FAMILY AND MEDICAL LEAVE ACT

The Family Medical Leave Act of 1993 (FMLA) entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. Eligible employees are entitled to:

Twelve workweeks of leave in a 12-month period for:

• • The birth of a child and to care for the newborn child within one year of birth;

  • The placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;

  • To care for the employee’s spouse, child, or parent who has a serious health condition;

  • A serious health condition that makes the employee unable to perform the essential functions of his or her job;

  • Any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on “covered active duty;” or

Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the servicemember’s spouse, son, daughter, parent, or next of kin (military caregiver leave).

An eligible employee is one who:

• Works for a covered employer,

• Has worked for the employer for at least 12 months

• Has at least 1,250 hours of service for the employer during the 12-month period immediately preceding the leave and,

• Works at a location where the employer has at least 50 employees within 75 miles

The 12 months of employment do not have to be consecutive. That means any time previously worked for the same employer (including seasonal work) could, in most cases, be used to meet the 12-month requirement. If the employee has a break in service that lasted seven years or more, the time worked prior to the break will not count unless the break is due to service covered by the Uniformed Services Employment and Reemployment Rights Act (USERRA), or there is a written agreement, including a collective bargaining agreement, outlining the employer’s intention to rehire the employee after the break in service.

For those employees who fall under FMLA and desire to request such leave, please complete and submit LESP 26-Request for Leave or Comp Time Form and include the appropriate supporting documents by hand carrying or mail to ensure the security of personally identifiable information through the chain of command to the Human Resources Division. All employees and supervisors are asked to stay current with FMLA guidelines to ensure that this benefit is not abused.

SUPPORTING DOCUMENT(S)

Employee

• WH-380-E - Certification of Health Care Provider for Employee’s Serious Health Condition

• WH-380-F - Certification of Health Care Provider for Family Member’s Serious Health Condition

• WH-384 - Certification of Qualifying Exigency For Military Family Leave

• WH-385 - Certification for Serious Injury or Illness of a Current Servicemember - for Military Family Leave

• WH-385V - Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave

Human Resources Division

• WH-381 - Notice of Eligibility and Rights & Responsibilities