IS-2006 Family and Medical Leave (Procedure)

1.1 Request the Certification of Health Care Provider form (WH-380) from your supervisor or the Human Resources Department.

1.2 Take the Certification of Health Care Provider form (WH-380) to your physician for completion.

1.3 Write a memo to your immediate supervisor requesting Family and Medical Leave indicating dates of the leave and any leave bank time that will be used.

1.4 Contact the respective Human Resources Representative for questions regarding FMLA eligibility, benefit coverage, or other related matters, if necessary.

1.5 Respond to employee questions regarding FMLA.

1.6 Attach the memo requesting FMLA to the Certification of Health Care Provider form (WH-380) and hand-deliver, if possible, to your supervisor.

1.7 Immediately review the request to ensure it meets eligibility requirements.

1.8 Notify employee that s/he is eligible for FMLA.

1.9 Discuss other options with employee if s/he is not eligible.  Contact Human Resources Representative to discuss options, if necessary.

1.10 Discuss and verify with the employee that s/he understands that s/he has the option of electing FMLA leave as unpaid or paid.

1.11 If the employee has elected to be paid from his or her leave banks, ensure this is documented on the request for FMLA.

1.12 Contact the Human Resources Representative to review the Employer Response to Employee form (WH-381) if there are questions.

1.13 Review the Family and Medical Leave request within two days of receipt of employee's request to ensure it meets eligibility requirements.  Complete the Employer Response to Employee form (WH-381) and hand-deliver, if possible, to employee requesting FMLA leave.  If the employee is unavailable to receive a copy through inter-office mail, a memorandum must be posted certified mail/return receipt requested.

1.14 Initial and date confirmation of Family Medical Leave request on the employee's memo.

1.15 Attach the memo to the original Certification of Health Care Provider form (WH-380) and forward to the respective Human Resources Representative.

1.16 Review documentation for procedural compliance.

1.17 Contact supervisor if there are any questions.

1.18 Initial document.

1.19 Forward documents to records unit to file in employee's official confidential personnel file.

1.20 Forward documents to Human Resources Technician or designee.

1.21 Reference pertinent documents and generate Personnel Data Form (PDF) reflecting dates of Family Medical Leave and indicate unpaid leave or types of leave bank(s).

1.22 Forward aforementioned documents to Human Resources Representative or designee.

1.23 Review personnel data form for accuracy and sign.

1.24 Return to Human Resources Technician or designee.

Human Resources Technician

1.25 Make a copy of Personnel Data form (PDF) and forward the original to Payroll Coordinator.

1.26 Enter FMLA dates on appropriate Banner screen and file the Personnel Data Form (PDF) once returned from payroll.

1.27 Route PDF, medical certification form, FMLA confirmation, and a copy of re-employment/benefit eligibility memorandums to records unit to file in the employee's official confidential file.

1.28 Provide the supervisor with the physician's return to work documentation specifying "with or without work restrictions" prior to reporting to work from FMLA leave.

1.29 Review the physician's return-to-work documentation provided by the employee.

1.30 Notify the employee that you have received documentation and s/he may return to work as scheduled.

1.31 Contact Human Resources Representative if there are work restrictions which may or may not require a reasonable accommodation in compliance with the Americans with Disabilities Act.