APPLICATION FOR MEDICAL LEAVE OF ABSENCE
IMPORTANT INFORMATION
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PURPOSE

A Medical Leave of Absence may be granted when serious medical and/or psychological circumstances preclude a student’s ability to adequately complete coursework for a given semester. When a Medical Leave of Absence is granted, ALL CLASSES for which a student is registered will be automatically cancelled. In addition, any classes for which a student has registered for the subsequent semester will be cancelled pending evaluation of the student by the Student Health and Counseling Center staff for a determination regarding return to the Campus.

ELIGIBILITY

A Medical Leave of Absence may be granted to any full or part time student and is initially granted for one semester only. A request for a continuance may be granted for up to one year.

PROCEDURE

A student who wishes to request a Medical Leave of Absence must complete this form, attach adequate medical documentation (see below for additional information)* and submit it to the Student Health and Counseling Center at: C.W. Post Campus of LIU, Life Science Building – Room 154, 720 Northern Blvd., Brookville, N.Y. 11548; FAX: 516-299-4113.

The steps in the Medical Leave process are:

1. The student must complete the application for Medical Leave of Absence and attach adequate supporting medical documentation* and submit it to the Student Health and Counseling Center. (If the student is incapable of completing the form him/herself, a parent or guardian may do so. However, medical documentation must be included which specifically states that the student is incapable of completing this form).

2. The Director of Student Health and Counseling will evaluate the request, grant the medical leave if appropriate and forward the decision to the Academic Standing Committee, Bursar, Registrar and, in cases of graduate students, to the appropriate Dean. The Academic Standing Committee notifies the student in writing.

Typically, this process takes two to four weeks to complete. A request for a Medical Leave of Absence must be filed no later than the last day of the semester for which the Medical Leave is requested.

*DEFINITION OF ADEQUATE MEDICAL DOCUMENTATION

Adequate medical documentation must accompany any request for a Medical Leave of Absence. This includes a signed letter from a physician or licensed psychotherapist documenting the diagnosis giving a description of the disorder, the first date it appeared and the recommendation for a medical leave for the semester. Medical documentation will be reviewed by Student Health and Counseling Center staff.

Financial Aid Implications

A student who receives federal, state and/or university assistance and who is granted a Medical Leave of Absence may lose financial assistance for the semester for which he/she is granted the leave based on the effective date of the Medical Leave. Eligibility for future financial assistance will be reviewed on a case-by-case basis. Renewal will be based upon the student’s academic standing, federal, state and university regulations and availability of funds. Students applying for a Medical Leave of Absence are required to contact the Financial Assistance Office, preferably in person or in writing concerning the effects of the change in their status on both current and future financial aid eligibility.

Tuition Liability

A request for a Medical Leave of Absence, even if granted, does not automatically result in a tuition adjustment. Each request is evaluated on an individual basis, and a decision having to do with tuition liability will be based on several factors including, but not limited to, date of last class attendance. If tuition liability is reduced, any resulting credit will be held for future registrations. The C.W. Post Bursar’s Office makes this decision.

Residence Hall/Meal Plan Adjustments

A student who resides in a residence hall for any portion of the semester during which a Medical Leave of Absence is granted, will incur a prorated room charge which will be based upon the date of official checkout of the residence hall. Meal plan charges will be based upon the last week of usage. All housing and meal plan charges (based upon date of checkout and usage) are the student’s responsibility. Financial aid, if cancelled, will not cover these charges.

Return From Medical Leave

A student granted a Medical Leave of Absence is required to be evaluated by the staff of the Student Health and Counseling Center before he/she may return to classes. The student must bring his/her medical documentation to this meeting stating he/she is now able to return to classes. The student must make an appointment with Student Health and Counseling 3-4 weeks before the start of the semester he/she wishes to return. Students on Medical Leave may not register for classes until they have been cleared for return by Student Health and Counseling.