Family and Medical/Parental Leave
The Family and Medical Leave Act of 1993 requires employers to grant up to 12 weeks (26 weeks for military caregiver leave) of job protected leave to eligible employees for certain qualified medical conditions. This page contains all the forms you may need to file for Leave, policy and FMLA resources, and process guides for Medical and Family/Parental Leave.
To qualify, employees must have 12 cumulative months of state employment and at least 1250 hours worked in the year immediately prior to the first day of leave. As an eligible employee, you may take family and medical leave for:
- The birth of a child and the care of the newborn
- The placement of a child with an employee in connection with the adoption or State-approved foster care of the child
- The serious health condition of a child, parent, or spouse
- The serious health condition of the employee
- Military Family Leave: qualifying exigency leave or military caregiver leave
Family and Medical Leave Application
Parental Leave
If you do not meet eligibility requirements for FML, you are entitled to 12 weeks of Parental Leave for the birth of child, care of the newborn, and the placement of a child under three years of age in connection with adoption or a state-approved foster care of a child.
Parental Leave Application
Forms
Download and fill out the appropriate medical certification that applies to your situation. Then, submit a Family and Medical Leave Application or a Parental Leave Application.
-
Medical Certification Forms for Employee or Family Member
Certification of Health Care Provider for Employee
Certification of Health Care Provider for Family Member -
Medical Certification Forms for Serious Injury/Illness of Covered Service Member
Caregiver Certification for Serious Injury/Illness of Covered Service Member
Certification for Serious Injury/Illness of Covered Service Member
Certification for Serious Injury/Illness of a Veteran for Military Caregiver leave -
Medical Certification Forms for Qualifying Exigency for Military Family Leave
Certification of Qualifying Exigency for Military Family Leave
Process Guides
Employee must use all accrued leave first; Employee will be placed on leave without pay when accrued leave is exhausted.
- Employee notifies their Supervisor at least 30 days prior to leave, or as soon as possible in the case of an emergency.
- Employee completes the Family and Medical Leave Application and attaches applicable documentation at least 30 days prior to leave or within three days in the case of an emergency.
- HR Benefits sends Employee a Health Provider Certification. Employee secures a completed certification from their health care provider within 15 days of receipt of this form and submits the certification to HR Benefits.
- HR Benefits reviews the application. If approved, Benefits provides copies of the application to Employee and their Supervisor. If denied, or if Health Provider Certification is unclear, Benefits will contact Employee.
- Supervisor enters and approves Absence Management Request(s) in TRAM for approved time.
- Employee pays ERS any insurance premiums due while on unpaid leave for an entire month.
- HR Benefits will collect any missing premiums upon Employee return from leave.
- Employee returns to work and provides release to return to work from Health Care Provider, if applicable.
