FMLA PROCEDURES for EMPLOYEES
- FMLA protects job and benefits during FMLA leave for 12 weeks.
- To initiate the FMLA request process, the employee will need to complete and send this Employee Absence Statement to Human Resources so that HR can determine eligibility and provide an FMLA packet of information.
Please contact Mercedes Hinojosa at firstname.lastname@example.org or Isacc Ramirez at email@example.com.
- Notice provided to employer:
- If possible, an employee must give at least 30 days advance notice of the need to take FMLA leave when he or she knows about the need for the leave in advance
- If 30 days advance notice is not possible because the foreseeable situation has changed, or the employee does not know exactly when leave will be required, the employee must provide notice of the need for leave as soon as possible
- Determine if the employee meets the statutory eligibility:
The first requirement in determining eligibility is that the employee has worked for at least 12 months and 1,250 hours of service in the previous 12 months.
- Once Human Resources receives the Absence Statement the employee will be provided the following Information and notices.
- COVER LETTER – SPECIFIC TO EMPLOYEE
- NOTICE OF FMLA ELIGIBILITY AND RIGHTS AND RESPONSIBILITIES – SPECIFIC TO EMPLOYEE
- FMLA Section of HAYS COUNTY PERSONNEL POLICY
- FMLA POSTER
- PHYSICIAN’S CERTIFICATE TO BE COMPLETED BY PHYSICIAN – WITH HAYS COUNTY CONTACT INFORMATION PROVIDED
- So that medical eligibility can be determined, Human Resources will also request that the employee obtain a Physicians Certificate for one of the following eligible conditions. Note that each condition has a different form.
- Employee’s Serious Health Condition
- Family Member’s Serious Health Condition
- Qualifying Exigency for Military Family Leave
- Serious Injury or Illness of a Current Service Member—For Military Family Leave
- Serious Injury or Illness of a Veteran for Military Caregiver Leave
- The information provided by your medical provider will determine if the requested leave is for a FMLA-qualifying reason, which includes:
- Incapacity due to pregnancy, prenatal medical care, or child birth
- Care for the employee’s child after birth, placement for adoption, or foster care
- Care for the employee’s spouse, son, daughter, or parent who has a serious health condition
- A serious health condition that makes the employee unable to perform the employee’s job.
Human Resources will provide the FMLA Designation Notice to the employee and the Treasurer’s office once the Physician Certification determines eligibility.
Employee Absence Statement Form
|Date||June 5, 2019|