be sure to attach
of copy of the medical we received, if available.

Contagious Disease Template

Send to GSOC: GSOC@amazon.com

Subject: “Site-Account Name from DALI contact record-

Communicable/Contagious Disease Reported”

Email body:

Assign to: Communicable/Contagious Disease

Severity: Sev. 3

Site Employee works at: Site-Account Name from DALI contact

record

Employee Name: Employee Name

Employee Login: Employee Alias

Reported Disease: Contagious Disease Name

Date Reported to DLS: Claim create date

Is Reported Case Confirmed? (Note: this field should be

marked yes if we have medical on file): Yes/No

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 Additional Information: (Note- helpful information from the
case, such as employee needs interpreter, or employee
mentioned they visited multiple sites) 

Thank you,

STEP 4: TERMINATED OR SUSPENDED EMPLOYEES & COVID CASES

Terminated employees and COVID 19 Cases require additional steps.

A. TERMINATED/SUSPENDED EMPLOYEES
Before taking any action on the Claim, the Case Manager must first confirm the employee does not have a status of terminated
or suspended. If the employee is not in terminated or suspended status, proceed to reviewing for indications of COVID 19.

I. Suspended Employees
A suspended employee can be eligible for leave and STD benefits, but they would need to be:
1. An active (not suspended) employee on the date of disability.
If eligible at the beginning of the leave, STD would continue regardless of their status as long as paperwork supports STD.
Leave will only be approved when the employee is in a non-suspended status. Any time in which the employee is in
suspended status would be denied.

The employee would need to provide paperwork to meet the standards for leave and STD, if applicable. If the employee did
not meet the criteria then the DLS Case Manager will deny the leave and pay benefits if applicable, send the
correspondence, call the employee to inform them and close the case.

II. Terminated Employees

1. Verify the Termination Review Task Populated
If an employee is terminated a termination review task, called the “Reinstatement Review” or “Term Review – Status
Change” task, will automatically populate on the Case or Absence Claim respectively.  Verify a termination review task
populated.

If a task failed to populate, notify a manager so they may escalate and create a Trouble Ticket.
2. Complete the Correspondence Ready to Send and/or Review Information with Employee Task without Taking
Action
Case Managers will complete the task(s) that brought them to the Case, without sending any letters or making any
decisions.

a. All correspondence tasks populate under the “Open Activities” section at the case level.
b. Right click on the task name and open in a new tab.
c. Select “Mark Complete” in the top right corner.
d. Return to the Case tab and refresh the screen. The task will move from the “Open Activities” object to the
“Activity History” object.

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 3. Create a Case Note
Create a Case note recapping all findings and all actions taken on the Case/Claim.

B. REVIEWING THE CASE/CLAIM FOR COVID

COVID 19 Cases will typically be sent to the CRC team for processing. However, there may be circumstances where a Case is
incorrectly routed to the DLS team.

I. Initial Review for COVID

Case Managers will review all new Cases and Absence Claims for COVID indicators.
1. Review the Case to determine if there are notes, documents, or Special Circumstances referencing COVID.
2. Review the Absence Claim Intake for COVID indicators.

Note: Do not send ACK letters on a new EOHC case for an employee who was previously confirmed for submitting
fraudulent documentation on an ELR or ELR extension. Consult with Sr. CM or DLS manager to confirm if case should be
closed/cancelled.

II. Determining if the Claim is a CRC Case

If a Claim is related to COVID, the Case Manager will check to see if this is the first COVID request or if this is a referred to
leave Claim after an Emergency Leave Response (ELR).

 Note: If the first claim was not ELR (e.g. - first claim was LEA, MLOA, PLOA, etc.), check the first claim to
ensure the employee was RRTW. If the RRTW was keyed, then no need to confirm if the EE actually RTW.
You can proceed with setting up the ELR in step 4.

1. If the employee has a COVID related Case/Claim that was not reviewed for ELR, create the ELR
2. If the employee has a COVID related Case/Claim that already been reviewed for ELR, check MyTime to determine if
the employee returned to work between the two claims.
3. Review if an employee applies for a COVID Leave of Absence (LOA) with a Confirmed or Presumptive status within
90 days of their last confirmed or presumptive case.
a. Employees will be eligible for an EOHC Extension if a COVID Leave of Absence (LOA) is requested within 90
days of their last Confirmed or Presumptive case. step 4.
4. If an employee applies for a COVID Leave of Absence (LOA) with a Confirmed or Presumptive status outside 90
days of their last confirmed or presumptive case.
a. Employees will be eligible for a new COVID Leave of Absence (LOA) if requested 90 days after their first
Confirmed or Presumptive case-

b. Determining if the employee is hourly or salaried?

Verify if the employee is hourly or salaried. Navigate to the Contact Record and view the employees “Type Code
Description.”

i. If the employee is salaried, the CRC team will review and verify if a 2 nd special grant of pay is warranted.
ii. If the employee is hourly, check MyTime to determine if they have returned to work.

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 c. Checking MyTime
Hourly employees use MyTime for timekeeping. Check to see if the employee has returned to work between
claims.
i. To verify if an hourly employee has returned to work, copy the employee’s ID number from the Contact
level, and navigate to MyTime and search for the employee.
ii. Using QuickFind, enter the employee ID.
iii. Edit the time period for the date range from the employees last day worked (LDW) through today.
iv. Select “Find.”

v. Select the employees name from the list that populates.

vi. Review the timecard for any punches during between the LDW and today.

5. If the employee returned to work between the two claims, the ELR will be administered by the CRC.
6. If the employee did not return to work after the initial ELR, this will be handled as a standard Claim, proceed to
step 4.
III. Editing the Case Information to Reflect COVID
1. If the Case Manager determined a Claim should be reassigned to the CRC team, the Case “Leave Reason” will be
updated to ELR.
a. To update, navigate to the Case. Select “Edit” at the top of the Case.
b. Update the “Leave Reason” to ELR.
c. Update the “Special Circumstance” by adding “COVID Suspected” in the text box.
d. Select “Save” to implement changes to the Case.
2. The Absence Claim will also need to be updated to ELR.
a. Absences 7 Calendar Days
i. Withdraw the current Absence Claim.
ii. Add a new Absence Claim ensuring ELR questions are answered.
ELR Questions
1). What is the reason for the need for leave? Select “Emergency Leave Response.”
2). Emergency: “Pandemic” will auto populate.
3). What was the first date of your illness? Use the information from the original claim.
4). What was your first work day missed? Use the information from the original claim. If the employee is
hourly, verify information in MyTime.
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 5). Have you returned to work? Use the information from the original claim. If the employee is hourly,
verify information in MyTime.
6). Under Weekly Schedule, the DLS Case Manager will not be able to update the “Schedule Begins On”
section from intake or “Add Time.” DALI will default this field to match the Leave Start Date.
A). If the DLS Case Manager identifies the “Schedule Begins On” field needs to be adjusted
retroactively, navigate to the Contact level and select the “Change Schedule” button
located at the top of the screen.
B). Update the “Schedule begins on” field.
C). Select “Save.”

7). Dates: Input the dates from the original request.

A). On the Case level, create a Case note recapping all findings and all actions taken on the
Case/Claim.
IV. Absence Requests 8 Calendar Days or More
1. Update the leave dates on the current Absence Claim to reflect day 8 through the end date of the request.
a. Note: Employee’s work state may require the employee has 10 days of ELR, then the extension will begin
on day 11.
2. Add a new case/Absence Claim for ELR ensuring ELR questions are answered.
a. The ELR case/claim will auto assign to CRC via round robin. DALI will also set up a COVID case in the CRC
system (CEM).
3. Send the acknowledgement letter on the EOHC case/claim. You do not need to send an acknowledgement letter
on the ELR as this is completed by the CRC in their own system.
4. On the Case level, create a Case note recapping all findings and all actions taken on the Case/Claim.

STEP 5: UPDATING LEAVE DATES

If during the Case/Claim review the Case Manager identifies the leave dates have changed, the leave dates will need to be updated.

A. CHECKING MYTIME
I. Determine if the employee is hourly or salary.
II. If the employee is salaried, proceed with updating the leave dates based on the employee’s request.
III. If the employee is hourly, Check MyTime to confirm the employees last day worked (LDW).
1. If the employee worked after their requested leave start date (LSD), change the LSD to the day after the employees
LDW, unless the worked day is the ERTW or later.
2. If the employee did not work after their requested LSD, change the dates based on the employee’s request.

B. CHANGING LEAVE DATES

Any leave dates that are changed on the Work Status object, will be updated 1 at a time as DALI will not allow multiple changes
to the Work Status object at one time.

I. Updating the Adjusted Start Date

I. Navigate to the Absence Claim.
i. On the top right side select the drop down from the pick list.
ii. Select “Work Status.”

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 iii. Select “Adjusted Start Date.”

iv. Update the “Adjusted Start Date” with the new leave start date.
v. Update the “Status Reason” to “First Day Absent.”
vi. Select “Save.”
vii. You will also need to update the “Last Day Worked” (LDW).
viii. Ensure the change to the leave start date is showing accurately on the claim.

NOTE: When the leave start date is changed, DALI will automatically adjust the Benefit Date and the Date of Disability on the Benefit
Claim. It can take a few minutes for Benefit Claim to update.

II. Notifying the Employee of Changes to the Leave Start Date (LSD)
a. To notify the employee, the DLS team member will navigate to Conga and send “Correspondence Ready to Send - L021
- Change in Leave Start Date – EE”. Exception: when using the One Leave content tool, please refer to the One Leave
job aid for details on this updated communication.
b. The” Correspondence Ready to Send” task will be auto completed on the Case level. DLS team members can see the
completed task on the ‘Activity History” object.

C. CHECK THE LEAVE STATUS FEED (LSF)

I. Navigate to the Case level and click on “Leave Status Feed.”
1. Verify that the Leave Status Feed (LSF) is correct.
a. When a Case Manager sends a Leave Status Feed (LSF), the LSF will feed over to People Soft 6 days prior to the
effective date unless the employee’s return is less than 6 days away.

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 b. From the Case level, navigate to the Leave Status Feed object. Here, Case Managers will be able to see historic
and forecasted LSFs.

STEP 6: OREGON FAMILY LEAVE ACT (OFLA) STATE OF EMERGENCY UPDATES

OFLA  (Oregon Family Leave Act) OFLA  Updates:

Effective 1/1/22, all employees of a covered employer are eligible to take OFLA leave during a
period of time covered by a public health emergency

Exception:

 an employee who worked for the covered employer for less than 30 days immediately
before the date on which the requested leave would commence; or
 an employee who worked for the covered employer for an average of fewer than 25 hours
per week in the 30 days immediately before the requested leave would commence.

Current State of Emergency is in effect until 6/30/2022

OFLA – Sick Child Leave

Reasons for Leave  To care for a child who does not have a serious health condition but
requires home care.
 Effective September 14, 2020, sick child leave includes absence to care
for an employee's child whose school or child care provider has been
closed in conjunction with a statewide public health emergency declared
by a public health official. The public health emergency is currently
extended to 6/30/22.

Eligibility  FMLA, if applicable, will run concurrent with OFLA

 During Oregon’s State of emergency status,
 New Hire- employee must work at least 30 days, average of 25 hours per
week immediately preceding the leave request
 Terminated or Laid off remain eligible to receive OFLA upon return if: (1)
they return within 180 days of their separation of employment; and (2)
they were eligible to return prior to separation of employment
 Any time previously used will be deducted from the current available
time
 Credit for days of employment prior to a break in service must be
restored to the employee when the employee is reemployed/returned to
service by the former employer within 180 days of separation.
 

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Duration
Timely filling
Documentation Requirement:
Less than 15 days requested
Greater than 15 days requested
UPT/ Points Charged:
STEP 7: MILITARY USERRA CASES
If during the Case/Claim review the Case Manager identifies the event reason is Military USERRA (for self), the Case Manager will
review for RTA. If the leave event reason is anything other than Military USERRA, proceed to Step 6.
A. USERRA OVERVIEW
Continuous or Intermittent up to 12 weeks in a 1-year period,
Rolling backwards method applicable
(Note - A female employee is allowed to take an additional 12
weeks of leave for a disabling illness, injury, or condition related to
pregnancy or childbirth. Further, an employee who takes 12 weeks
of leave for a new child may take an additional 12 weeks when a
child has an injury or illness requiring home care.)
If the request is reported late we will continue to honor the request
as long as the state remains in a state of emergency which currently
is in effect until 6/30/2022.
 Currently no documentation is required for this leave reason.
 If Fraudulent activity is suspected we may ask for supporting
documentation which includes:
o Employee verification of:
 The child’s name;
 The school of the child or childcare provider’s name;
 A statement from the employee that no other family
member of the child is willing and able to care for the
child; and,
 if the child is older than 14, a statement that special
circumstances exist that require the employee to
provide home care.
If the request is less than 15 days, the ERC DLS team will submit a TT to CTK to
code time missed as excused.   Through the TT: Excused Time SIM
 The request is handled by the PLOA team and leave request
is initiated as a PLOA
 Standard PLOA eligibility applies
Any UPT or points charged for the missed time due to the school
closure or Child Care Closure will need to be waived through the
following TT: UPT refund
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When an employee who serves in the US armed forces is requesting a leave for active duty, training, or drill they have the
option to take a continuous or intermittent leave. The maximum duration for leave under USERRA is five years, however please
review the RTA SOP to determine eligibility criteria

B. REVIEW INFORMATION WITH EMPLOYEE TASK

Because there is no acknowledgement letter for Military USERRA cases, Case Managers will be notified via the “Review
information with employee” task. Upon receipt of this task, the Case Manager will verify the Absence Claim intake reflects
Military leave for self under USERRA.

C. APPROVE THE ABSENCE

You can review how to approve a Military absence on the RTA SOP. If the Case Manager was unable to approve the Claim,
no letter will be sent. Proceed to scheduling an “Employee Interview needs to be completed” task for the Case Manager.

D. REVIEWING THE DECISION

After the leave decision is made, the Case Manager will navigate back to the Absence Claim to review the approval. This can be
found on the Absence Claim.

I. Ensure the status reflects approved.

II. Confirm the leave dates are correct.
III. If the employee is requesting an intermittent claim and has included the usage dates (for example, the employee is
requesting intermittent leave for 1 year and provides a drill schedule or dates of absences) the Case Manager will Add
Time. DALI will auto approve as long as the time isn’t outside of frequency and duration.
1. Adding Time
a. Navigate to the Absence Claim.
b. Select “Add Time” from the quick actions dropdown.

c. On the Add Time page, ensure that the “From” and “to” date match the date range being reported off.

29 | P a g e
 d. Add the appropriate hours and minutes and select the day of the week that the intermittent time was

reported off.
e.Check against intermittent dates approved.
f.Once time has been added, DALI will auto approve if the time if it is within the approved frequency and
duration.
NOTE: A warning message will populate if the DLS Case Manager attempts to add more than 12 hours 59 minutes of time.
The message will populate even when multiple add time requests are made, if the total of all requests exceed 12 hours 59
minutes.
IV. Check the LSF.

E. SENDING MILITARY DECISION LETTER

If the Case Manager was unable to approve the Claim, no letter will be sent. Proceed to scheduling an “Employee Interview
needs to be completed” task for the Case Manager.

I. Once the Absence Claim have been approved, and time has been added (when applicable), the Case Manager will
navigate to the Case level to send L031 for Intermittent cases and L050 for Continuous Cases
II. There is a picklist located under the Conga Generator for employee correspondence. Select “L031 – Decision –
Intermittent - EE).”
a. Ensure the E008 is always attached and the E005 for intermittent cases only.
III. For step-by-step guidance, navigate the RTA Job Aid

F. EDITING L031

Remove the information highlighted in green.

Re: Your Leave of Absence Request – Employee Name, Case #

Dear Employee Name,

On application date we received your request for a leave of absence. See below for more information about the status of your claim.
Leave Decision  The following plans are assigned to your case:
Notification
Plan Name Status Decision Date Start Date End Date

Plan Name Plan Status Decision date, if

Decision start Decision end
no decision,
date, if no date, if no
leave blank decision, leave decision, leave
blank blank
You have been approved for intermittent time. Review below for plans and details.

Plan Name Time used Estimated Time

remaining

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 Amazon Military Leave

○ Please note, your approval end date may change based on

your available FMLA and/or state leave balances. If you need to change this date,
contact us via phone at (888) 892-7180 or email at amazondls@amazon.com.
○ At this time, we are unable to estimate how many hours of
FMLA or state leave law you will use, however you are able to request reports of your
intermittent usage every 30 days during your leave.
Pay Available
During Leave  Your leave is unpaid.
 Salaried Employees: As a salaried employee, you will continue to receive your regular
wages for partial intermittent days (less than your normally scheduled shift). If you miss a
full shift, you will not receive wages for that date.
 You can request to apply any accrued and available Sick, Personal, Floating Holiday,
and/or Vacation pay.
 Work State CA & NJ: You may be eligible for benefits through your state. If you’re
eligible and approved, you’ll receive payment according to the state plan. For assistance
applying for the state plan, review the “Applying for State Benefits” handout.
 You may be eligible for Military Differential Pay. Military Differential Pay is the difference between
your Amazon wages and Military Pay as calculated based on your
 Leave and Earnings Statement (LES). To apply for Military Differential Pay, please submit a copy of
your orders and LES via fax at {FAX} or email at {EMAIL}.
 Review all the enclosed information to learn about pay processes for employees on a
leave of absence.

What Happens
Next  We will notify your HR representative and Manager of your claim decision.

 You must report your absence(s) when you are away from work due to your intermittent leave. Refer to the
enclosed How to Report Intermittent Absences for specific instructions. You must also follow your regular
absence reporting process.
 If we request it, you must show that your certification is still valid by providing an updated certification form. We
will notify you if you need to provide additional certification. If you do not provide updated certification in a
timely manner, your intermittent leave may end and your absences may be subject to Amazon’s attendance
policies.

G. EDITING LO50

RE: Decision Notification – Employee Name, Case #

Dear Employee Name,

On September 13, 2020 we received your request for a leave of absence. See below for more information about the status of
your claim.
Ensure the correct
Leave Decision approval dates are
   September 13, 2020 to November 23, 2020  has been approved and will be pulled into the
Notification designated under Amazon’s Military Leave, which aligns with USSERA decision.
Pay Available     The requested leave is unpaid.
During Leave
    You can request to supplement any accrued and available Sick, Personal, Floating
Holiday, and/or Vacation pay.
    You may be eligible for Military Differential Pay. Military Differential Pay is the
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 difference between your Amazon wages and Military Pay as outlined on your Leave and
Earnings Statement (LES). To apply for Military Differential Pay, please submit a copy of your
ordersVerify
and the
LEScorrect
via fax at 1-855-579-1799 or email at amazondls@amazon.com. Your case
expected return to whether you are eligible for Military Differential Pay and the amount
manager will determine
uponwork dateofwas
receipt pulled
your orders and LES.
into the decision.
    Visit enclosures for more information on how time off pay coordinates with leave
and wage policies.
What Happens     We will notify your HR representative and Manager of your claim decision.
Next     You have informed us you expect to return to work is November 24, 2020. If this
changes, please contact us immediately. Otherwise, you may return to work on that date as
scheduled. If a decision is made
   Our records indicate that you returned to work on November 24, 2020. after the employee
has returned to work,
   USERRA provides reemployment rights, should your employment with Amazon end will
this sentence duepull
to
extended Military service. To enact these rights, you must contact us to evokeinto the letter. If the
your rights. Notification of your desire to return to Amazon must be timely. Please
employee has not
contact us as soon as you are discharged from Military Service to begin making these to work, this
returned
arrangements. sentence can be
    As a convenience, you can notify us of your orders, when you receive them   eachdeleted.
fiscal year. We will proactively notify your Manager, HR and payroll on your behalf. 
Thank you for your commitment and continued service to our country.

H. VERIFY OR SCHEDULE AN “EE INTERVIEW NEEDS TO BE COMPLETED” TASK

Regardless if the USERRA Absence is approved or if there wasn’t enough information to make a decision, the Case Manager will
schedule and ensure the “EE Interview/Initial Call needs to be completed” task triggers on the Absence Claim.

 If the task triggered, leave it on the Absence Claim and verify it is assigned to the Case owner. No other action is needed.
 If the task did not trigger, create a manual "EE interview needs to be completed” assigned to the Case owner, due the next
business day.

1. To schedule an “EE interview needs to be completed” task, navigate to the Case level and scroll down to “Open
Activities”
2. Click the adjacent dropdown arrow and select “Add New”
a. Subject: Select “EE interview needs to be completed” from the dropdown.
b. Due Date: Next business day
c. Comments: Relevant comments and signature line (location/alias/date)
i. Example 1 - Approval Made: “Call EE to review decision and go over go over documents need for MDP,
and next steps. Las16/swillisa/15 Sept 20”
ii. Example 2 - Unable to Approve Leave: “I was unsure which dates the employee was requesting as they
were conflicting in the Absence and Intake. Please contact the EE to clarify dates, go over documents need
for MDP, and next steps. LAS16/swillisa/15 Sept 20.”
d. Related to: DALI requires the ‘related to’ field be completed with the related Case, Claims, or Accommodation
Request (AR).
i. An error will populate if you fail to relate your task to a Case/Claim/AR. The ‘related to’ Case/Claim/AR
will be automatically added if the task is scheduled from the Case/Claim/AR.
e. Priority: “Normal”
f. Status: “Open”
g. Reminder Set: Leave blank
h. Select “Save”

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 I. COMPLETING THE “REVIEW INFORMATION WITH EMPLOYEE” TASK
Once the USERRA Claim is reviewed and the Employee Outbound Contact task is scheduled, complete the “Review Information
with Employee” task.

I. All tasks populate under the “Open Activities” section at the case level.
II. Right click on the task name and open in a new tab.
III. Select “Mark Complete” in the top right corner.
IV. Return to the Case tab and refresh the screen. The task will move from the “Open Activities” object to the “Activity
History” object.

J. COMPLETING THE “CM/AC REVIEW” TASK

I. Check the Case and Absence Claim to ensure there is no “CM/AC Review” task scheduled.
II. If the task is scheduled complete it as the “EE interview/Initial Call needs to be completed” or “Check for Site
Response” tasks will bring the Case Manager back to the Case/Claim for action.

K. CREATE A CASE NOTE

On the Case level, create a Case note recapping all findings, all actions taken on the Case/Claim, tasks completed, and action
items for the Case owner. This will include the approval date range if an approval was made or any missing information needed
that prevented the Case Manager from making a fast approval. This is the last action needed for USERRA Claims. The Case
Manager will move to the next task from their assigned daily work.

STEP 7: NON-USERRA CASES – ACKNOWLEDGEMENTS

For all in scope leave reasons except Military USERRA Cases, Case Managers will send the acknowledgement letter. *This does not
apply for OPS PLOA Cases/Claims as they are not in scope for this team.

A. FMLA DENIALS & ACKNOWLEDGEMENTS

Because DALI auto adjudicates FMLA eligibility, scenarios may occur that cause multiple letters to populate for the employee, an
acknowledgement and denial. If FMLA is denied, but the employee is eligible for other absences, the Acknowledgement and
Eligibility team will proceed with sending the acknowledgement. If FMLA is denied and the employee is not eligible for other
absences, the Acknowledgement and Eligibility team will complete the correspondence task without sending it and the DLS Case
Manager will need to send the appropriate denial letter to the employee.

I. FMLA Denial but Eligible for Other Absences

When the employee is denied FMLA but is eligible for other leave types, DALI will generate 2 “Correspondence Ready to
Send” tasks (an acknowledgement and denial). When this occurs, the Acknowledgement and Eligibility team will send the
acknowledgment correspondences as the acknowledgement correspondence has the FMLA denial decision included in the
letter and the other leaves of which the employee is eligible.

1. The Acknowledgement and Eligibility team sends the employee acknowledgement notification through Conga and
verifies the ER acknowledgment notification was automatically sent by DALI.
2. Document all actions taken in a case note.

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 II. FMLA Denial but not Eligible for Other Absences
When the employee is denied FMLA but IS NOT eligible for other leave types, DALI will generate 2 “Correspondence Ready
to Send” tasks (an acknowledgement and denial). When this occurs, the Acknowledgement and Eligibility team will
complete acknowledgment correspondences without sending and follow their standard process for next steps (i.e. verifying
the follow-up task is scheduled for the case owner for the next business day). Upon receipt of the case, the DLS Case
Manager will review the case per standard process and send the denial letter since the employee is not eligible for other
absences.
1. The Acknowledgement and Eligibility team will complete the employee acknowledgement notification without sending
then ensure the follow up task is scheduled for the case owner to be brought back to the case, and document all
actions taken in a case note.
2. The DLS Case Manager will send the denial notification through Conga , verify the ER decision notification was
automatically sent by DALI, and document all actions taken in a case note.

B. SENDING ACKNOWLEDGEMENT LETTERS

I. Correspondence Ready to Send Tasks
a. Case Managers will be notified of non-USERRA Cases via the “Correspondence Ready to Send” task. After steps
1 – 5 are completed, the Case Manager will verify which letter needs to be sent and which tool will be used.
b. All of the following letters: CFFM, EOHC, Pregnancy, including continuous and intermittent claims should
contain the deadline of the documentation to properly inform the employee of their obligation on this process
except for L005 request for PLOA, L004 for Leave Share and L003 for School visitation. The Case Manager may
need to modify the letter and include the deadline of the documentation which can be calculated as following:
 If it's a past dated claim, the deadline should be 21 calendar days from the day the Acknowledgment
letter is being sent.
 If it's a future dated claim the deadline starts 21 days from the LSD.
 If it’s a COVID case the deadline will be calculated the same but using 15 calendar days instead.
 All intermittent cases except for School Visitation will require a deadline of 21 days instead of 15
days.

1. The Case Manager will navigate to the Case level to send the letter referenced in “Open Activities.”
c. Acknowledgement - CFFM – Continuous - One Leave Tool
d. Acknowledgement – Military Exigency and Caregiver – One Leave Tool
e. L002 - Acknowledgement - Pregnancy – EE *note in certain scenarios you’ll be using the One Leave Tool details
noted below*
f. Acknowledgement EOHC Continuous - One Leave Tool
g. Acknowledgement - Intermittent EOHC, Pregnancy, CFFM, Bonding and Adoption/Foster Care- One Leave Tool
h. L003 - Acknowledgement - Intermittent (All other leave types not covered in One Leave)- EE
i. L004 - Acknowledgement - Leave Share - EE
j. L005 - Acknowledgement - PLOA NONNACF – EE
k. Acknowledgement Personal Protected Leave (Crime), continuous and intermittent - One Leave Tool
l. Acknowledgement – Bonding/Parental - One Leave Tool
2. On F & R class EEs’ Pregnancy cases which include an STD component, you must review the EDD (estimated
delivery date) on the Claim Intake to determine the appropriate mechanism or enclosures to be sent, as shown
below:
m. LSD is 4 weeks or less before EDD – Use the One Leave Tool
n. LSD is more than 4 weeks, 5 weeks or 6 weeks before EDD – Include “E106- Form-Physician Statement-
Standard”

II. Sending Acknowledgement Letters (Except for when LSD is 4 weeks or less before EDD and L007)
1. If the LSD is 4 weeks or less before EDD you’ll need to use the One Leave tool
2. There is a picklist on the Case level, located under the Conga Generator, for employee correspondence. Select the
letter title listed in the “Open Activity” task.

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 3. Click the” EE Correspondence” button located in the top right corner.
4. Ensure the letter has the correct dates pulled into letter. Ensure all items in yellow, see below, are reflected
correctly with data from the approval and return to work on the Absence Claim.
5. Update the signature on the letter to the generic DLS signature.

Disability & Leave Services

Email: AmazonDLS@amazon.com
Phone: 888-892-7180, Option 1
Get HR Help: hrservices.amazon.co

6. Starting 01/07/2022 DALI will not auto send the employer correspondence for leave acknowledgement, “L055 -
General Acknowledgment – ER.” Do not send it manually.
7. For step-by-step guidance, navigate to the Sending Letters and Correspondence appendix.
III. Editing Acknowledgement Letters (Except L007)
1. Review the example letters for the different leave reasons.
2. Anything highlighted in yellow is specific to the employee and will pulled into the letter from the employee’s
profile.
3. Bolded sections with the downward arrow icon ( ↓) will only pull in based on the employee’s eligibility. The
description provided in the example is for the purpose of this SOP. It is not included in the actual letter.
4. The “What You Need to Do,” “What Happens Next,” and “Questions” sections are not included in the examples as
they do not require editing from Case Managers. Case Managers will still review these sections before sending.

IV. Sending Acknowledgement L007

1. There is a picklist on the Case level, located under the Conga Generator, for employee correspondence. Select the
letter title listed in the “Open Activity” task.
2. Click the” EE Correspondence” button located in the top right corner.
3. Ensure the letter has the correct dates pulled into letter.
4. Determine which letter will be sent to the employee.
5. Paste in the sections that are listed in the editing L007 section.
6. Ensure all items in red, see below, are reflected correctly with data from the approval and return to work on the
Absence Claim.
7. Starting 01/07/2022 DALI will not auto send the employer correspondence for leave acknowledgement, “L055 -
General Acknowledgment – ER.” Do not send it manually.
8. For step-by-step guidance, navigate to the Sending Letters and Correspondence appendix.
V. Editing Acknowledgement Letter L007
1. Determining which letter to Send (Bonding, Parental, or Crime & Domestic Violence)
In order to determine which letter for L007 to send, review the following indicators.

a. Bonding Vs. Parental Indicators

i. Review the Case level. The “Claim/ Request Reason” will say “Bonding” if the Case originated as a bonding
Case.
ii. Review the Absence Claim intake. The details will indicate the relation with the kid (I.e. father-mother),
the number of children delivered, last date of disability, and estimated date of delivery.
iii. From the Absence Claim, click on “Absence” on the right sidebar to review eligibility for Paid Parental.

35 | P a g e
 iv. If any results show as “Ineligible,” send the bonding acknowledgement. If all results show eligible, send
the parental acknowledgement.

b. Crime & Domestic Violence Indicators

i. Review the Case level. The “Claim/Request Reason” will say “Crime” if the Case originated as a crime Case.

ii. Regardless of the Case type, review the Absence Claim intake. The leave reason will show “Personal
Protected Leave.” If the Case originated as something other than crime, or there are multiple Absence
Claims, the Absence Claim Intake will still indicate if the new request is for crime or domestic violence.

2. Standard Edits (Regardless of Type)

a. Leave the introduction information in the letter as it will pull in based on the employee’s information. This
section will pull into the letter and does not need be edited.

Email Subject: Leave Request Notice – {Legal Name}, Case Number {Case #}, Claim Number {Claim #}

Email Body Template:

{TODAY’S DATE}

{LEGAL NAME}
{ADDRESS}
{ADDRESS}

Dear {PREFERRED NAME},

On {APPLICATION DATE}, Disability & Leave Services (DLS) received your request for a leave of absence. See below for more
information about the status of your claim.

b. Leave the plan information chart as is.

c. If the letter is for paid parental, leave the information specific to how to file for the state benefit.
d. Paste in the remaining sections.
e. Sections in red will need to be edited. Leave dates and eligibility are found on the Absence Claim, the
employees work state is located on the Contact Record.

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C. COMPLETE CORRESPONDENCE READY TO SEND TASKS
Once the acknowledgement letter is sent on Non-USERRA Claims, complete the “Correspondence Ready to Send” task.

I. All tasks populate under the “Open Activities” section at the case level.
II. Right click on the task name and open in a new tab.
III. Select “Mark Complete” in the top right corner.
IV. Return to the Case tab and refresh the screen. The task will move from the “Open Activities” object to the “Activity
History” object.

D. COMPLETING REVIEW INFORMATION WITH EMPLOYEE TASK

In some scenarios, a “Review Information with Employee” task will populate with a “Correspondence Ready to Send” task. This
task triggers when an employee requested their leave via MyHR. After the acknowledgement is sent, the Case Manager will also
complete the “Review Information with Employee” task.

I. All tasks populate under the “Open Activities” section at the case level.
II. Right click on the task name and open in a new tab.
III. Select “Mark Complete” in the top right corner.
IV. Return to the Case tab and refresh the screen. The task will move from the “Open Activities” object to the “Activity
History” object.

E. VERIFY OR SCHEDULE A FOLLOW-UP TASK AND COMPLETING DUPLICATES

I. (All type of leaves except PLOA Cases) Scheduling an Employee Interview Task
For any Case where an acknowledgement letter was sent, skip this section for USERRA or CORP/CS PLOA Cases, after
sending the acknowledgement letter and completing the “Correspondence Ready to Send” task, the Case Manager will
verify that there is an " EE interview/initial call needs to be completed " task triggers on the Absence Claim.

 If the task triggered, leave it on the Absence Claim and verify it is assigned to the Case owner. No other action is
needed.
 If the task did not trigger, create a manual " EE interview/initial call needs to be completed” assigned to the Case
owner, due the next business day.

1. To schedule an “EE interview needs to be completed” task, navigate to the Case level and scroll down to “Open
Activities”
2. Click the adjacent dropdown arrow and select “Add New”
a. Subject: Select “EE interview needs to be completed” from the dropdown.
b. Due Date: Next business day
c. Comments: Relevant comments and signature line (location/alias/date)

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 d. Related to: DALI requires the ‘related to’ field be completed with the related Case, Claims, or Accommodation
Request (AR).
i. An error will populate if you fail to relate your task to a Case/Claim/AR. The ‘related to’ Case/Claim/AR
will be automatically added if the task is scheduled from the Case/Claim/AR.
e. Priority: “Normal”
f. Status: “Open”
g. Reminder Set: Leave blank
h. Select “Save”

II. (All EOHC Continuous Cases) Scheduling a custom “Day 11 – Documentation Reminder” Task
1. To schedule a “Day 11 – Documentation Reminder” task, navigate to the Case level and scroll down to “Open
Activities”
2. Click the adjacent dropdown arrow and select “Add New”
3. Type in the subject field “Day 11 – Documentation Reminder”
4. Set the due date: 11 days from LSD or date you are sending the acknowledgement letter, whichever is later.
Reminder the task due date should only be set on a business day (Mon-Fri) *Example if day 11 falls on
Saturday/Sunday, make the task due the following Monday.*
5. Select “Save”

III. (CORP/CS PLOA Cases) Scheduling a Check for Site Response Task
For CORP/CS PLOA Cases, to confirm an employee is a Corp Employee, we need to always check the "Organizational
Structure Code 1" on the Contact page of the employee and it should indicate:

 Corporate
 Customer Service
 Ops - Pillpack Fulfillment

After sending the acknowledgement letter and completing the “Correspondence Ready to Send” task for L005, the Case
Manager will schedule a manual “Check for Site Response” task assigned to the Case owner, due in 6 business days.

1. To schedule an “Check for Site Response” task, navigate to the Case level and scroll down to “Open Activities”
2. Click the adjacent dropdown arrow and select “Add New”
a. Subject: Select “Check for Site Response” from the dropdown.
b. Due Date: 6 business days
c. Comments: Relevant comments and signature line (location/alias/date)
d. Related to: DALI requires the ‘related to’ field be completed with the related Case, Claims, or Accommodation
Request (AR).
i. An error will populate if you fail to relate your task to a Case/Claim/AR. The ‘related to’ Case/Claim/AR
will be automatically added if the task is scheduled from the Case/Claim/AR.
e. Priority: “Normal”
f. Status: “Open”
g. Reminder Set: Leave blank
h. Select “Save”

IV. (Non-CORP/CS PLOA Cases) Scheduling PLOA Decision Task

For any Case where an acknowledgement letter was sent, skip this section for USERRA or CORP/CS PLOA Cases, after
sending the acknowledgement letter and completing the “Correspondence Ready to Send” task for L005, the Case Manager
will verify that there is an " PLOA-Decision " task triggers on the Absence Claim.
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  If the task triggered, leave it on the Absence Claim and verify it is assigned to the Case owner. No other action is
needed.
 If the task did not trigger, create a manual " PLOA-Decision” assigned to the Case owner, due the next business day.

1. To schedule a “PLOA-Decision” task, navigate to the Case level and scroll down to “Open Activities”
2. Click the adjacent dropdown arrow and select “Add New”
a. Subject: Select “PLOA-Decision” from the dropdown.
b. Due Date: Next business day
c. Comments: Relevant comments and signature line (location/alias/date)
d. Related to: DALI requires the ‘related to’ field be completed with the related Case, Claims, or Accommodation
Request (AR).
ii. An error will populate if you fail to relate your task to a Case/Claim/AR. The ‘related to’ Case/Claim/AR
will be automatically added if the task is scheduled from the Case/Claim/AR.
e. Priority: “Normal”
f. Status: “Open”
g. Reminder Set: Leave blank
h. Select “Save”
V. Completing the “CM/AC Review” Task
1. Check the Case and Absence Claim to ensure there is no “CM/AC Review” task scheduled.
2. If the task is scheduled complete it as the “EE interview/Initial Call needs to be completed” or “Check for Site
Response”(CS, Corp) or “PLOA-Decision” (Non CS, Corp) tasks will bring the Case Manager back to the Case/Claim
for action.

F. CREATE A CASE NOTE

On the Case level, create a Case note recapping all findings, all actions taken on the Case/Claim, tasks completed, and action
items for the Case owner. The Case Manager will move to the next task from their assigned daily work.

EXAMPLE LETTERS

Please refer to the One Leave Tool job aid to identify if you should use the tool for letters. If you should not

A. EDITING LETTER L001 - ACKNOWLEDGEMENT – CFFM, MILITARY EXIGENCY AND CAREGIVER – EE

Re: Your Leave of Absence Request – Employee Name, Case #

Dear Employee Name,

On application date you requested a leave of absence. Here is the information you’ll need to make sure you receive leave
and/or payment benefits according to our policies and plans.

Your Leave  You requested to begin your leave on leave start date.
Request
 You expect to return to work on date.
 You’re taking leave due to Caring for a family member or Military Exigency.
 You’re taking a continuous leave (full work days in a row).
↓ FMLA eligible employee acknowledgements will pull into the following section. ↓
 You are eligible for leave under the federal Family and Medical Leave Act (FMLA).
 If your leave is approved it will be designated as federal Family and Medical Leave Act (FMLA), and/or

39 | P a g e
 any applicable state/local leave law(s). Your time off from work will reduce your available leave
balance(s).
 Your requested leave will use approximately estimated hours of FMLA hours of FMLA out of your
balance of current balance of FMLA hours of FMLA. Please note, this is an estimate and is subject
to change if your leave dates change.

↓ FMLA ineligible employee acknowledgements will pull into the following section the reason for
denial will be reflected in the letter. It may include one or multiple of the following. ↓
 You are not eligible for leave under the federal Family and Medical Leave Act because:
 You have not worked 1,250 hours in the previous 12 months. As of the date of this letter you
have worked approximately hours.
 You have not worked for Amazon for 12 months. As of the date of this letter you have worked
approximately tenure in months.
 You have exhausted your FMLA entitlement for the current year period.
 You have requested leave to care for a family member who is not covered under the FMLA

 The following plans are assigned to your case:

Plan Name Status Decision Date Start Date End Date

Plan Name Plan Status Decision date, if Decision start Decision end
no decision, date, if no date, if no
leave blank decision, leave decision, leave
blank blank
Pay Available  Your leave is unpaid.
During Leave
↓ Paid Family Leave (PFL) verbiage will pull into the letter if the employees work state has a PFL
benefit.↓
 You may be eligible for benefits through your state. If you’re eligible and approved, you’ll receive
payment according to the state plan. For assistance applying for the state plan, review all of the
material in this packet for more information.
What You  Read all of the material in this packet, which describes your rights and responsibilities under
Need to Do state/local and federal laws.
 Return the enclosed Certification Form. Certification is needed to approve leave and/or disability
payments if eligible.  You must return this by Documentation Deadline via fax 1-855-579-1799 or
email amazondls@amazon.com.
 Apply for benefits through your state. If approved, the state will pay some of your wages. Review the
'Applying for State Benefits' handout for help applying.

B. EDITING LETTER- EOHC ACKNOWLEDGEMENT LETTER– EE

The E&A team can use 8 new employee own health condition (EOHC) acknowledgment templates. These new templates replace the
existing L002 template that populates automatically in CONGA:
 L106 - EOHC Acknowledgement - Paid Statutory FMLA
 L107 - EOHC Acknowledgement - Paid Statutory Non FMLA
 L108 - EOHC Acknowledgement - Paid Non Statutory FMLA
 L109 - EOHC Acknowledgement - Paid Non Statutory Non FMLA
 L110 - EOHC Acknowledgement - Unpaid Statutory FMLA
 L111 - EOHC Acknowledgement - Unpaid Statutory Non FMLA
 L112 - EOHC Acknowledgement - Unpaid Non Statutory FMLA
 L113 - EOHC Acknowledgement - Unpaid Non Statutory Non FMLA

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These are separated based on three parameters:
 Paid: There is an Amazon paid leave/Short-Term Disability (STD) component to the case (including ELR extension)
 Statutory: There is a state leave associated where the employee must apply for benefits through the state
 FMLA: The employee is eligible for FMLA/state leave benefits

The statutory templates should only be used for: WA, CT, NJ, MA, CA, RI, DC (Excluding NY and HI)

I. ” Removing a preloaded template in CONGA

To remove the preloaded template in CONGA, follow the next steps:

 In the Selected template list, choose the L002 letter and remove it to the left with the arrow:

 In the template list on the left side, choose the appropriate letter template you will use and move it to the right with the
arrow:

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  Make sure that letter is placed after the Cover letter, you can drag the letter and place it where needed.

 Follow the next steps as usual when composing a letter.

II. Editing for COVID related extension

Please make the below adjustments for COVID related extensions, only for employees who work in CA, CO, NY, PR or Philadelphia,
PA.

 For COVID related extensions, make sure to edit the documentation deadline 15 days (from leave start date or date you are
sending the letter, whichever is later)*

 For COVID extension cases for F/R employees, delete the following sentence:
STD pay will only begin after 7 days. You can use available Sick, Personal, Floating Holiday and/or Vacation time to cover
this 7 day unpaid period.

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 III. Editing WC section

A. In the Required Next Steps section add the following verbiage as below:

For all WC cases, except employees who work in the state of WA:

• If you have not done so already, please report your work-related injury or illness to your site AMCARE/Safety team. If your
site does not have AMCARE/Safety, please notify your manager. The site will assist you in reporting your injury/illness and
provide next steps on filing for a worker’s compensation claim after the appropriate documentation has been completed.

• You should return to work after seeing the medical provider or on your next scheduled shift to provide your medical
paperwork. Your site AMCARE or HR will assist you with the next steps once your documentation is received. Failure to update
your site and workers’ compensation contact can cause delays and/or denial of any workers’ compensation benefits.

• You will be notified of the status of your leave of absence case when a decision about your workers’ compensation claim
has been made.

For employees who work in the state of WA:

• Amazon’s Washington Workers’ Compensation program is managed by the Depart of Labor and Industries (L&I). This means
that you must file a claim with L&I to receive benefits. Below are the steps you can take to file a claim: • File your claim by
phone: 1-877-561-FILE • File your claim online: http://www.lni.wa.gov/ORLI/ECS/FileFast.asp • Or complete a Report of
Accident at your physician’s office and send the state form to the department directly.

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 • You should return to work after seeing the medical provider or on your next scheduled shift to provide your medical
paperwork. Your site AMCARE or HR will assist you with the next steps once your documentation is received. Failure to update
your site and workers’ compensation contact can cause delays and/or denial of any workers’ compensation benefits.

• You will be notified of the status of your leave of absence case when a decision about your workers’ compensation claim
has been made.

B. In the Pay Available During Leave section, add the below verbiage only if the case is WC AND has an STD claim:

• If your workers compensation claim is compensable you will receive pay directly from Sedgewick; Amazon will also approve
the Short-term disability benefit and apply an offset.

• If your workers compensation claim is non-compensable, you may be eligible for Amazon’s Short-Term Disability (STD) plan
administrated in accordance with the terms of the federal Employee Retirement Income Security Act (ERISA) at 60% of your
pay. Return the attached Physician’s Statement form or medical documentation to support your leave and pay request.

• Only for employees who work in the state of CA, WA, MA, CT, NJ: If your workers compensation claim is non-compensable,
you will be required to apply for paid benefits through your state. After applying with your state, you must submit your state
benefit decision letter to Amazon within 5 days of receipt. Submit your decision letter by replying directly to this email, on the
Resources page at atoz.amazon.work or via the Disability and Leave Services (DLS) Portal at dls.idp.amazon.corp.com (on the
Amazon network).

• Your medical related benefit coverage will end the first of the month following the end date of the short-term disability
exhaust date or 26 weeks whichever comes first. Please contact the Benefits Service Center or ERC to discuss coverage. You
can also review the End of Benefits guide included in all correspondence for more information about when your benefits will
begin, end, and how a leave of absence impacts your health benefits, pay and stocks, if applicable.

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 IV. Editing the email template

Note: Do not add this for COVID extensions cases and cases for the Mental Health pilot:

o Add the following wording in the email after the DLS general signature:
Amazon DLS is committed to providing you an efficient and frustration-free experience. Provide your feedback and
help us make Amazon the world's best employer:
https://amazonvoe.eu.qualtrics.com/jfe/form/SV_5inx5r0jONXjROK?Source=Control
Before sending, be sure that your email to the employee

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C. EDITING LETTER L002- ACKNOWLEDGEMENT -PREGNANCY

*Note - Team should include the deadline of the documentation

Re: Your Leave of Absence Request – Employee Name, Case #

Dear Employee Name,

On application date you requested a leave of absence. Here is the information you’ll need to make sure you receive leave
and/or payment benefits according to our policies and plans.

Your Leave  You requested to begin your leave on leave start date.
Request  You expect to return to work on date.
 You’re requesting leave due to your own serious health condition.
 You’re requesting a continuous leave (full work days in a row).
↓ FMLA eligible employee acknowledgements will pull into the following section. ↓
 You are eligible for the federal Family and Medical Leave Act (FMLA).
 If your leave is approved it will be designated as federal Family and Medical Leave Act (FMLA), and/or
any applicable state/local leave law(s). Your time off from work will reduce your available leave
balance(s).}
 Your requested leave will use approximately estimated hours of FMLA hours of FMLA out of your
balance of current balance of FMLA hours of FMLA. Please note, this is an estimate and is subject
to change if your leave dates change
↓ FMLA ineligible employee acknowledgements will pull into the following section the reason for denial
will be reflected in the letter. It may include one or multiple of the following options. ↓
 You are not eligible for leave under the federal Family and Medical Leave Act because:
 You have not worked 1,250 hours in the previous 12 months. As of the date of this letter you
have worked approximately hours.
 You have not worked for Amazon for 12 months. As of the date of this letter you have worked
approximately tenure in months.
 You have exhausted your FMLA entitlement for the current year period.
 The following plans are assigned to your case:

Plan Name Status Decision Date Start Date End Date

Plan Name Plan Status Decision date, if Decision start Decision end
no decision, date, if no date, if no
leave blank decision, leave decision, leave
blank blank

Pay Available ↓ Pay available to the employee will pull into the following section depending on whether the
During Leave employee is eligible for STD, Paid Leave, a State benefit (like NJ TDI or CA SDI), or WC. It may include one
or multiple of the following options. ↓
 Your leave is unpaid.
 You can request to apply any accrued and available Sick, Personal, Floating Holiday, and/or Vacation
pay.
↓ Only include if the EE works in one of the following states, otherwise delete this section. ↓
 Work State -CA, NJ, WA, NY, HI, and RI: You may be eligible for benefits through your state. If you’re
eligible and approved, you’ll receive payment according to the state plan. For assistance applying for

46 | P a g e
 the state plan, review the “Applying for State Benefits” handout.

↓ Only include if the EE is eligible for STD benefit, otherwise delete this section. ↓

 You may also be eligible for a disability payment under Amazon’s Short Term Disability Plan. If
approved, you will be eligible to receive up to 60% of your base wages.

↓ Only include if the EE F/R class, otherwise delete this section. ↓

 Pre-Partum, Post-Partum, or Parental: You may be eligible for a pay benefit under Amazon’s Pregnancy
and Parental Leave Plans. You may be eligible to receive up to 100% of your base wages.
 Pre-Partum, Post-Partum, or Parental & Work State WA, RI, HI (Pre, Post), MA, CA and NJ: We will
deduct the amount you are eligible to receive from the state plan from your Amazon payment. Be sure
to apply for your state plan as soon as possible.
 Review all the enclosed information to learn about pay processes for employees on a leave of absence.

What You  Read all of the material in this packet, which describes your rights and responsibilities under
Need to Do state/local and federal laws.
 Return the enclosed Certification Form. Certification is needed to approve leave and/or disability
payments if eligible.  You must return this by Documentation Deadline via fax 1-855-579-1799 or
email amazondls@amazon.com.
 Apply for benefits through your state. If approved, the state will pay some of your wages. Review the
'Applying for State Benefits' handout for help applying.

D. EDITING LETTER L003 - ACKNOWLEDGEMENT - INTERMITTENT – EE (EOHC, CFFM, CRIME, & DV)
Re: Your Leave of Absence Request – Employee Name, Case #

Dear Employee Name,

On application date you requested a leave of absence. Here is the information you’ll need to make sure you receive leave
and/or payment benefits according to our policies and plans.

Your Leave  You’re taking leave due to your own serious health condition, caring for a family member, being a
Request victim of a crime, or domestic violence, sexual assault, or stalking.
 You’re taking an intermittent leave (multiple absences for the same reason)].
↓ FMLA eligible employee acknowledgements will pull into the following section. ↓
 You are eligible for the federal Family and Medical Leave Act (FMLA).
 If your leave is approved it will be classified under the Federal Family and Medical Leave Act (FMLA),
any applicable state leave law(s) and/or Amazon’s leave policies. Your time off from work will reduce
your available leave balance(s). At this time, we are unable to estimate how many hours of FMLA you
will use, however you are able to request reports of your intermittent usage every 30 days during your
leave.
↓ FMLA ineligible employee acknowledgements will pull into the following section the reason for denial
will be reflected in the letter. It may include one or multiple of the following options. ↓
 You are not eligible for leave under the federal Family and Medical Leave Act because:
 You have not worked 1,250 hours in the previous 12 months. As of the date of this letter you

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 have worked approximately hours.
 You have not worked for Amazon for 12 months. As of the date of this letter you have worked
approximately tenure in months.
 You have exhausted your FMLA entitlement for the current year period.
 Other

Pay Available  Your leave is unpaid.

During Leave  Salaried Employees: As a salaried employee, you will continue to receive your regular wages for partial
intermittent days (less than your normally scheduled shift). If you miss a full shift, you will not receive
wages for that date.
 You can request to apply any accrued and available Sick, Personal, Floating Holiday, and/or Vacation
pay.
 Employees Whose Work State Has a SDI Benefit: You may be eligible for benefits through your state. If
you’re eligible and approved, you’ll receive payment according to the state plan. For assistance
applying for the state plan, review the “Applying for State Benefits” handout.
 Review all the enclosed information to learn about pay processes for employees on a leave of absence.
What You  Read all of the material in this packet, which describes your rights and responsibilities under
Need to Do state/local and federal laws.
 Return the enclosed Certification Form. Certification is needed to approve leave and/or disability
payments if eligible.  You must return this by Documentation Deadline via fax 1-855-579-1799 or
email amazondls@amazon.com.
 Apply for benefits through your state. If approved, the state will pay some of your wages. Review the
'Applying for State Benefits' handout for help applying.

E. EDITING LETTER L003 - ACKNOWLEDGEMENT - INTERMITTENT – EE (SCHOOL VISITATION)

I. Editing Letter L003 – Acknowledgement – School Visitation

1. Use the Conga Composer to create an acknowledgement letter for a School Visitation (I003) intermittent leave.
You will need to remove the highlighted attachments below.

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2. The image below shows how a School Visitation leave acknowledgment letter should look before the CM sends the
letter.

3. Please delete the portion of text highlighted in red below. Then, replace the yellow highlighted text with the
following information:
i. “Please reply confirming that you are requesting this leave to participate in child's school or childcare activities
or discipline. Please confirm the leave is for a child attending school for kindergarten through 12 th grade.
Finally, confirm if you are the parent, legal guardian, stepparent, foster parent, grandparent of, or in loco
parentis to the child.”
4. The screenshot below shows how your acknowledgement letter should look before sending.

5. After we make sure that letter has been updated with the correct details, we need to replace the highlighted text
below with the following information:

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 i. “Please reply confirming that you are requesting this leave to participate in child's school or childcare activities
or discipline. Please confirm the leave is for a child attending school for kindergarten through 12 th grade.
Finally, confirm if you are the parent, legal guardian, stepparent, foster parent, grandparent of, or in loco
parentis to the child.”
6. Before sending, be sure that your email to the employee looks like this:

F. EDITING LETTER L004 - ACKNOWLEDGEMENT - LEAVE SHARE - EE

Letter 4 does not require any edits by the Case Manager. It is a form for the employee to complete. Proceed with sending.

G. EDITING LETTER L005 – ACKNOWLEDGEMENT – PLOA – NONNACF – EE

Re: Your Leave of Absence Request – Employee Name, Case #

Dear Employee Name,

On application date you requested a leave of absence. Please review the details below and contact us if you have any questions.
Your Leave  You requested to begin your leave on leave start date.
Request
 You expect to return to work on date.
Pay Available  This leave is unpaid.
During Leave
 You can request to supplement any accrued and available Sick, Personal, Floating Holiday, and/or
Vacation pay.
 Review all the enclosed information to learn about pay processes for employees on a leave of absence.

H. EDITING LETTER L007 - ACKNOWLEDGEMENT - BONDING, SMALL NECESSITIES

Letter L007 – Acknowledgement – Bonding – Small Necessities is unique in comparison to the other acknowledgement letters.
L007 has three leave types included in the acknowledgement letter; Bonding, Parental, and Crime and Domestic Violence.
These letters will be separated in a future enhancement. Until the enhancement deploys, Case Managers will edit L007
depending on the leave type.

I. Calculator
Some of the manual edits require a date to be included. Add the leave start date or the day you are sending the letter,
whichever is later, in the “Start” section and the due date will populate (21 days after LSD or the date the letter is sent,
whichever is later).

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Start Due
10/5/2020 10/25/2020
II. Bonding

Leave Request Information

 You requested bonding leave from {Start Date} to {End Date}.
 You plan to return to work on {ERTW Date}.
 DLS requires documentation in order to make a decision on your request for leave. Review What You Need to Do in
this email for instructions on submitting documentation.
 <Only Include if FMLA Eligible, if not FMLA Eligible Delete this section> You are eligible for the federal Family and
Medical Leave Act (FMLA). If your leave is approved it will be designated as federal Family and Medical Leave Act
(FMLA), and/or any applicable state/local leave law(s). Your time off from work will reduce your available leave
balance(s).}
o Your requested leave will use approximately {Estimated hours of FMLA} hours of FMLA out of your balance of
{current balance of FMLA} hours of FMLA. Please note, this is an estimate and is subject to change if your
leave dates change.
 <Only Include if Not FMLA Eligible, if FMLA Eligible Delete this Section>{You are not eligible for the federal Family and
Medical Leave Act because:
o You have not worked 1,250 hours in the previous 12 months. As of the date of this letter you have worked
approximately {Hours} hours.
o You have not worked for Amazon for 12 months. As of the date of this letter you have worked approximately
{Tenure} months.
o You have exhausted your FMLA entitlement for the current year period.
We will review your eligibility for other state/local or company plans. We will reach out to discuss available options.
 The following plans are assigned to your case (This pulls in automatically, leave this plan information and paste the
other sections above or below the chart per this example):
Plan Name Status
{Plan Name} {Plan
Status}
{Plan Name} {Plan
Status}

What You Need to Do

 You must submit documentation to support your leave request:
 By {Use the calculator above to calculate: Bold: Date Letter is sent + 21 days OR Leave start date +21 days, whichever
is later}, fill out the included certification form. Submit this form by visiting the DLS Portal found on the Amazon AtoZ
Resources page or on the network via https://dls.idp.amazon-corp.com. While on the portal, select “View All Requests”
and then select case number {Case number}. Then click the “Upload Documents” tab.
 Read all of the material in this packet, which describes your rights and responsibilities under state/local and federal
laws, and potential impacts of your leave to stock and benefits.
 <Only include if the EE works in one of the following states, otherwise delete this section. CA, WA, NJ, NY, MA
(beginning 12/2/2021), RI>{You work in a state that has paid family leave benefits. To receive wages, apply for benefits
through your state. See the section Pay Available During Leave for more information.}
 If anything changes, such as your leave start or end dates, contact your DLS Case Manager right away.

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Pay Available During Leave
 If approved, your leave will be unpaid.
 You can request to supplement any approved leave with any accrued and available Sick, Personal, Floating Holiday,
and/or Vacation pay (if applicable) by contacting your DLS Case Manager.
 <Only include if the EE works in one of the following states, otherwise delete this section. CA, WA, NJ, NY, MA
(beginning 2021), RI>{You may be eligible for family leave paid benefits through your state. If you are approved to
receive state benefits, you will receive payment according to the state plan.}

What Happens Next?

 We will notify your Human Resources representative and Manager of your leave request.
 Once DLS receives your supporting documentation, we will make a decision on your case within two (2) business days
and notify you of your next steps.
 If you fail to provide supporting documentation by {Use the calculator above to calculate. Bold: Letter Date + 21 days
OR Leave start date +21 days, whichever is later}, your leave request will be denied.

III. Parental
Leave Request Information

 You requested bonding leave from {Start Date} to {End Date}.

 You plan to return to work on {ERTW Date}.
 DLS requires documentation in order to make a decision on your request for leave. Review What You Need to Do in
this email for instructions on submitting documentation.
 < Only Include if FMLA Eligible, if not FMLA Eligible Delete this section >{You are eligible for the federal Family and
Medical Leave Act (FMLA). If your leave is approved it will be designated as federal Family and Medical Leave Act
(FMLA), and/or any applicable state/local leave law(s). Your time off from work will reduce your available leave
balance(s).}
o Your requested leave will use approximately {Estimated hours of FMLA} hours of FMLA out of your balance of
{current balance of FMLA} hours of FMLA. Please note, this is an estimate and is subject to change if your
leave dates change.
 < Only Include if Not FMLA Eligible, if FMLA Eligible Delete this Section >{You are not eligible for the federal Family
and Medical Leave Act because:
o You have not worked 1,250 hours in the previous 12 months. As of the date of this letter you have worked
approximately {Hours} hours.
o You have not worked for Amazon for 12 months. As of the date of this letter you have worked for Amazon for
approximately {Tenure} months.
o You have exhausted your FMLA entitlement for the current year period.
We will review your eligibility for other state/local or company plans. We will reach out to discuss available options.

 The following plans are assigned to your case (This pulls in automatically, leave this plan information and paste the
other sections above or below the chart per this example):

Plan Name Status

{Plan Name} {Plan Status}

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 {Plan Name} {Plan Status}

What You Need to Do

 You must submit documentation to support your leave request.

 By {Use the calculator above to calculate Bold: Letter Date + 21 days OR Leave start date +21 days, whichever is
later}, fill out the included certification form. You can submit this form by visiting the DLS Portal found on the Amazon
AtoZ Resources page or on the network via https://dls.idp.amazon-corp.com. While on the portal, select “View All
Requests” and then select case number {Case number}. Then click the “Upload Documents” tab.
 Read all of the materials in this packet, which describe your rights and responsibilities under state/local and federal
laws, as well as the impact to pay processes, stocks and benefits, and Sign On Bonuses for employees on a leave of
absence.
 <Only include if the EE works in one of the following states, otherwise delete this section. CA, WA, NJ, NY, MA
(beginning 12/2/2021), RI>{You work in a state that has family leave benefits. To receive your full wages, apply for
benefits through your state. See the section Pay Available During Leave for more information.}
 If anything changes, such as your leave start or end dates, contact your DLS Case Manager right away.

Pay Available During Leave

 You are eligible for Paid Parental Leave, which is paid at 100% of your base pay (pay rate as of leave start) unless a
state-sponsored benefit applies (explained below). You cannot supplement your leave with any Sick, Personal, Floating
Holiday, and/or Vacation pay.
 <Only include if the EE works in one of the following states, otherwise delete this section . CA, WA, NJ, NY, MA
(beginning 2021), RI>{You may be eligible for family leave paid benefits through your state. We will deduct the
amount you are eligible to receive through the state plan from your Amazon payment. Be sure to apply for your state
plan as soon as possible by calling [Pulls into the original letter, leave this information. NUMBER] or following this link:
[Pulls into the original letter, leave this information. URL].}

 There will be no interruption to your medical benefits, paid time off (PTO) accruals, and Restricted Stock Units vesting
schedule during Paid Parental.

 Unpaid Bonding Leave approvals and /or Unpaid Bonding Leave extensions under FMLA and / or State provided
benefits impact RSUs release schedules; After a 14-calendar-day grace period, vesting is suspended on calendar day 15
of leave. Personal leave of absence suspends on the first day of leave.

 Information about the impact of the Bonding Leave on the vesting of stock-based awards (including Restricted Stock
Units or Stock Options) should update within the next 72 hours after returning to work. More information can be found
here https://inside.amazon.com/en/Employment/Stock/LOA/Pages/United-States.aspx . You must be on the Amazon
network to view the link.

What Happens Next?

 We will notify your Human Resources representative and Manager of your leave request.

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 Once DLS receives your supporting documentation, we will make a decision on your case within two (2) business days
and notify you of your next steps.
 If you fail to provide supporting documentation by {Use the calculator above to calculate. Bold: Letter Date + 21 days
OR Leave start date +21 days, whichever is later}, your leave request will be denied.

IV. Crime and Domestic Violence

Leave Request Information

 You requested leave from {Start Date} to {End Date}.

 You plan to return to work on {ERTW Date}.
 You may be eligible for Personal Protected Leave. To be approved, you must return documentation as outlined in the
section What You Need to Do.

What You Need to Do

 You must submit documentation to support your leave request.

 By {Use the calculator above to calculate. Bold: Letter Date + 21 days OR Leave start date +21 days, whichever is
later}, provide documentation as outlined below. You can submit this documentation by visiting the DLS Portal found
on the Amazon AtoZ Resources page or on the network via https://dls.idp.amazon-corp.com. While on the portal,
select “View All Requests” and then select case number {Case number}. Then click the “Upload Documents” tab.
 <CM: Select this paragraph and bullets if leave reason is Crime Victim, remove this paragraph and bullets if leave
reason is Domestic Violence/Sexual Assault/Stalking>Please return documentation supporting your leave request.
Acceptable documentation can include paperwork from:
o The court or government agency setting the hearing;
o The district attorney or prosecuting attorney’s office; or,
o The victim/witness office advocating on behalf of you.
 <CM: Select this paragraph and bullets if leave reason is Domestic Violence/Sexual Assault/Stalking, remove this
paragraph and bullets if leave reason is Crime Victim>Please return documentation supporting your leave request.
Acceptable documentation can include (but is not limited to):
o A written statement from you indicating that you or your family member is a victim of domestic violence,
sexual assault, or stalking;
o A copy of a police report indicating you or your family member was a victim of domestic violence, sexual
assault, or stalking;
o A court order or other evidence from the court or prosecuting attorney that you or your family member has to
appear in court.
o Certification from a medical professional, health care provider or counselor indicating that you or your family
member is a victim of domestic violence, sexual assault, or stalking; or,
o Certification from an advocate indicating you or your family member was undergoing treatment for physical or
mental injuries or abuse sustained as a result of domestic violence, sexual assault, or stalking.]
 Read all of the materials in this packet, which describes your rights and responsibilities under state/local and federal
laws, and potential impacts of leave to stock and benefits.
 If anything changes, such as your leave start or end dates, contact your DLS Case Manager right away.

Pay Available During Leave

 Your leave is unpaid.

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  You can request to supplement your leave with any accrued and available Sick, Personal, Floating Holiday, and/or
Vacation pay (if applicable) by contacting your DLS Case Manager.

What Happens Next?

 We will notify your Human Resources representative and Manager of your leave request, however details of the reason
you are off work are kept confidential within DLS.
 Once DLS receives your supporting documentation, we will make a decision on your case within two (2) business days
and notify you of your next steps.
 If you fail to provide supporting documentation by {Use the calculator above to calculate. Bold: Letter Date + 21 days
OR Leave start date +21 days, whichever is later}, your leave request will be denied.

APPENDIX: STANDARD CASE MANAGEMENT PROCESSES

A. SENDING LETTERS AND CORRESPONDENCE

I. Navigating to Conga to Send EE Correspondence
Correspondence will be sent to the address information located on the case or the temporary case information. To edit this
information, the Case Assistant will navigate to the case and select the “Edit” button at the top of the screen.

1. The correspondence title will be located in the title of the “Correspondence Ready to Send” task.
2. There is a picklist located under the Conga Generator for employee correspondence.
a. The letter that needs to be sent will be selected from this picklist.
b. If the picklist does not have the letter pre-selected, select the correspondence title that is identified in the
“Correspondence Ready” task.
3. Click the EE Correspondence button located in the top right corner.
4. The Case Assistant will be redirected to Conga where the enclosure templates will be pre-selected. This list will
include the Acknowledgment letter enclosures. Review this list for accuracy.
5. Select “Next” to review the enclosure templates and Conga email template.
6. Select “Merge & Email” to preview the enclosure template packet. Review the acknowledgment letter for
accuracy, but do not make changes to any legal enclosures, such as the FMLA Rights and Responsibilities or a state
leave enclosure. Please note that the formatting may appear distorted in this view, but will be corrected when the
enclosure attachment is generated.
a. CAs must wait until all the letters and enclosures have been
added in Conga and the screen should be loaded before
clicking on the next button. Failure to do so can cause
downstream impacts.
7. If the employee has opted to receive postal mail, add the
appropriate return address to the cover letter.
a. Statutory leave return address: PO. Box # 81149, 5801 Postal
Road, Cleveland, Ohio 44181
b. General leave return address: PO. Box # 81103, 5801 Postal
Road, Cleveland, Ohio 44181
c. Appeals return address: PO. Box # 811120, 5801 Postal Road,
Cleveland, Ohio 44181
8. Select “Continue” to generate the enclosure template packet and create the Conga email template body. In this
view, you will see the body of the email that the employee will receive. Attached will be a PDF version of your
enclosure template packet. Manual attachments can be added from the Case Manager’s computer by selecting
“Add Attachment” in the bottom right corner.
9. Review the email for accuracy. Press “Send” and the correspondence will be sent via email and/or mail service.

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II. Sending an Adhoc Letter to the Employee
This process is used when an ad hoc letter needs to be sent to an employee.

1. Verify the “No Email US Mail” checkbox, located in the “Temporary Contact Information” section on
Case, has been checked before initiating the ad hoc letters. If this box is checked,
the letters will be sent by mail only. If the employee elects to receive
correspondence via mail, at intake, the checkbox will auto populate. The DLS Case
Manager will ensure that this box is checked before initiating ad hoc letters that
require mailing.
2. From the Case, verify that “None” is selected under “EE Communications.”

3. Click the “EE Communications” button in the top right corner to open Conga.
a. Select any template that you want printed out. Make sure “Your Leave Cover Letter” is selected first.
b. Click “Next.”
c. Select the “Conga Email templates” tab.
d. Select “General Employee” from the list.
e. Click “Merge & Email”
i. DLS Case Managers must wait until all the letters and enclosures have been added in Conga and
the screen should be loaded before clicking on the next button. Failure to do so can cause
downstream impacts.
f. Edit the email accordingly and add the needed correspondence.
g. Click “Send.”
III. Navigating to Conga to Send ER Correspondence
Employer correspondence will be sent to the employee’s HR contact and manager automatically by DALI. If for some
reason, the correspondence does not send, the following steps can be used to manually send or resend to HR and employee
managers. .

1. The correspondence title will be located in the title of the “Correspondence Ready to Send” task.
2. Once the correspondence title has been identified, navigate to the associated Case.
a. From the Absence Claim, select the hypELRinked case number.
3. Click the ER Correspondence button located in the top right corner.
4. The Case Assistant will be redirected to Conga.
5. The Case Assistant will search for the template on the “Conga Email Templates” tab.
6. Select “Merge & Email” to edit the template.
7. CAs must wait until all the letters and enclosures have been added in Conga and the screen should be loaded
before clicking on the next button. Failure to do so can cause downstream impacts.
8. Attachments can be added by selecting “Add Attachment” in the bottom right corner.
9. After editing the template body, select “Send” and the correspondence will via email.

IV. Sending an Adhoc Email to the Employer (or Internal Stakeholder)

1. From the Case, verify that “None” is selected in the picklist under “EE Communications.”
a. Select “Save.”
2. Click the “ER Communications” button in the top right corner to open Conga.
a. Select the “Conga Email Templates” tab.
b. Select “Ad Hoc ER Template.”
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 c. Next, select “Merge & Email.”
d. The Ad Hoc Email Template will open with a greeting and the Case Manager signature only. The
Case Manager will free type, or paste in (for manual templates), the body of the email.
i. If the Case Manager does not want to send the email to the employees HR or Manager, ‘X’ out
of the email addresses and type the address of the intended recipient.
e. If an attachment needs to be added, select “Add Attachment” in the bottom right corner of the
Conga Composer. Select the file and click “Attach.”

V. Termination Review Adhoc Email

To: loaa-termination-review@amazon.com
Subject: Termination Review – EE Name: [EE name], HR ID: [EE ID], Case #: [DALI Case Number]

Hello,

This following employee opened a leave of absence case and has been terminated:
Employee Name:
Employee ID:
Termination Reason & Date:
Termination Ticket Link:

Details of the completed review, indicating reasons for review request:

o Include details of completed review for error, inaccurate denials or extenuating circumstances
o Include any relevant information from employee contact, tickets or other sources
o Attach clear documentation that would support the leave (or extension) request and advise if your manager has
signed off on the documents to support leave approval if reinstatement is approved

Please let me know if you require additional information or have leave related questions.

Regards,
[DLS Case Manager Signature]

B. CREATING CASE NOTES

Case Managers will be responsible for creating Case notes to document the actions taken on the Case. When creating Case
notes, remember that Case notes for LOA are completed on the Case level.

1. Navigating to the Case

2. Navigating to the “Notes” object
3. Select the drop down adjacent to the object title
4. Select “New”
a. Title the note “Leave Reason – Case Note.” For example, “PLOA – Case Note,” “CFFM – Case Note,” “EOHC – Case
note.”
5. Include all details about the Case action
a. Case Notes will include all actions taken on the case/claim.

C. WITHDRAWING CLAIMS
If the employee states that leave is no longer needed, the Case Manager will either deny or withdraw the leave. If the case was
previously approved, the Case Manager must stop the payments. For information on how to stop payments, please navigate to
the Pay SOP.
I. Denial Appropriate (EOHC, Including Pregnancy Related Claims)
1. If time has been missed and the employee doesn’t have PTO to cover the missed time, the Case Manager will
render a denial decision, send all appropriate correspondence, and close the case.
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II. Withdrawal Appropriate
Withdrawal requests must be made by the employee or an authorized representative.
1. If no time has been missed, a withdrawal is appropriate.
2. If time has been missed but the employee states that they will use UPT, Personal Time, Vacation, etc. to cover their
time out of work and has not been paid STD benefits on the case, a withdrawal is appropriate.
3. If the request is for a paid claim, the employee must confirm if they intend to withdraw only the paid claim or the
entire case.

Withdrawing PLOA
PLOA requests may be withdrawn at any time at the request of the employee.

Exception: If the leave is really due to employee’s own health condition it will not be withdrawn. Instead, the EOHC
Absence Claim, FMLA, or Statutory request will be initiated (use the Intake SOP to add an Absence Claim to the Case).
After the new Absence Claim is added, if employee wants to withdraw the PLOA. The Case Manager can withdraw the
leave.

Withdrawing Leave
Withdrawing leave is a two-step process, the Case Manager must complete a Physician’s Statement (Rationale Screen)
to cancel the claim, then close the claim.
a. Complete the Physicians Statement (Rationale Screen)
i. What type of certification is being added? – Input “Other,” a text box will
populate, input “Withdraw Request.”
ii. Rationale - The Case Manager will document the rationale for closing being sure
to include the employee’s request to withdraw.
iii. Date Range – The Case Manager will include the applicable leave dates.
iv. Status – Cancelled
v. Status Reason – Cancelled – Withdrawn
vi. Select “Save.”
vii. Verify the LSF.
b. Close the Absence Claim
Navigate to the Absence Claim, select the pencil icon adjacent to “Claim Status.”
i. Claim Status - Select “Closed.”
ii. Date Closed – Select today’s date from the calendar.
iii. Close Reason – Select “Cancelled.”
iv. Select “Save.”

NOTE: All tasks must be completed before the claim can be closed.

Withdrawing STD
When an appropriate request from an employee to withdraw only STD is received, the Case Manager will confirm if the
employee would also like to withdraw their leave claim.

Advise the employee that withdrawing STD will forfeit income replacement benefits and could impact their stock
vesting (Pre & Post-Partum have a bigger impact).

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a. Update the Benefit Claim
Navigate to the Benefit Claim, from the Absence Claim, select the hypELRinked Insurance
Claim. Locate the “Benefits Claimed” section and identify the claim that needs to be
withdrawn. For STD60 claims, this will be located adjacent to the “Short Term Disability
(STD)” link. For Pre & Post-Partum, there are two separate links one for Pre and one for Post plan type.
i. Select the hypELRinked benefit number, adjacent to the plan you need to withdraw.

The “Benefits Claimed” screen will populate.

1). Select the pencil icon adjacent to “Status” to edit the plan status and status
reason
A). Status – Select “Closed.”
B). Status Reason – Select “Withdrawn.”
C). Select “Save.”
D). Repeat this process for all benefits (STD, Pre, or Post-Partum) that need
to be withdrawn.
ii. Repeat this process for all benefits (STD, Pre, or Post-Partum) that need to be
withdrawn.
1). If any claims are not withdrawn, proceed with standard case management.
iii. Click on the hypELRinked “Claim” to return to the Insurance Claim.
b. Update the Insurance Claim
i. Select the pencil icon adjacent to “Status” to edit the Insurance Claim status.
1). Status – Select “Closed.”
2). Select “Save.”

Documentation & Correspondence

a. Document the conversation in case notes
b. DALI will generate the “Correspondence Ready” task advising the employee to send the L018 - Cancellation – EE.”
The Case Manager will need to send this letter using Conga. “L019 - Cancellation – ER correspondence” will
automatically be sent by DALI.
i. The Case Manager will follow the process for sending correspondence from Conga.

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