We understand that you face health and family challenges in your personal life. There may be times that you need to take time off from work to deal with those challenges.
What is FMLA?
The Family and Medical Leave Act (FMLA), a federal law, protects you from negative impacts to your job when you take leave for any of the following reasons:
- A serious health condition, either yours or a family member’s
- Prenatal medical care or incapacity due to pregnancy and/or delivery
- Time to bond with your new baby or newly placed adopted or foster child
- Qualifying activities (exigencies) related to a family member’s military active duty
- A serious injury or illness of a family member who is a current member of the armed forces or a veteran
The University determines when to label a leave as “FMLA” based on the facts of each individual situation. When we know facts that indicate your leave might be covered under FMLA, we are required to inform you of your rights under this law. You are responsible for providing enough information that the University can make an FMLA determination.
What FMLA is not
FMLA is a designation, not a type of accrued leave. You do not accrue FMLA leave or choose when to use it, like you do with annual or sick leave. If your leave meets FMLA criteria, it will be designated as FMLA, even if you are using accrued paid leave.
Am I eligible?
Based on federal requirements, we use a two-question assessment to determine whether you are eligible for FMLA protection.
Question 1: Have you worked for a Washington state agency for at least 12 months as of the start date of your requested leave?
The 12-month requirement includes your time working for the University as well as any other time you’ve worked for a Washington state agency. If you had a break in service that lasted more than seven years, generally, that prior service is not counted.
Question 2: Have you worked for a Washington state agency for at least 1250 hours in the 12 months prior to your first day of leave?
The 1250 hours must be actual worked hours.
If you are eligible for overtime, your overtime hours count toward the 1250 hours. But paid and unpaid leave — except military leave — do not count toward the 1250 hours.
If your FTE has been 0.6 or less in the previous 12 months, you probably have not worked the required 1250 hours.
If the answer is “yes” to those two questions, you qualify for FMLA, as long as:
- Your leave is for an FMLA-qualifying reason
- You haven’t already used up your 12-week entitlement (as of the start date of your leave)
If the answer is “no” to either or both questions, you don’t qualify for FMLA for this particular leave. However, you may still be eligible for leave under state law or University policy. Your leave specialist can help you assess your leave options.
And of course, your FMLA eligibility status can change over time. If you were denied FMLA coverage because you haven’t worked at the University long enough or have used up your leave entitlement for the 12-month period, you may be eligible when you need leave at a later date.
What form do I need?
Health-related or new child leave
If your FMLA leave is for your or a family member’s health condition or for the arrival of a new child, you will need to submit a health-care provider certification form, explaining your need for leave.
Using the appropriate form(s) below, complete the employee information sections. Include your personal, supervisor, and department information. We need that information to communicate with your department regarding your leave needs as stated by your health-care provider.
Your health-care provider should complete the medical information section.
If you need intermittent leave but your provider is unable to specify the exact amounts of leave that you will need, we suggest they use this phrasing: “Employee could need up to x hours per x, from x date to x date.” This allows for some flexibility in dealing with symptoms and flare-ups but also gives your department an idea of what to expect.
Submit the completed form, using the Human Resources contact information listed on the form. For your own privacy, do not give a copy of your completed health certification form to your supervisor or department. This information is kept in your medical file in Human Resources and should not be seen by department personnel or kept in department files.
The form must be returned within 15 days of receipt. Your health-care provider may fax your completed paperwork to HR, but we recommend that you get a copy yourself so that you can send it to HR directly if necessary. Provider offices are well intentioned, but HR forms may not be their highest priority!
Call to duty leave
If your leave is related to a family member being called to military duty, complete the appropriate form below, and submit it to HR (with the requested supporting documentation) within 15 days of receiving the form.
Health-care provider certification forms
Parental/Maternity Leave for Birth Mother - FMLA (campus) (MS Word)
Parental Leave for Parent other than Birth Mother - FMLA (campus) (MS Word)
FMLA (campus) Personal Serious Health Condition (MS Word)
FMLA (campus) Family Member's Serious Health Condition (MS Word)
FMLA (campus) Serious Injury or Illness of Military Family Member (MS Word)
FMLA (campus) Military Family Qualifying Exigency (MS Word)
FMLA (med centers) Personal Serious Health Condition - Maternity/Pregnancy (PDF)
FMLA (med centers) Family Member's Serious Health Condition - Parental Leave (not birth mother) (PDF)
FMLA (med centers) Personal Serious Health Condition (PDF)
FMLA (med centers) Family Member's Serious Health Condition (PDF)
FMLA (med centers) Serious Injury or Illness of Military Family Member (PDF)
FMLA (med centers) Military Family Qualifying Exigency (PDF)
During your leave, we may ask that you update us periodically about your ability to return to work. If your need for leave changes significantly or is longer than anticipated, we may ask for an updated health-care provider certification.
We protect the confidentiality of your health information. You should not disclose your or your family member’s medical diagnosis to your supervisor or department. Any required certification should be submitted directly to Human Resources, where it will be kept confidential and separate from your personnel file.
What happens after I submit my form?
Once you submit your form(s), your leave specialist will review the information you provided, and if it is sufficient, an email will be sent to your supervisor advising them of the dates and type of leave you have been approved for.
If the information provided isn’t sufficient, your leave specialist will be in touch with you for follow up with your health-care provider.