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illness or injury. If the employee does not have sufficient <br />accumulated sick leave at the commencement of such <br />industrial illness or injury, they shall be advanced sick leave for <br />this purpose. Subsequently, the City shall deduct an equal <br />amount previously advanced from any sick leave accrued by <br />the employee until the total amount is recovered. If the <br />employee terminates before recovery of all advanced sick <br />leave, the City shall deduct the unrecovered cost of sick leave <br />from such terminated employee's final paycheck, to the extent <br />possible. <br />The City may authorize employees to use sick leave, vacation, <br />or compensatory time for approved workers' compensation <br />medical appointments as specified herein. The City may <br />authorize use of such leave for City approved medical <br />appointments wheneversuch appointments cannot be secured <br />outside the employee's regular workday, and salary <br />continuation or workers' compensation benefits are not <br />available. <br />D. Limit. The maximum total accumulation of sick leave with pay shall be <br />two hundred (200), eight (8) hour working days. Sick leave usage of <br />less than a full day shall be charged in minimum increments of one - <br />half ('/2) hour, with fractional usage rounded upward to the next higher <br />multiple of one -half ('/2), <br />E, Extended. The City Manager may grant leave up to six (6) months <br />without pay to an employee who has exhausted all of his or her <br />accrued sick leave if a licensed physician designated by the City <br />Manager indicates that the employee shall be sufficiently recovered <br />to return to his or her employment within a six (6) month period. Prior to <br />the expiration of the additional time, the employee may return to his or <br />her position provided that the employee has a certificate from a <br />licensed physician stating that the employee is able to perform all the <br />duties of his or her position without qualification. In addition to the <br />above, the City Manager may grant a further extension not to exceed <br />a total of one (1) year without pay. <br />F. Extension by Use of Accrued Compensatory Time Off and /or Vacation. <br />After an employee's sick leave has been exhausted, he or she maybe <br />granted permission to use, first, any unused compensatory time off <br />CONFIDENTIAL ASSOCIATION OF SANTA ANA(CASA MOU: 2015 -2017 Page 44 <br />25G -46 <br />