Crime-Victim and Witness Court-Attendance Leave Request Packet

PAID SAFE-LEAVE LEGAL-PROCEEDING REQUEST PACKET

District of Columbia — D.C. Code §§ 32-531.01 to 32-531.12

Use this packet for accrued paid leave to take legal action, including preparing for or participating in a civil or criminal legal proceeding related to or resulting from domestic violence or sexual abuse affecting the employee or a qualifying family member.

1. EMPLOYEE AND EMPLOYER

Excluded categories in D.C. Code § 32-531.01 require separate review, including specified volunteers, religious officeholders performing religious functions, casual babysitters, independent contractors, qualifying students, health-care workers who elect premium pay, and certain short-term DCPS substitutes.

2. VICTIM AND RELATIONSHIP GATE

The victim is:

• ☐ The employee
• ☐ Spouse or identified domestic partner
• ☐ Parent of a spouse
• ☐ Child, foster child, or grandchild
• ☐ Spouse of a child
• ☐ Parent
• ☐ Brother or sister
• ☐ Spouse of a brother or sister
• ☐ Child living with the employee for whom the employee permanently assumes and discharges parental responsibility
• ☐ Person sharing or having shared a mutual residence with the employee for at least the preceding 12 months and maintaining a statutory committed relationship

Relationship, if applicable: [________________________________]

The covered legal action relates to or results from:

• ☐ Domestic violence
• ☐ Sexual abuse

The statute's legal-action clause does not expressly include stalking. Obtain counsel review before using this court-attendance route for stalking alone.

3. COVERED LEGAL ACTION

• ☐ Preparing for a related civil legal proceeding
• ☐ Participating in a related civil legal proceeding
• ☐ Preparing for a related criminal legal proceeding
• ☐ Participating in a related criminal legal proceeding
• ☐ Other qualifying legal action: [________________________________]

Court, agency, counsel, or proceeding: [________________________________]

Case identifier, using the minimum necessary information: [________________________________]

Proceeding or preparation date and time: [________________________________]

Expected work absence: [DATE / START / END]

4. ACCRUAL AND AVAILABILITY

The employee may begin to access accrued paid leave after 90 days of service. Record the applicable accrual tier using the employer's average monthly full-time-equivalent employee count for the prior calendar year:

• ☐ 100 or more employees — at least 1 hour per 37 hours worked, up to 7 days per calendar year
• ☐ 25 through 99 employees — at least 1 hour per 43 hours worked, up to 5 days per calendar year
• ☐ 24 or fewer employees — at least 1 hour per 87 hours worked, up to 3 days per calendar year
• ☐ Restaurant or bar employee who regularly receives tips, commissions, or other gratuities supplementing a below-minimum base wage — at least 1 hour per 43 hours worked, up to 5 days per calendar year, compensated at the District minimum wage

The employee will make a reasonable effort to schedule the leave so it does not unduly disrupt employer operations.

5. NOTICE

The request must state the reason for the absence and expected duration.

• ☐ Foreseeable leave: written request provided at least 10 days in advance
• ☐ Foreseeable leave: written request provided as early as possible because 10 days was unavailable
• ☐ Unforeseeable leave: oral request provided before the start of the affected work shift
• ☐ Emergency: employer notified before the next work shift
• ☐ Emergency: employer notified within 24 hours after onset because that occurred sooner

Notice date, time, method, and recipient: [________________________________]

Reason stated with minimum necessary detail: [________________________________]

Expected duration stated: [________________________________]

Employee or designee: _________________________ Date: ______________

6. CERTIFICATION, IF PERMITTED AND REQUESTED

For 3 or more consecutive days of paid leave, the employer may require reasonable certification. The employee provides it upon returning to work.

• ☐ Fewer than 3 consecutive days; statutory certification threshold not met
• ☐ Police report indicating victim status
• ☐ Court order
• ☐ Signed statement from a victim and witness advocate
• ☐ Signed statement from a domestic-violence counselor affirming involvement in related legal action

Secure return-to-work delivery date and method: [________________________________]

All information provided under the paid-leave provision must remain confidential except when the employee requests or consents to disclosure, a court or administrative agency orders disclosure, or applicable federal or District law requires it.

7. EMPLOYER RESPONSE AND NONRETALIATION

• ☐ Employee and District work coverage confirmed
• ☐ Victim and relationship gate confirmed
• ☐ Domestic-violence or sexual-abuse legal-action purpose confirmed
• ☐ 90-day access and accrued balance confirmed
• ☐ Notice route confirmed
• ☐ Certification not permitted, received, or calendared
• ☐ Paid leave approved: [HOURS / DATES]
• ☐ Confidential-storage and access controls applied
• ☐ Absence excluded from an attendance-control policy that could lead to adverse action
• ☐ No interference, restraint, denial, discharge, or discrimination because of protected leave or protected activity
• ☐ Counsel review required

Employer representative: _____________________ Date: ______________

8. ENFORCEMENT ALERT

D.C. Code § 32-531.12 permits civil and administrative actions and provides specified additional damages for accrued days denied, civil penalties for willful violations, back pay, reinstatement or other injunctive relief, compensatory and punitive damages, attorney fees, costs, and interest. Obtain prompt legal advice; this packet is not an administrative or civil complaint.

9. CHANGE LOG

OFFICIAL SOURCES VERIFIED

• D.C. Law Library — § 32-531.01
• D.C. Law Library — § 32-531.02
• D.C. Law Library — § 32-531.03
• D.C. Law Library — § 32-531.04
• D.C. Law Library — § 32-531.08
• D.C. Law Library — § 32-531.12