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Office of the Chancellor

Initiating FMLA Leave

If an employee informs the supervisor that s/he will need to take more than 3 continuous days off for medical purposes, the supervisor should immediately contact the Leaves Office to request a FMLA eligibility determination.  Immediate action is critical so employees may be notified of their rights and responsibilities pertaining to Family and Medical Leave.  If the employee is eligible for FMLA, the Leaves Office will send the employee a FMLA packet within 5 business days of notification.  The FMLA packet includes:

  • A provisional designation letter notifying the employee that the leave has been temporarily designated as leave under FMLA until a conclusive determination is made.
  • Leave of Absence Request form
  • Medical Certification form
  • Return to Work Certification form (if applicable)

The Leave of Absence Request and Medical Certification forms should be returned to the Leaves Office no later than 30 days prior to the expected leave start date (if the leave is foreseeable), or by the due date indicated on Part B of the Notice of Eligibility and Rights and Responsibilities form provided by the Leaves Office.  When the FMLA forms are returned, the Leaves Office will work with the supervisor and Payroll to track the leave, including use of sick leave and vacation.

If the Leaves Office determines that the employee is not eligible for FMLA, the supervisor should immediately notify the employee and discuss other options that may be available, such as a personal leave.  If the leave is not FMLA designated, the Leaves Office will track the use of sick leave, vacation, and leave without pay, so it is important to communicate all leaves with the Leaves Office.