Your Rights Under the Family and Medical Leave Act (FMLA) The Family and Medical Leave Act (FMLA) FMLA allows eligible employees the ability to take unpaid, job-protected leave for qualified medical reasons. FMLA provides continuation of applicable insurance coverage and job protection under the same terms and conditions as if the employee had not taken leave. Eligible employees are entitled up to twelve (12) work weeks of leave in a rolling 12-month period for the following qualified reasons: An employee’s serious health condition, A serious health condition of the employee’s spouse, parent, or child, Bonding with the employee’s newborn child or placement of a child with the employee for adoption or foster care, Any qualifying exigency arising out of the fact that the employee’s spouse, parent, or child is on active duty, or Military caregiver leave to care for a covered service member with a serious injury or illness for up to twenty-six (26) work weeks Family Medical Leave may be taken on an Extended, Reduced Schedule, or Intermittent basis, subject to certain conditions and requirements outlined in the Family and Medical Leave Policy. Employees who accrue sick or annual leave may be able to use their available leave to cover all or part of their salary during FMLA-protected leave. Employees who submit a claim for voluntary short-term disability may use their annual leave balance to supplement disability income, not to exceed regular weekly earnings. Academic faculty should consult the Faculty Handbook for additional information on paid leave. FMLA Request If the need for leave is foreseeable, the employee must give 30 days advance written notice. If the need for leave is unforeseen, the employee should provide such notice as is practical, which means following one’s supervisor’s usual and customary notice call-in procedures for reporting an absence. Supervisors may report an employee’s need to Human Resources. Follow the steps below to initiate the FMLA process: Complete and return the FMLA Leave Request Form: Complete the form, obtain signature approval from your manager, and return to Human Resources. Complete and return the applicable Medical Certification Form: This form should be completed by both the employee requesting leave and the attending physician then returned to Human Resources. The physician may fax this form directly. The Benefits Office in the Department of Human Resources has been designated to administer all FMLA requests. Primary Leave Administrator: Olivia Kreydatus. Phone: 256-824-2259 olivia.kreydatus@uah.edu benefits@uah.edu FMLA Forms and Resources UAH Leave Guide Request Forms Employee FMLA Checklist FMLA Request for Leave Form Health Care Provider Certification Forms Employee Serious Health Condition Physician Certification Form Family Member's Serious Health Condition Physician Certification Form Certification of Qualifying Exigency for Military Family Leave Certification for Serious Injury or Illness of Current Servicemember for Military Family Leave Certification for Serious Injury or Illness of a Veteran Servicemember for Military Family Leave Leave Usage and Return to Work FMLA Intermittent Timesheet Fitness-For-Duty Form This form must be completed by your physician prior to your return to work. Other Helpful Resources Comprehensive Leave Guide Family and Medical Leave Policy Employee Rights and Responsibilities Employee's Guide to FMLA : Department of Labor Employee's Guide to Military FMLA : Department of Labor
