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Printable Form 8965 Hayward California: What You Should Know

Other Benefits for E.B.  You may be eligible for several benefits that are designed for employees in the Hayward Unified School District. For more information, visit their Benefits page. The E.B. has a Personal Leave Program (PLC) to give eligible employees time off to care for a sick or injured partner or child. Employees who are eligible for a paid leave that provides for at least a 20 hour, unpaid vacation every five months during the year, are entitled to a 50% pay off if a disability lasts for two consecutive years, or longer if an injury or illness occurred during the year in or after the first year of employment. Employee shall pay for all expenses up to a maximum of two (2) times the employee's weekly wage. Employees may take up to one (1) two (2) hours on a pay-per-use basis (e.g. to get to the store, buy medication, pick up an equipment, etc.). You may request a pay-off by providing written notice to the School Board Director.  Workers' Compensation Plan (CCP): Medical and Physical Rehabilitation Coverage • Injured Workers' Compensation Insurance • Work Injury Insurance Employee pays 10% of the total premiums (and 75% of the least of the average monthly premium for disability benefits during the year or the applicable maximum annual amount of benefits which could be paid in the year (1 for Disability and 2 for Work Injury). For those covered under CCP, this means a maximum of 1,500 for Disability coverage. Paid Time Off (PTO): Employees are eligible for PTO on a prorated basis that ranges from 12 to 20 workweeks. The amount of PTO will be calculated on the employee's weekly wage.  PTO is available to any employee who is eligible for medical and physical rehabilitation benefits. Workers' Compensation Benefit Eligibility: Paying a PTO premium (or deductible) for a claim will deduct 100% of the maximum amount of wages paid as compensation (including commissions) for a work-related injury. If you were injured due to negligent or wrongful behavior at work (including acts of commission or omission on your part)—or if you voluntarily stopped working because of injury—you may be eligible for Work Injured Compensation. This benefit is not the same as WIC.

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