FMLA Guidelines

  • FMLA provides unpaid, job-protected leave.  Leave may be taken all at once or intermittently as the medical condition requires.  An allowance of 12 weeks (84 days) off if you meet this criterion:

    *Must have worked at least 12 months and at least 1250 hours in the 12 months before you take leave. 

    Thirty (30) days’ notice of your need to take FMLA is required.  Notice from doctor, hospital, military within 15 business days of submitting completed FMLA form.  Please note, all referenced forms can be found in the files to the right.

    Qualifying reasons for FMLA are:

    • Medical Leave
    • Maternity
    • Paternity
    • Child Care or care of immediate family member
    • Military Family Leave

FMLA Rights and Responsibilities

  • FMLA is an unpaid leave. However, if you have sick time or personal time, you may use that time, along with FMLA leave in order to continue to get paid.  Sick time used runs concurrently with FMLA time used.  If you have available sick or personal time that exceeds the FMLA days you’ve used, you can continue to use that time in order to remain being paid.

    District health benefits will remain in effect while you are on payroll which means your normal premiums will not change.  If you are off payroll at any time while you are on a leave of absence, your district benefit premiums will change.  See your Health and Benefits administrator for more information regarding both topics.

FMLA Applications

  • At-A-Glance Guidelines:

    Purpose

    Requirements

    Time off

    Sick,Personal,Vacation time

     

    Calendar Days counted

    Returning

    Medical

    Certification for Health Care Provider Form WH-380-E; Completed and properly signed FMLA form

    84 days per 12 months. *See above.

    Can be used to stay on payroll.  Certification for Health Care Provider Form WH-380-E is required in order to use sick time.

    Only work days are counted

    Doctor’s note upon return

    Maternity

    Certification for Health Care Provider Form WH-380-E; Completed and properly signed FMLA form.  Notice of child’s DOB a.s.a.p. in order to calculate recovery portion of FMLA days.

    84 days per 12 months. *See above. Note: 6 weeks recovery for natural birth; 8 weeks recovery for C-section

    Can be used to stay on payroll.  Certification for Health Care Provider Form WH-380-E is required in order to use time accrued.

    Only work days are counted

    Doctor’s note upon return

    Paternity

    Certification for Health Care Provider Form WH-380-E; Completed and properly signed FMLA form

    84 days per 12 months.  *See above.

    Can be used to stay on payroll.  Certification for Health Care Provider Form WH-380-E is required in order to use time accrued.

    Only work days are counted

    No note required.

    Child or Immediate Family

    Certification for Health Care Provider Form WH-380-F showing you are primary care-giver; Completed and properly signed FMLA form

    84 days per 12 months.  *See above.

    Can be used to stay on payroll. Certification for Health Care Provider Form WH-380-F is required in order to use time accrued.

    Only work days are counted

    No note required

    Military Family Leave

    Certification of Qualifying Exigency form WH-384; and/or Certification for Serious Injury or Illness of a Current Servicemember Form WH-385 Completed and properly signed FMLA form

    84 days and may take up to 26 weeks of FMLA leave in a single 12-month period to care for a covered service member with a serious injury or illness.

    Can be used to stay on payroll.  Certification of Qualifying Exigency Form WH-384 is required to stay on payroll.

    Only work days are counted

    Doctor’s note required if you’ve completed a Form WH-385