State Family and Medical Leave Act
- FMLA Leave Request Form
- FMLA Certificaton of Healthcare Provider (For employee's own serious health condition)
- FMLA Certification of Healthcare Provider (For employee's family member's health condition)
- Employee Rights and Responsibilities Under The Family & Medical Leave Act
Eligible State employees may be granted a Family Medical Leave of up to 12 weeks of unpaid leave (or paid leave; the provisions set forth in the Attendance Rules and Collective Bargaining Agreements continue to govern the use of any paid leave) in a calendar year including long term care and intermittent care for the purpose of:
- Caring for a son or daughter following his/her birth, adoption or foster care placement (must be taken within 1 year of the event);
- Caring for a spouse, child or parent with a serious health condition; or
- For the State employee's own serious health condition which renders the State employee unable to perform any of the essential functions of their position.
The following requirements must be met in order to meet the service requirements for the Family Medical Leave Act (FMLA):
- The State employee must have been employed for at least 12 cumulative months on the date FMLA leave is to begin. A State employee's total State Service must be counted when determining if the State employee has completed the required 52 cumulative weeks of service, regardless of any breaks in service and regardless of the percentage of time paid during each of the 52 weeks. A week counts toward the 52 weeks if the State employee was paid for any portion of that workweek.
- The State employee must have worked a minimum of 1250 hours during the 52 consecutive weeks immediately preceding the date FMLA leave is to begin. When counting the number of hours necessary to meet this 1250 - hour threshold, the University must include all hours the State employee actually worked. The law does not include paid leave time such as holiday, vacation, sick leave, sick leave at half-pay, STD, worker's compensation leave, personal leave, military leave, leave for jury duty or witness leave as time worked toward the 1250- hour minimum.
- Every State employee shall receive information regarding FMLA eligibility and requirements upon hire.
- Upon request, a State employee will be provided with an "State employee Request for Leave under FMLA" and a "Certification of Health Care Provider" from their supervisor or Human Resources Department.
- The State employee is responsible for completing the "State employee Request for Leave Under FMLA" form, which is to be submitted by the State employee to the Human Resources Department.
- The State employee is responsible for having the 'Certification Of Health Care Provider' completed by their Health Care Provider. The Certification of Health Care Provider form is to be submitted to the State employee's Human Resources Department for evaluation.
- Human Resources Department notifies State employee in writing of approval/denial of request for FMLA. A copy of the letter is sent to Timekeeping and the State employee's supervisor.
- If approved: The State employee may be requested to periodically submit re-certifications of his/her or spouse's, child's or parent's serious health condition to the Human Resources Department.
- If denied: The State employee may be requested to submit additional information if request for leave is incomplete. The State employee will be notified of the reason for denial if other than incomplete application.
- Additional Conditions of Approved FMLA Leave:
- To extend an approved long term leave additional medical documentation is required.
- Returning to work prior to the end of the original leave is deemed an end to the State employee's FMLA.
- Subsequent leaves require submission of a new request for a FMLA leave by the State employee.
- Intermittent Leave: State employees granted FMLA leave for intermittent absences for a specified time period must designate such absences as a FMLA absence when calling in absence to the supervisor. FMLA leave also must be indicated on the timesheet by the State employee. Improper designation of unscheduled absences that are not covered by an approved FMLA leave for intermittent absence is misconduct for which appropriate administrative action will be taken.
- State employees who have been on a leave due to their own illness must submit medical clearance to Human Resources from their authorized Health Care Provider on official letter head that specifies:
- Their return to work date and,
- The fact that they can return to full unrestricted duty before being permitted to return to work. State employees out on leave for family members are required to notify their supervisor of their return prior to reporting to work. The State employee's supervisor will notify Human Resources and Timekeeping.
- A request to cancel an FMLA leave must be made by the State employee in writing to Human Resources.
- A biological, adopted or foster child, stepchild or legal ward who is either under 18 years of age or over 18 and incapable of self-care because of a mental or physical disability.
- A biological or adoptive parent or an individual who stands or stood in loco parentis to a State employee when the State employee was a child.
- A husband or wife as defined or recognized under state law for purposes of marriage in the state where the State employee resides, including common law marriage in states where it is recognized.
- Serious Health Condition
- An injury, illness, impairment or physical or mental condition that involves inpatient care, subsequent treatment in connection with such inpatient care or a period of incapacity requiring absence of more than three calendar days that also involves continuing treatment or supervision by a health care provider. The definition of a serious health condition does not generally cover minor illness.
- Health Care Provider
- A Doctor of Medicine, Doctor of Osteopathy, Podiatrist, Dentist, Optometrist, Psychologist, Chiropractor, Nurse Practitioner, Nurse Midwife, Christian Science Practitioner or Clinical Social Worker.
- Long-term Leave
- Long-term leave is granted for a specific serious health condition for a single, specified time period.
- Intermittent Leave
- Intermittent leave is granted for a specific serious health condition that requires intermittent absences over a specified time period. Reduced Work Schedule: A leave schedule that reduces the usual number of hours per workweek, or hours per workday, of a State employee over a specified time period.