Eligibility

You’re eligible for FMLA leave if you’ve worked at {​{​Organization Name​}​} for at least 12 months (not necessarily consecutive), logged at least 1,250 hours of service in the 12 months prior to the leave, and are employed at a worksite where 50+ {​{​Organization Name​}​} {​{​employees​}​} work within 75 miles.

Interaction with State and Local Laws

Where state or local family and medical leave laws offer more protections or benefits, the protections or benefits that are more favorable to you, as provided by these laws, will apply.

How To Request Leave

When you need to take FMLA leave, it’s important to give us enough information to understand whether your situation qualifies. Please also share the anticipated timing and length of your leave, if you know it.

If your leave is planned, like for a scheduled medical procedure, let us know at least 30 days in advance when possible.

If you can’t give advance notice, contact your {​{​manager​}​} or {​{​the HR Team​}​} as soon as you reasonably can, ideally before leaving work that day or before your next scheduled shift begins. Follow our usual procedures for unscheduled absences. If you need time off for a reason connected to a previous FMLA-qualifying leave, let us know.

Keep in mind that if you don’t provide enough notice or follow these procedures, your leave could be delayed or denied.

Reasons for Leave

You can take family and medical leave for any of the following reasons (the bolded terms are defined in the next section):

• The birth of your son or daughter or the placement of a son or daughter with you for adoption or foster care (as long as leave is taken within 12 months of the birth or placement).
• To care for your spouse, son, daughter, or parent who has a serious health condition.
• For your own serious health condition that prevents you from working or requires medical treatment.
• Because of a qualifying exigency related to your spouse, son, daughter, or parent being a military member on covered active duty (or has been notified of an impending call or order to such duty).
• To care for a covered service member (who is your spouse, son, daughter, parent or next of kin) with a serious injury or illness (military caregiver leave).

Definitions

The terms used in this policy have the meanings established in the FMLA and related regulations:

• Serious health condition: An illness, injury, impairment, or physical or mental condition that involves either an overnight stay in a medical care facility, or continuing treatment by a health care provider for a condition that prevents you from working or prevents a qualified family member from participating in school or daily activities. This includes, under certain conditions, incapacity of more than three consecutive calendar days plus treatment, incapacity due to pregnancy, or incapacity due to a chronic condition.
• Covered service member:
  • (A) A current member of the Armed Forces (including National Guard or Reserves) who is receiving medical treatment, recuperation, or therapy, is in outpatient status, or is on the temporary disability retired list, for a serious injury or illness; or
  • (B) A covered veteran who is receiving treatment, recuperation, or therapy for a serious injury or illness.
• Covered active duty:
  • (A) For Regular Armed Forces: duty during deployment to a foreign country;
  • (B) For Reserve components: deployment to a foreign country under a federal call or order in support of a contingency operation.
• Military member: Your spouse, son, daughter, or parent serving in the Regular Armed Forces, National Guard, or Reserves.
• Serious injury or illness:
  • For a current Armed Forces member: an injury or illness incurred in the line of duty while on active duty (or preexisting and aggravated in the line of duty) that may make the service member unfit for duty.
  • For a covered veteran: an injury or illness incurred or aggravated in the line of duty that manifested before or after discharge, and meets at least one of these criteria:
    1. Continues from an injury that rendered the veteran unable to perform duties while in service.
    2. Has a VA service-related disability rating of 50% or more related to the need for leave.
    3. Substantially impairs the veteran’s ability to work or would do so without treatment.
    4. Is the basis for enrollment in the VA’s Program of Comprehensive Assistance for Family Caregivers.
• Outpatient status: When a servicemember is receiving medical care as an outpatient either:
  • At a military medical treatment facility, or
  • While assigned to a special unit that manages servicemembers getting outpatient care
• Qualifying exigency: The need to manage issues arising from deployment, including short-notice deployment, arranging childcare, attending certain school activities, handling financial or legal arrangements, attending counseling or military ceremonies, spending time with a deployed family member on rest and recuperation leave, or participating in post-deployment activities.
• Designated 12-month period: A rolling 12-month period measured backward from the date you use any family and medical leave. During this period, you may take up to 12 workweeks of leave.
• Single 12-month period: The 12 months starting on the first date you take military caregiver leave. In that time, you may take up to 26 workweeks of leave per covered service member per injury or illness. Additional leave for the same service member and the same injury is not available in a new 12-month period.
• Son or daughter: A biological, adopted, or foster child, stepchild, legal ward, or child for whom you stand in loco parentis, who is (A) under 18 years old, or (B) 18 or older and incapable of self-care due to a mental or physical disability.
• Spouse: A husband or wife as recognized under the laws of the place where the marriage occurred.
• Next of kin: The nearest blood relative of the covered servicemember (for example, a spouse, parent, sibling, or adult child).
• Covered veteran: Someone who served in the Armed Forces (including National Guard or Reserves), was discharged under conditions other than dishonorable, and whose service ended within the five years before you first take leave to care for them.

Duration

If you’re eligible, you may take up to 12 workweeks of family and medical leave during the designated 12-month period for any of these reasons:

• The birth of your son or daughter, or the placement of a son or daughter with you for adoption or foster care;
• To care for your spouse, son, daughter, or parent with a serious health condition;
• For your own serious health condition; or
• Due to a qualifying exigency related to a military member on covered active duty.

If you're taking military caregiver leave, you can take up to 26 workweeks of leave in a single 12-month period. During that single 12-month period, you are entitled to a combined total of 26 workweeks for all qualifying reasons. This means that any family and medical leave you take for other reasons counts toward the 26-week maximum. For example, if you use 10 weeks for your own serious health condition, you have up to 16 weeks remaining for military caregiver leave within that same 12-month period.

If you take leave for an FMLA-qualifying reason, that time will count against your available FMLA entitlement, even if other policies or state laws apply.

Intermittent or Reduced Schedule Leave

If you're eligible and approved for family and medical leave, you may take leave in full-day increments or, in some situations, intermittently or on a reduced schedule.

• Medically Necessary Leave: If your leave is due to a serious health condition (for yourself or a family member) or for military caregiver leave, you may take intermittent or reduced schedule leave when medically necessary.
• Parental Leave: If your leave is for the birth or placement of a child, intermittent or reduced schedule leave requires {​{​Organization Name​}​}’s prior agreement.
• Qualifying Exigency Leave: Leave related to a qualifying exigency may also be taken intermittently.

Whenever possible, you should schedule planned medical treatments in advance to minimize disruption to business operations. If your intermittent or reduced schedule leave is foreseeable due to planned medical treatments, {​{​Organization Name​}​} may temporarily transfer you to another position with equivalent pay and benefits that better accommodates the leave schedule.

Medical Certification

If you request leave for your own or your family member’s serious health condition, you’ll need to provide a medical certification from the treating health care provider. This helps us verify that your leave meets FMLA requirements.

Obtaining Certification

{​{​The HR Team​}​} will give you the certification form. You should return it as soon as possible and no later than either the date your leave begins or within 15 days of {​{​Organization Name's​}​} request.

Certification Content for Your Own Condition

For leave related to your own serious health condition, the certification must include:

• The date the condition began
• The expected duration of the condition
• Relevant medical facts confirming the condition
• Information about your ability to perform essential job functions, including any work restrictions and their expected duration

Certification Content for a Family Member’s Condition

If you’re requesting leave to care for a family member (either due to a serious health condition or for military caregiver leave), the certification must include:

• Sufficient details establishing the serious health condition or injury and when it began
• The expected duration of the condition
• A statement confirming that your care is needed for the family member’s health or recovery
• An estimate of how much time you’ll need to provide that care

Additional Certifications and Second Opinions

If the initial certification is incomplete or insufficient, we'll let you know and you’ll have seven calendar days to provide updated information. We may also contact the health care provider to verify the certification or clarify information as needed.

If we have reason to doubt the validity of the certification, we may request a second opinion (at our expense) from a health care provider we select who is not employed by us. If the second opinion differs from the original, we may require a third opinion (at our expense) from a provider we jointly select with you. The third opinion is final and binding.

Recertification

We may ask you to provide recertification on a reasonable basis during your leave.

Fitness for Duty

Before returning to work after leave for your own serious health condition, you must submit a release confirming you’re fit to resume your job.

Important Note About Genetic Information

To help us comply with the Genetic Information Nondiscrimination Act of 2008 (GINA), please do not provide any genetic information when submitting documentation. “Genetic information” includes family medical history, genetic test results, and similar details.

Certification of Qualifying Exigency

If you request leave due to a qualifying exigency (for example, to manage issues arising from a military family member’s covered active duty), you’ll need to submit a Certification of Qualifying Exigency for Military Family Leave (Form WH-384). Please complete and return it as soon as possible, no later than within 15 days of your leave request.

Pay and Benefits

Family and medical leave is generally unpaid. Per our policy, you must use any available PTO or sick leave during your leave, unless applicable law states otherwise. Your use of PTO or sick time will depend on the terms and conditions of those policies. During any unpaid portion of your leave, you won’t accrue PTO or sick leave and won’t be paid for holidays.

While you're on family and medical leave, you can maintain your group health benefits for up to 12 workweeks (or up to 26 workweeks for military caregiver leave), as if you were actively working. You must continue paying your share of premiums for yourself and any covered dependents during your leave. If you don’t return to work after your approved leave ends, we may recover our share of the premiums paid on your behalf, unless the reason you’re unable to return is beyond your control or otherwise excused.

Any benefits you accrued before your leave began will not be lost because you took leave.

Reinstatement

If you return to work immediately after your approved leave ends, you’ll be reinstated to your same position, or to an equivalent position with the same pay, benefits, and working conditions.

If you don’t return to work on the first workday after your leave ends and haven’t been granted an extension, we may consider this a voluntary resignation.

In some cases, key {​{​employees​}​} may not be eligible for reinstatement after family and medical leave if reinstatement would cause substantial and grievous economic harm to {​{​Organization Name​}​}. If you're designated as a key {​{​employee​}​} (defined as one of the highest paid ten percent of our employees within 75 miles of your work location) we'll inform you in writing if your reinstatement rights may be affected.

Employer Responsibilities

It is our responsibility to let {​{​employees​}​} who request leave know whether they're eligible under the FMLA and, if applicable, state law. If you request leave, we'll review your eligibility and provide you with a completed Notice of Eligibility and Rights & Responsibilities (Form WH-381). This form outlines your rights and responsibilities and explains any additional documentation or steps required. If you're not eligible for FMLA leave, we'll include the reason for your ineligibility.

Once you submit the required information, we'll let you know whether your leave is designated as FMLA-protected using the Designation Notice (Form WH-382) and how much of your leave entitlement it will use. If the leave does not qualify for FMLA protection, we'll notify you in writing.

Conduct During Leave

Alternative Employment

While you're on FMLA leave or any other approved leave of absence, you may not engage in other paid or unpaid work (including self-employment) without prior written authorization from {​{​Organization Name​}​}. Working elsewhere without permission may result in disciplinary action, up to and including termination.

Abuse of Leave

You are expected to use leave honestly and for its intended purpose. Misrepresenting the reason for leave, failing to return to work when medically cleared, or engaging in activities inconsistent with your stated need for leave may be considered abuse and could result in disciplinary action, up to and including termination.

Leave Designation

If we become aware of any qualifying reason for FMLA leave, we will designate it as such, even if you do not request FMLA by name. You may not decline or refuse FMLA designation once the leave qualifies.

No Retaliation

{​{​Organization Name​}​} strictly prohibits retaliation or discrimination against any {​{​employee​}​} who exercises rights under the FMLA or applicable state law. If you believe you've experienced retaliation or interference, please report your concerns to your {​{​manager​}​} or {​{​the HR Team​}​} right away.