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Orange County Personnel Rnles and Regulations Effective Date: May 17, 2010 14 <br />iii. Whether the covered service member is a current member of the <br />Armed Forces, the National Guard or Reserves, and the covered <br />service member's military branch, rank, and current unit <br />assignment; <br />iv. Whether the covered service member is assigned to a military <br />medical facility as an outpatient or to a unit established for the <br />purpose of providing command and control of members of the <br />Armed Forces receiving medical care as outpatients (such as a <br />medical hold or warrior transition unit), and the name of the <br />medical treatment facility or unit; <br />v. Whether the covered service member is on the temporary disability <br />retired list; <br />vi. A description of the care to be provided to the covered service <br />member and an estimate of the leave needed to provide the care. <br />d. An employee may use the Department of Labor form, WH-385; to obtain <br />certification that meets FML's service member medical caregiver <br />certification requirements. (httn:!/www.dol.gov/whd/formslWH-385.pdf) <br />This form allows an employee to furnish appropriate information to <br />support his or her request for leave to care for a covered service member <br />with a serious injury or illness. An alternate form containing the same <br />basic information may be used. <br />e. The County may seek authentication and/or clarification of the <br />certification. However, second and third opinions are not permitted for <br />leave to care for a covered service member. Additionally, a recertification <br />is not permitted for leave to care for a covered service member. <br />15. Certification for Leave for Qualifying Exigencies. The County may require <br />that leave for any qualifying exigency be supported by a certification from the' <br />employee that sets forth the following information: <br />a. A statement or description, signed by the employee, of appropriate facts <br />regarding the qualifying exigency for which FML is requested. The facts <br />must be sufficient to support the need for leave. Such facts should include <br />information on the type of qualifying exigency for which leave is <br />requested and any available written documentation which supports the <br />request for leave; such documentation, for example, may include a copy of <br />a meeting announcement for informational briefings sponsored by the <br />military, a document confirming an appointment with a counselor or <br />school official, or a copy of a bill for services for the handling of legal or <br />financial affairs; <br />b. The approximate date on which the qualifying exigency commenced or <br />will commence; <br />i. If leave is for a single, continuous period of time, the beginning <br />and end dates for such absence; <br />rss~e Hate: May r~, zoro Page 11 <br />