Family and Medical Leave Act (FMLA)
Listed below you will find information regarding the Family and Medical Leave Act (FMLA). The published version of the regulations can be found via the Department of Labor website: http://www.dol.gov/whd/regs/statutes/fmla.htm.
Basic Leave Entitlement
FMLA requires covered employers to provide up to 12 weeks of unpaid, job-protected leave to eligible employees for the following reasons:
- For incapacity due to pregnancy, prenatal medical care or child birth;
- To care for the employee’s child after birth, or placement for adoption or foster care;
- To care for the employee’s spouse, son or daughter, or parent, who has a serious health condition; or
- For a serious health condition that makes the employee unable to perform the employee’s job.
Employees are eligible if they have worked for a covered employer for at least one year, for 1,250 hours over the previous 12 months, and if at least 50 employees are employed by the employer within 75 miles.
FMLA also includes a special leave entitlement that permits eligible employees to take up to 26 weeks of leave to care for a covered service member during a single 12-month period. A covered service member is a current member of the Armed Forces, including a member of the National Guard or Reserves, who has a serious injury or illness incurred in the line of duty on active duty that may render the service member medically unfit to perform his or her duties for which the service member is undergoing medical treatment, recuperation, or therapy; or is in outpatient status; or is on the temporary disability retired list.Military Family Leave is unpaid but employees may use benefit time.
- Leave due to qualifying exigencies may also be taken on an intermittent basis.
- Leave is unpaid, but may be covered by short-term disability (STD), Workers Compensation, or benefit time.
- The 12 month period of eligible leave is calculated on the anniversary of an employees original date of hire.
- Employees must provide 30 days advance notice of leave when the leave is foreseeable or as soon as practical.
- Employees must provide sufficient information for the employer to determine if the leave may qualify for FMLA protection and the anticipated timing and duration of the leave. Sufficient information may include that the employee is unable to perform job functions, the family member is unable to perform daily activities, the need for hospitalization or continuing treatment by a health care provider, or circumstances supporting the need for military family leave.
- Employees also must inform the employer if the requested leave is for a reason for which FMLA leave was previously taken or certified. Employees also may be required to provide a certification and periodic re-certification supporting the need for leave.
When taking a FMLA leave, the employee must have the the appropriate FMLA Form completed and returned to either Human Resources or their department. Please see below to download the forms. The department will then complete an unpaid leave of absence form and then submit it to Human Resources (with any additional paperwork). Upon return, the department should submit a Personnel Action Form, returning the employee from their leave.
Please use the appropriate form when requesting a FMLA leave. Note that most of the form should be completed by the attending physician (or their office staff).
- Certification of Health Care Provider for Employee’s Serious Health Condition
- Certification of Health Care Provider for Family Member’s Serious Health Condition
- Certification of Qualifying Exigency for Military Leave
- Certification for Serious Injury or Illness of a Current Servicemember – for Military Leave
- Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any “genetic information” when responding to this request for medical information. “Genetic information” as defined by GINA, includes your family medical history (including manifestations of a disease or disorder), your genetic tests or those of a family member’s, the fact that you or a family member sought or received genetic services or participated in clinical research that includes genetic services, and the genetic information of a fetus carried by you or a family member and genetic information of an embryo legally held by you or a family member receiving assisted reproductive technology.