If your medical emergency is anticipated to continue past your return to duty date (approved Leave Bank timeframe end date), you may apply for an extension. Details are below:
- Submit a new recipient package with an updated beginning and end date.
- Fax Cover Sheet (NIH 2941)
- Application (NIH 2940)
- Authorization to Disclose Information (NIH 2923)
- Confidential Medical Documentation (if applicable)
- Deadline: If your/your family member’s medical emergency is active and ongoing, extension requests must be submitted within 60 calendar days from your original case approval date or from your original approved end date, whichever is later. If your/your family medical emergency has ended and you have returned to work, you must submit your application within 30 calendar days from the termination of your medical emergency.
- Follow the process outlined on the Recipient Information page.
If you have reached the yearly hourly cap of 480 hours for a personal medical emergency or family medical emergency, please contact the Leave Bank Office and/or your Leave Bank case manager before submitting an extension application to discuss your options.
More information: LeaveBank@od.nih.gov or call 301-443-8393.