921.03 Required Verification SR 97-28, Dated 08/97 (FAM-A)

If the individual requests child care services during an absence from work, require the following verifications:

• A signed and dated statement from the employer stating the individual will be re-employed at the end of the leave of absence; and

• A signed and dated statement from a physician or licensed mental health professional describing the reason for the leave of absence and the expected duration.

Exception: If a third party is unable or unwilling to provide verification, accept a signed and witnessed statement from the individual that includes all of the following:

- The reason for the absence;

- The expected duration of the absence; and

- Whether or not the individual expects to be re-employed after the absence.