Disability Services Forms

Military Related Leaves

Beginning December 16, 2020, leaves of absence will be requested in Workday (workday.wsu.edu). See Workday Knowledge base reference guide Employee Request a Leave of Absence for instruction.

• Military Caregiver Leave Health Care Provider Statement – Covered Veteran
• Military Caregiver Leave Health Care Provider Statement – Active Servicemember
• Military Leave Certification of Qualifying Exigency
• Your Rights Under Uniformed Services Employment and Reemployment Rights Act (USERRA) – DOL Poster

Modified Duties – Faculty

• Faculty Modified Duties Request
• Interim COVID-19 Related Dependent Care Faculty Modified Duties

Reasonable Accommodation

• High-Risk Employee Workers’ Rights – Accommodation Request
• Accommodation Request for Disability or Serious Medical Condition
• Medical Release Statement for Reasonable Accommodation Requests
• Health Care Provider Statement for Reasonable Accommodation Requests

Shared Leave

Beginning December 16, 2020, shared leave requests and donations will be processed through Workday (workday.wsu.edu). See Workday Knowledge base reference guide Employee Request a Leave of Absence for instruction.

• Shared Leave Employee Request – COVID-19
• Shared Leave Health Care Provider Statement – Medical Conditions
• COVID-19 and Compliance with Non-Discrimination Laws

State of Washington Shared Leave Pools

• Shared Leave Employee Request – Uniformed Services Shared Leave Pool – State of Washington
• Shared Leave Donor Form – Uniformed Services Shared Leave Pool – State of Washington
• Shared Leave Employee Request – Veterans’ In-State Service Shared Leave Pool – State of Washington
• Shared Leave Donor Form – Veterans’ In-State Service Shared Leave Pool – State of Washington
• Shared Leave Employee Request – Foster Parent Shared Leave Pool – State of Washington
• Shared Leave Donor Form – Foster Parent Shared Leave Pool – State of Washington

Victims of Domestic Violence, Sexual Assault or Stalking Leave

• Domestic Violence Leave Request

Washington Paid Family & Medical Leave

• Online Application
• Paid Family & Medical Leave – Statement of Employee Rights – ESD
• Paid Family & Medical Leave Poster – ESD

Workers’ Compensation

• Online Incident Report
• Supervisors Accident Investigation Report
• Activity Prescription Form
• Minor Volunteer Consent and Release
• Volunteer Monthly Report
• Witness/Injured Person Statement
• Workers’ Compensation – File a Claim
• Notice to Employees – If a Job Injury Occurs – L&I Poster
• Your Rights as a Worker in Washington State – L&I Poster