FMLA Application for Leave
Employees seeking to use FMLA are required to provide 30 days advance notice when the need is foreseeable. If the leave is unforeseeable, notice must be provided as soon as practicable.
A Medical Certification Statement
- If this leave is for a serious medical condition of yourself or a member of your immediate family, attach a statement from a physician certifying medical necessity for the leave; please give anticipated beginning and ending dates for this leave.
- If this leave is for maternity/paternity, attach a statement from the physician verifying the pregnancy, and give the expected date of delivery and return date.
- If this is for an adoption, attach a statement of the anticipated date of placement.
Required Postings
FMLA Explained
Acceptable Reasons to Apply for FMLA
A full time employee may be granted a short term leave of absence of up to twelve (12) work weeks, without pay, during any twelve (12) month period for one or more of the following reasons:
Eligibility Requirements
To be eligible for this leave, an employee must have been employed for at least twelve (12) months. The entitlement to leave for the birth or placement of a child begins on the date of birth or placement and expires at the end of a twelve (12)-month period. The maximum aggregate leave entitlement under this provision is twelve (12) work weeks in any twelve (12) month period.
A physician's statement supporting reasons (3) and (4) above must accompany the leave request. The statement must include an estimate as to the amount of time the employee will be needed to care for a child, spouse or parent for reason (3) and the duration of the employee's inability to perform the function of his/her position for reason (4).
Sick Leave
An employee may use accumulated sick leave to cover any or all of this leave. After the expiration of this leave, the employee has the right to return to the same or an equivalent position. If the leave is nine (9) weeks or less, the employee may return to their original assignment.
Insurance
The Board paid portion of the employee's health insurance will continue during this leave. The employee is responsible for paying the employee portion, in advance, to the Finance Office.
Returning to Work