FMLA POLICY (HR2413) REDLINED 08-21-2019.PDF

MARICOPA COUNTY INTERNAL POLICY
Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT
Current Adoption Date: 08-21-2019
(FMLA) APPROVED LEAVES OF ABSENCE
Current Implementation Date: 08-21-2019
Approved by: Board Agenda Number: C-31-13-018-6-01
BOARD OF SUPERVISORS
Original Adoption Date: 03-2001
I. PURPOSE
To inform employees and supervisors of the guidelines and process to follow when employees
request and take traditional, non-military leave covered by the Family and Medical Leave Act
(FMLA). In addition, this policy addresses the process to follow when employees take military-
related leave covered by the FMLA [refer to Section IX below for specific information about military-
related leave]. The FMLA allows eligible employees protected, unpaid leave for a variety of
healthcare and military reasons. No employee may be subjected to discrimination or retaliation in
any manner as a result of exercising their rights under the FMLA.
II. AUTHORITY
This Policy is authorized by the Board of Supervisors pursuant to A.R.S. § 11-251.
II.III. APPLICATION
This Policy applies to all eligible employees of Maricopa County elected offices, appointed
Ddepartments as well as the Flood Control District of Maricopa County and the Maricopa County
Library District (Special Districts). The Board of Supervisors is authorized to jointly adopt policies
applying to the Special Districts under the Intergovernmental Agreement, C-06-18-393-6-00,
approved on April 11, 2018.
This Policy also applies to eligible employees of County elected offices unless the elected official
has implemented a similar policy specific to his or her office.
III.IV. DEFINITIONS
A. Appointing Authority: An elected official, the single administrative or executive head of a
Department/Special District, or the designated representative authorized to act in this capacity.
B. Certification: The certification an employee provides for a Serious Health Condition signed by
a The Certification of Healthcare Provider form Health Care Providerprepared by the County
Human Resources Department, which is compliant with the federal Department of Labor
standards. The certification is typically completed on a U.S. Department of Labor Certification
of Healthcare Provider form.
C. Child: A biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person
standing in loco parentis (in the place of a Parent), who is under 18 years of age, or 18 years of
age or older and incapable of self-care because of a mental or physical disability. For the
purposes of military-related FMLA leave, an employee’s child on Covered Active Duty may be
of any age.

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
B.D. Continuous Leave: Leave taken for an FMLA-qualifying reason in a single, continuous
block of time (e.g., 3 weeks off for surgery and recovery).
E. Department HR: The employee’s assigned internal human resources office. If there is no
departmental human resources office, then it refers to the department’s assigned HR liaison.
F. FMLA Coordinator: The employee at County Human Resources assigned to handle the
administration of FMLA for employees in an appointed department.
III. Department/Special District (Department): A division of the County, including elected offices
and/or Special Districts. Special Districts are the Flood Control District of Maricopa County,
Maricopa County Library District, and the Maricopa County Stadium District.
D.G. Health Care Provider: A doctor of medicine or osteopathy who is authorized to practice
medicine or surgery by the State in which the doctor practices or any other person determined
by the U.S. Department of Labor to be capable of providing health care services under the
FMLA.Includes:
III. A doctor of medicine or osteopathy who is authorized to practice medicine or surgery (as
appropriate) by the State in which the doctor practices; or
0. Any other person determined by the Secretary of Labor to be capable of providing health
care services, only including:
. Chiropractors, limited to treatment consisting of manual manipulation of the spine to
correct a subluxation as demonstrated by x-ray to exist, podiatrists, dentists, clinical
psychologists, and optometrists, who are authorized to practice in the State and
performing within the scope of their practice as defined under State law;
. Nurse practitioners, nurse-midwives, and clinical social workers who are authorized to
practice under State law and who are performing within the scope of their practice as
defined under State law;
. Christian Science practitioners listed with the First Church of Christ, Scientist, in Boston,
Massachusetts;
. Any provider of health care from whom the HR Liaison or the Employee Benefits
Manager, will accept certification of the existence of a Serious Health Condition to
substantiate a claim for benefits; and
K. A provider of health care listed above who practices in a country other than the United States,
who is authorized to practice in accordance with the law of that country, and who is performing
within the scope of his or her practice as defined under such law.
L.H. HR/FMLA Liaison: For purposes of The employee in an Elected Office assigned to
handle the administration of FMLA for employees of that Office.this Policy, the individual(s) in a
Department who have been trained to handle the administration of FMLA or, if no such individual
is assigned, then the individual in County Human Resources responsible for administration of
FMLA for that Appointing Authority.
M. Immediate Family Member: Includes the employee’s Spouse, Child, or Parent:
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
0. Spouse: A husband or wife as defined or recognized under Arizona law.
0. Child: A biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person
standing in loco parentis (in the place of a parent), who is under 18 years of age; or 18 years
of age or older and incapable of self-care because of a mental or physical disability.
P. Parent: A biological, adoptive, step or foster father or mother, or any other individual who stood
in loco parentis to the employee when the employee was a child. This term does not include
parents "in law."
Q.I. Intermittent Leave: Qualified leave taken for an FMLA-qualifying reason as separate blocks of
time of no less than 15 minutes (e.g., 2 hours every Wednesday for physical therapy) or working
a reduced schedule for an FMLA qualifying reason.
J. Parent: A biological, adoptive, step or foster father or mother, or any other individual who stood
in loco parentis to the employee when the employee was a Child. This term does not include
Parents “in law.”
K. Serious Health Condition: An illness, injury, impairment, or physical or mental condition that
involves inpatient care or continuing Treatment by a Health Care Provider as defined by the
U.S. Department of Labor.
R. Spouse: A husband or wife as defined or recognized under Arizona law.Regimen of
Continuing Treatment: Includes, for example, a course of prescription medication (e.g., an
antibiotic) or therapy requiring special equipment to resolve or alleviate the condition. It does
not include the taking of over-the-counter medications such as aspirin or antihistamines, bed-
rest, drinking fluids, exercise, and other similar activities that can be initiated without a visit to a
Health Care Provider.
S. Serious Health Condition: An illness, injury, impairment, or physical or mental condition that
involves one of the following:
0. Inpatient/Hospital Care: Any period of incapacity or Treatment connected with inpatient
care (i.e., an overnight stay) in a hospital, hospice, or residential medical care facility, and
any period of incapacity or subsequent Treatment in connection with such inpatient care.
0. Absence Plus Treatment: A period of incapacity of more than three consecutive, full
calendar days (including any subsequent Treatment or period of incapacity relating to the
same condition) that also involves:
. Treatment two or more times, within 30 calendar days of the first day of incapacity, by a
Health Care Provider, by a nurse or physician’s assistant under the direct supervision of
a Health Care Provider, or by a provider of health care services (e.g., physical therapist)
under the orders of, or on referral by, a Health Care Provider; or
. Treatment by a Health Care Provider on at least one occasion that results in a Regimen
of Continuing Treatment under the supervision of the Health Care Provider.
. The first (or only) in-person Treatment visit must take place within seven calendar days
of the first day of incapacity.
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
0. Chronic Conditions Requiring Treatment: A condition which continues over an extended
period of time, requires two or more visits to a Health Care Provider a year, and may involve
occasional episodes of incapacity (e.g., asthma, diabetes, migraines, epilepsy). A visit to
the Health Care Provider is not necessary for each absence.
0. Pregnancy: Any period of incapacity due to pregnancy, or for prenatal care. A visit to the
Health Care Provider is not necessary for each absence.
0. Permanent Long-term Conditions Requiring Supervision: A permanent or long-term
condition for which Treatment may not be effective (e.g., Alzheimer’s, severe stroke,
terminal cancer). Only supervision by a Health Care Provider is required, rather than active
Treatment.
BB. Other: Any absences to receive multiple Treatments for restorative surgery or for a
condition that would likely result in a period of incapacity of more than three consecutive
calendar days if not treated.
L.
CC.M. Treatment: Includes eExaminations to determine if a Serious Health Condition exists
and evaluations of the condition. Treatment requires an in-person visit to a Health Care
Provider. Treatment does not include routine physical examinations, eye examinations, or
dental examinations.
V. FMLA EMPLOYEE ELIGIBILITY AND USAGE
A. The FMLA allows eligible employees job-protected, unpaid leave for a variety of healthcare and
military reasons. Unless a critical need or other exigent circumstance occurs, Appointing
Authorities are required to hold an employee’s position open until FMLA leave is exhausted.
Employees may not be subjected to discrimination, harassment, or retaliation as a result of
exercising their rights under the FMLA.
B. Employee Eligibility: Consistent with the FMLA, employees who have been employed by the
County for at least 12 months, and have actually worked (i.e., in active work status) at least
1,250 hours during the past 12 months are eligible for FMLA leave. Previous employment with
the County going back seven (7) years shall count toward meeting the 12 month employment
requirement.
DD.
EE. Employees who have been employed according to the County Payroll System for at least twelve
months, and have actually worked (i.e., in active work status) at least 1,250 hours during the past twelve
months are entitled to FMLA leave. Previous employment with the County going back seven years shall
count toward meeting the twelve-month employment requirement.
QUALIFYING REASONS FOR TRADITIONAL, NON-MILITARY LEAVE
GG.C. The following events may qualify an eligible employee for traditional, non-military FMLA
leave:
1. The birth of a Cchild and to care for the newborn cChild within one (1) year of birth.;
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
2. Placement with the employee of a cChild for adoption or foster care and to care for the newly
placed cChild within one (1) year of placement.;
3. The care of the employee’s Spouse, Child, or Parent Immediate Family Member with a
Serious Health Condition.; and
4. The employee's own Serious Health Condition that makes the employee unable to perform
the essential functions of their job.
5. AMOUNT AND TYPES OF TRADITIONAL, NON-MILITARY FMLA LEAVE AVAILABLE
6.4. The FMLA provides job protection during periods of qualifying absence; it does not
require that employees be paid during such absence.
HH.D. Amount of Leave Entitlement: Eligible employees haveare entitled to up to 12 weeks
of FMLA leave per consecutive twelve12 month period calculated as a “rolling” 12- month period
measured forward from the date of any FMLA leave usage. An For purposes of FMLA, an
eeligible employee’’s normal workweek hours are used to calculate their up to 12- weeks of
FMLA leave entitlement (e.g., an employee working a 40 -hour workweek is eligible for 480
hours of FMLA leave; an employee working a 30- hour workweek iswould be eligible for 360
hours of FMLA leave).
E. Requirement to Use Paid Leave, If Available: If an eEligible employee has accrued Sick
Leave and/or Vacation time, the eligible employees must use accrued sicksick vacation leave
and vacation time (in that order) concurrently with FMLA leave. Once an an employee exhaustss
his or hertheir sick leave, his or hertheir vacation time will be used for any continuing absence.
When an employee Once Vacation Time is exhaustsed, all of his or her accrued sick leave and
vacation time, any remaining absence will be unpaid.
1. Employees who are eligible for and receive worker’s compensation benefits or short-term
disability benefits should refer to Section VI (C) and (D) below regarding the requirements
to use paid leave. All paid and unpaid FMLA -qualifying absences (whether paid or unpaid)
will count toward an employee’s 12- weeks of FMLA leaveentitlement and. All FMLA
qualifying absences must be entered into the County’s timekeeping system as anto indicate
that the leave was FMLA-qualified absence.
1.2. Any time off requested beyond an employee’s FMLA leave will be subject (as applicable)
to policies HR2415 Employee Leave and HR2429 ADA/ADAAA Reasonable
Accommodation for Applicants and Employees.
II. Consecutive or Intermittent Leave: Leave may be taken for a single, continuous block of time
(e.g., three weeks off for surgery and recovery) or on an Intermittent Leave basis (e.g., 2 hours
every Wednesday for physical therapy) if confirmed by the HR/FMLA Liaison to be medically
necessary per the employee’s Health Care Provider. Otherwise, Intermittent Leave is subject to
supervisory approval. If the employee needs Intermittent Leave for planned medical treatment,
the employee must try to schedule the treatment at a time that minimizes disruption to the
department. If Intermittent Leave is not approved, the employee may still be entitled to FMLA
leave for a continuous block of time.
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
JJ.F. Leave for Birth or Placement of a Child and to Care of afor Such Child for Adoption
or Foster Care: Leave to care for a newborn or newly placed Child will typically be granted for
continuous blocks of time. At the employee’s request, the Appointing Authority may approve
Intermittent Leave for the birth or adoption of a Child based on business needs. When both
parents are County employees and are using FMLA leave for the birth or placement of a Child,
each employee may take up to 12 weeks of FMLA leave. When the parents work in the same
department, they shall obtain Appointing Authority approval for scheduling FMLA leave either
consecutively or concurrently.If a father and mother are both employees and using FMLA leave
for birth or placement of a child, each employee may take up to 12 weeks of FMLA leave. If the
father and mother report to the same Appointing Authority, they shall obtain approval for
scheduling this leave consecutively or concurrently. In addition, leave to care for a newborn or
newly placed child (a.k.a. bonding leave) typically will only be granted for continuous blocks of
time. At the employee’s request, the Appointing Authority and the employee may agree to
Intermittent Leave (i.e., partial day absences or multiple consecutive periods of time) for the
birth or adoption of a child based on business needs.
VI. EMPLOYEE NOTIFICATION
A. Foreseeable Leave: When the need for leave under the FMLA is foreseeable, employees are
required to give their supervisor and FMLA Coordinator or HR/FMLA Liaison at least 30 days
advance notice. When the 30 day notice is not possible, employees are required to request
leave the same or next business day after they learn of the need for FMLA leave. Failure to
provide such notice without reason may delay the approval of the absence as FMLA-qualifying
and employees may be subject to disciplinary action for not following the provisions of this
policy. Employees must make reasonable efforts to schedule FMLA leave so that it does not
unduly disrupt the operations of their department. Prior to taking FMLA leave, employees shall
complete a leave request for the period they are expecting to be out on leave and indicate that
the time requested is for FMLA.
B. Unforeseeable Leave: When the need for leave is unforeseeable, employees are required to
give notice to their supervisor and, if practicable, to their FMLA Coordinator or HR/FMLA Liaison
the same or next business day after they learn FMLA leave is needed. Unless there are
extenuating circumstances employees must also comply with County and departmental policies
and procedures (including attendance or call-out procedures) to notify their supervisor of their
absence. When it is not possible for employees to complete a leave request before their
absence, supervisors are responsible for updating the County’s timekeeping system during the
absence. The employee’s leave request and timecard entry will indicate that the time off is for
an FMLA-qualifying absence.
KK.A. Supervisors shall not request that employees provide medical information or
Certifications directly to them. Medical information should be provided by employees directly to
their FMLA Coordinator or HR/FMLA Liaison. Supervisors should not contact employees while
they are absent from work on approved FMLA leave. Contacts regarding an employee’s work
status and benefits should be made by the FMLA Coordinator, HR/FMLA Liaison or Employee
Benefits.CONTINUATION OF HEALTHCARE BENEFITS COVERAGE AND
COORDINATION OF OTHER CARE PLANS
LL.A. County Sponsored Benefits:
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
MM.A. While an employee is on approved FMLA leave, their enrollment in healthcare benefits
must be continued during the period of approved leave in the same manner as prior to the
approved leave. This includes, for purposes of this policy, medical, dental, and vision benefits.
For employees in a paid leave status, premiums will continue to be automatically deducted from
their paycheck. Employees in an unpaid leave status will be required to make payment of their
share of premiums for any benefits coverage that they have elected. Employees must choose
at the start of the FMLA approved leave whether they wish to: 1) pay their premiums directly to
Benefits in advance of the leave, 2) make payment directly to Benefits on the same bi-weekly
payment schedule as if they were in a paid leave status, or 3) whether they wish to have the
County advance premiums, which will then be collected in arrears from the employee’s future
paychecks upon their return to work by doubling the premium charges until the employee’s full
debt is repaid. If the employee fails to notify the County of the option that they are choosing, the
County will select option 3 and collect the charges in arrears upon the employee’s return to
work.
NN.A. In addition, County-sponsored benefits, such as Basic Life and Accidental Death &
Dismemberment (AD&D) coverage, will continue during any period of approved FMLA leave.
OO.A. Continuation of other Voluntary Benefits Coverage:
PP.A. Employees who have enrolled in other voluntary benefits coverage, such as
supplemental life insurance or prepaid legal services, are responsible for making payment of
the premiums for such coverage during any period of approved FMLA leave. For employees in
a paid leave status, premiums will continue to be automatically deducted from their paycheck.
Employees in an unpaid leave status will be required to make payment of their share of
premiums for any benefits coverage that they have elected. Employees may choose at the start
of the FMLA approved leave whether they wish to: 1) pay their premiums directly to Benefits in
advance of the leave, or 2) make payment directly to Benefits on the same bi-weekly payment
schedule as if they were in a paid leave status. Employees who fail to make timely payments of
premiums for voluntary benefits coverage may have their coverage terminated.
QQ.A. Workers’ Compensation and FMLA:
RR.A. If an employee qualifies for FMLA leave due to a Serious Health Condition covered by
workers’ compensation, an employee must use accrued Sick Leave and Vacation time (in that
order) for the seven day waiting period before workers’ compensation benefits begin.
Employees may elect to sign a Supplemental Pay Agreement if they want to use leave accruals
while receiving workers’ compensation benefits. Whether the employee qualifies for and elects
to sign the Supplemental Pay Agreement, the work-injury related absence and an employee’s
FMLA-qualifying leave run concurrently. Employees who do not sign a Supplemental Pay
Agreement will have their accrued leave balances frozen after the 7-day waiting period and will
be considered in an unpaid leave status after the 7-day waiting period (or sooner if they do not
have sufficient paid leave for the waiting period) for purposes of benefits coverage (see Sections
A and B above). Employees who sign a Supplemental Pay Agreement will be considered in a
paid leave status for purposes of benefits coverage provided that their supplemental pay is
sufficient to allow for deductions of all benefits premiums. The Supplemental Pay Agreement
shall address how premiums will be collected/deducted.
SS.A. Short-Term Disability and FMLA:
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
TT.A. If an employee is applying for short-term disability and is approved, he/she must use
accrued Sick Leave and Vacation time (in that order) during the applicable waiting period before
benefits begin. If the employee does not have sufficient Sick Leave and Vacation to cover the
applicable waiting period, the employee will be placed on Leave Without Pay for the remainder
of the waiting period until the Short Term Disability benefit begins. Once an employee begins
receiving short-term disability benefits, he or she may not use any leave accruals. Absence from
work while receiving Short Term Disability benefits and an employee’s FMLA-qualifying leave
run concurrently. Employees receiving Short Term Disability benefits will be considered in an
unpaid leave status for purposes of benefits coverage (see Sections A and B above).
UU.A. Donated Leave and FMLA:
VV.C. Employees who receive Donated Leave during an approved FMLA leave may be
considered in a paid leave status provided their pay is sufficient to allow for deductions of all
benefits premiums.
IV.VII. PROCEDURES
A. Employee Request Procedure for a New New FMLA-Qualifying Event
1. Employees requesting leave for a new FMLA-qualifying event shall contact their FMLA
Coordinator or that has not been previously documented should submit a written request
(e.g., an email) to their supervisor and their HR/FMLA Liaison (as applicable) to discuss
their FMLA need, the anticipated dates of leave, and the type of leave requested. The written
request should contain the anticipated dates of leave and the type of leave requested using
one of the descriptions in Section IV. The written request does not need to contain specific
medical information Employees shall notify their supervisor of their request for an FMLA
absence but specific medical information should not be shared with supervisors..
2. Supervisors shall notifyensure that their FMLA Coordinator or HR/FMLA Liaison in writing
by the end of the next business day in the following circumstances:
a. receives a copy of the employee’s written documentation requesting FMLA leave. If the
employee is unable to prepare the written request, or if aWhen they supervisor becomes
aware of a potentialpossible FMLA qualifying event for an employees who haves not
requested FMLA leave. Notifications shall include the nature of the qualifying event, the
employee’s first day absent (or first expected absence), and any information the
supervisor knows about the potential FMLA need.
a.b. When an employee who has not previously requested FMLA leave is absent from
work for three (3) consecutive work days and the reason for the absence is unknown or
is for a medical reason (e.g., illness, medical appointments, overnight hospitalizations,
etc.). The notification shall include any information the supervisor knows about the
employees’ absence., the supervisor shall communicate with the HR/FMLA Liaison in
writing by the end of the next business day stating the employee’s first day absent and
that the absence might be FMLA-qualifying.
2. Foreseeable Leave: If the need for leave under the FMLA is foreseeable, the employee is
required to give their supervisor and HR/FMLA Liaison at least 30 days advance notice. If
30 days is not possible, the employee is required to request leave the same or next business
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
day after the employee learns of the need for FMLA leave. Examples of foreseeable leave
include planned surgeries, child birth, and baby bonding. Failure to provide such notice
without reason may delay the taking of the FMLA leave. In addition, the employee must
make reasonable efforts to schedule FMLA leave not to unduly disrupt the operations of the
department.
3. Unforeseeable Leave: If the need for leave is unforeseeable, the employee is required to
give notice to their supervisor and, if practicable, to their HR/FMLA Liaison the same or next
business day after the employee learns FMLA leave is needed. Examples of unforeseeable
leave include premature birth, a child suddenly becoming available for adoption, or a
medical emergency requiring immediate treatment. Employees must also comply with all
County and Departmental policies and procedures (including call-out procedures) to notify
of their absence, unless there are extenuating circumstances.
4. Employees shall complete one leave request for each pay period they are expecting to be
out on FMLA leave, and employees shall submit those leave requests before their FMLA
leave begins. The leave request shall indicate that the time requested is for FMLA.
5. If it is not possible for the employee to complete leave requests before their absence,
supervisors are required to complete the necessary leave requests for the employee. It
should be noted on the leave request that the time off is for an FMLA-qualifying event.
A. Employee Procedures for an Approved FMLA-Qualifying Event/Protocol for Intermittent
Leave
7. If an employee is approved to take Intermittent Leave under the FMLA, it is the employee’s
responsibility to inform their supervisor in subsequent leave requests for that condition that
the leave is for an FMLA-qualifying reason.
8. Employees with approved Intermittent Leave must still comply with all County and
departmental policies and procedures regarding absence from work and use of leave,
including the notice provisions for foreseeable and unforeseeable leave stated above in
Section A.
9. Generally, employees approved for Intermittent Leave cannot be required to provide fitness-
for-duty statements following each absence.
10. If an employee requires Intermittent Leave for foreseeable planned absences or
unpredictable recurring absences and the taking of that leave would substantially impair the
County’s operations, the employee may be temporarily transferred during the period of
Intermittent Leave to an available alternate position for which the employee is qualified and
which better accommodates recurring periods of leave than does the employee’s regular
position. Any request to transfer an employee due to an approved Intermittent Leave shall
be reviewed with the County Human Resources’ Employee Relations Division. The alternate
position must have equivalent pay and benefits, but does not need to have equivalent duties.
11. Verification Procedure and Responsibilities During Leave
3. Within five (5) business days of an employee’s request for FMLA leave or notification of a
possible need for FMLA leave, the FMLA Coordinator or HR/FMLA Liaison will send the
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
employee a Notice of Eligibility and Rights & Responsibilities form. The appropriate Health
Care Provider certification form and the U.S. Department of Labor Employee Rights Under
the FMLA poster will be included in these communications. When employees are requesting
FMLA time off for their own Serious Health Condition, a copy of their job
description/essential job functions should also be provided to assist Health Care Providers
in completing the certification form.
a. FMLA Coordinators will courtesy copy Department HR and the employee’s supervisor
when sending the Notice of Eligibility to the employee. Medical information will not be
sent to Department HR or supervisors.
a.b. When the employee provides documentation from a Health Care Provider prior
to being sent the Notice of Eligibility, FMLA Coordinators or HR/FMLA Liaisons will
review the documentation to determine whether sufficient information has been included
to approve the FMLA requests.Within five (5) business days of the Department learning
of the employee’s request or need for FMLA leave, the HR/FMLA Liaison will send to
the employee a Notice of Eligibility and Rights & Responsibilities form. The HR/FMLA
Liaison will include the proper Certification for the employee’s Health Care Provider to
complete in order to demonstrate that the employee qualifies for FMLA leave, unless the
employee has already provided documentation from their Health Care Provider that
includes the information sought on the Certification, such as contact information for the
health care provider, the start date of the condition, how long the condition is expected
to last, appropriate medical facts about the condition (such as information on symptoms,
hospitalization, doctors’ visits, etc), whether the employee is unable to work or the
employee’s family member is in need of care, and whether leave is needed continuously
or intermittently. If the employee is requesting time off for their own Serious Health
Condition, a copy of the employee’s essential job functions should also be provided to
the employee to give to their Health Care Provider. In addition, if the employee is
requesting Intermittent Leave, the certification (or documentation from the Health Care
Provider) should include an estimate of how much time the employee will need for each
absence, how often the employee will be absent and information establishing the
medical necessity for taking Intermittent Leave. If the employee needs the certification
sooner, they can obtain a copy on the Maricopa County intranet site (EBC), or the
employee can contact their HR/FMLA Liaison.
4. An The eemployee hass fifteen (15) calendar days to return the the Crequested certification
(or a comparable form inclusive of all information sought on the certification) and provide
any additional documentation necesto support the request for FMLA sary to establish the
entitlement to leave (e.g., birth certificate, adoption papers). When an employee’s
documentation is insufficient or incomplete, the FMLA Coordinator or HR/FMLA Liaison shall
notify the employee and request additional paperwork be provided within seven (7) calendar
days.
a. Employees with multiple FMLA-qualifying reasons are required to provide either
separate Certifications for each reason or a single Certification that clearly describes
each condition and the associated restrictions.
b. FMLA Coordinators or HR/FMLA Liaisons may contact Health Care Providers to clarify
the employee’s restrictions on a Certification or verify a Certification’s authenticity.
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Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
Supervisors, Department HR, and Appointing Authorities shall not contact Health Care
Providers for FMLA-related reasons.
c. FMLA Coordinators or HR/FMLA Liaisons should communicate with employees to
resolve any delays in returning requested documentation or to approve extensions of
time.
d. When FMLA Coordinators or HR/FMLA Liaisons have concerns about the validity of
documentation from a Health Care Provider, a second opinion may be requested by the
County at the County’s cost. When the first and second opinions differ, a third opinion
may be requested at the County’s cost and must be approved by both the County and
the employee. The opinion of the third Health Care Provider is considered final.
b.e. If employees do not provide proper documentation to support the need for FMLA
leave, the FMLA request may be denied. Any absences that were previously identified
as FMLA shall be corrected in the County’s timekeeping system and employees may be
subject to discipline for unauthorized absences, up to and including dismissal.The
HR/FMLA Liaison may contact the Health Care Provider for purposes of clarification and
authenticity of the medical certification. Supervisors and Appointing Authorities shall not
contact Health Care Providers. If the documentation provided by the employee is
insufficient or incomplete, the HR/FMLA Liaison shall send another request to the
employee requiring the employee to supplement or provide the requested paperwork.
This second notice shall provide the employee an additional seven (7) calendar days to
provide the requested documentation.
12. If the employee does not provide proper documentation, the FMLA leave request may be
denied. The Department will determine whether there is sufficient information to count the
absences against the employee’s FMLA leave entitlement. Discipline may be taken against
the employee for unauthorized absences.
5. Within five (5) business days of receiving an employee’s documentation, the FMLA
Coordinator or HR/FMLA Liaison will ensure the Certification is complete and will send a
Designation Notice to the employee approving or denying the request. The FMLA
Coordinator will courtesy copy Department HR and the supervisor with the employee’s
Designation Notice that includes the expected frequency and duration of absence(s).
a. Medical information will not be shared with employees’ supervisors. Certifications may
be shared with Department HR when an employee’s own Serious Health Condition
involves potential accommodations under the Americans with Disabilities Act (ADA).
b. FMLA Coordinators or HR/FMLA Liaisons shall verify that Designation Notices state that
a release to return to work from a Health Care Provider will be required for employees
who have taken Continuous Leave for their own Serious Health Condition.
a.c. For employees with multiple FMLA-qualifying reasons, the FMLA Coordinator or
HR/FMLA Liaison shall either provide separate Designation Notices for each reason or
clearly list each reason and the restrictions separately on the Designation Notice.Within
five (5) business days of the HR/FMLA Liaison receiving the necessary documentation
to approve or disapprove the FMLA leave request, the HR Liaison will provide a
completed Designation Notice to the employee. If the HR/FMLA Liaison has concerns
Page 11 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
about the validity of the documentation from the Health Care Provider, a second opinion
may be requested by the County at the County’s cost. If the first and second opinions
differ, a third opinion may be requested at the County’s cost.
13. The HR Liaison shall notify the supervisor of the FMLA leave approval and the expected
duration of absence(s) either by providing a copy of the Designation Notice or other means
of written communication.
14.6. Employees’ medical information and Certifications shall be kept confidential by FMLA
Coordinators or HR/FMLA Liaisons. FMLA documentation must be maintained separately
from personnel files and is not subject to public records requests. Limited medical
information may be shared by FMLA Coordinators or HR/FMLA Liaisons with management
only to the extent necessary to determine employees’ fitness-for-duty or to assess a
department’s ability to provide reasonable accommodations under HR2429 ADA/ADAAA
Reasonable Accommodation for Applicants and Employees.Other than the Designation
Notice, FMLA certification information is kept confidential by the FMLA Liaison and/or
County Human Resources. FMLA request forms and all related certification information
must be maintained separately from the employee’s personnel file and are not subject to
public records requests. Limited medical information may be shared by the HR/FMLA
Liaison with management only to the extent necessary to determine an employee’s fitness-
for-duty or to assess the Department’s ability to accommodate Intermittent Leave schedules.
B. Intermittent Leave
1. Employees approved for Intermittent Leave must comply with all County and departmental
policies and procedures regarding absence from work and use of leave, including the
provisions for Foreseeable and Unforeseeable Leave. Employees must inform their
supervisor of their expected absences and that the requested leave is for approved FMLA-
qualifying reasons. For planned medical Treatment, employees must attempt to schedule
Treatments at times that minimize disruption to their departments. Employees’ scheduled
use of foreseeable Intermittent Leave is subject to supervisory approval.
2. Employees approved for Intermittent Leave are not typically required to provide return-to-
work documentation following each absence. FMLA Coordinators and HR/FMLA Liaisons
may request that employees’ using Intermittent Leave provide a periodic release (e.g., every
30 days) when the employee’s FMLA-qualifying reason(s) may involve significant risk of
harm to the employee or others. When this situation applies, Designation Notices must state
the employees’ requirement to submit a periodic return to work release and the frequency
the release is required.
3. When an employee’s foreseeable Intermittent Leave substantially impairs County
operations, the employee may be temporarily transferred to an available alternate position
that he or she is qualified for and can perform within the expected leave. Alternate positions
must have equivalent pay and benefits, but do not need to have equivalent duties. Any
request to transfer employees due to foreseeable Intermittent Leave shall be reviewed by
the County Human Resources Employee Relations Division or legal counsel prior to
approval.
0. Supervisors shall not request employees to provide detailed medical information directly to
them or to provide copies of certification forms to them. All such information should be
Page 12 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
provided by the employee directly to their HR/FMLA Liaison. Supervisors also should not
contact an employee while the employee is on approved FMLA leave. Contacts about an
employee’s work status and/or benefits should be made by the HR/FMLA Liaison or the
Employee Benefits Division.
C. Return to Work from Continuous LeaveEmployee’s Return to Work
1. Employees shall notify their FMLA Coordinator or HR/FMLA Liaison no later than three (3)
business days prior to their anticipated return-to-work date from Continuous Leave. When
employees are unable to provide three (3) business days notice for their return to work, they
are required to give the notice the same or next business day after they learn of their
expected return to work date. Should the expected return to work date change, the
employee must notify the FMLA Coordinator or HR/FMLA Liaison as soon as
possible.Employees shall notify their supervisor and their HR/FMLA Liaison of their
anticipated return-to-work date. Should this date change, the employee must notify both the
supervisor and the HR/FMLA Liaison as soon as possible.
2. Employees who take Continuous Leave for their own Serious Health Condition must provide
medical documentation to the FMLA Coordinator or HR/FMLA Liaison to verify they have
been released by their Health Care Provider to return to work. FMLA Coordinators or
HR/FMLA Liaisons will approve employees’ return to work and notify Department HR and
supervisors of the expected return dates. Employees are not allowed to work without prior
approval from FMLA Coordinators or HR/FMLA Liaisons when returning from a Continuous
Leave for their own Serious Health Condition.Supervisors shall notify their HR/FMLA Liaison
when an employee actually returns to work. If the employee was required to provide a
release to return to work (see Section D below), supervisors are responsible to ensure the
employee has provided the necessary documentation to the HR/FMLA Liaison prior to
working. If the employee does not return to work on the expected return date, the supervisor
shall immediately notify their HR/FMLA Liaison that the employee did not return to work.
3. Restricted Work Status: When employees are unable to return to full duty without
restrictions on their schedule or work functions, their release documentation must include a
clear description of the restrictions. FMLA Coordinators or HR/FMLA Liaisons shall contact
Department HR and supervisors immediately to determine whether employees may return
to work in their current position with restrictions, and if not, whether other positions or
assignments are available. FMLA Coordinators or HR/FMLA Liaisons will then notify the
employees whether they may return to work with restrictions. When there is no available
work within the department for the employee to perform with the restrictions, the employee
may continue on FMLA leave until one of the following options occurs: 1) their FMLA
entitlement is exhausted, 2) they are able to return to full duty without restrictions, or 3) work
becomes available the employee can perform with the work restrictions.Employees who
have taken continuous, non-Intermittent Leave for their own Serious Health Condition must
provide a release from their Health Care Provider in order to return to work. The employee’s
HR/FMLA Liaison shall verify that the Designation Notice states that a release to return to
work will be required.
. Ability to Return to Full Duty: If the employee will be released to full duty, the employee
must provide a release to return to work from their Health Care Provider prior to returning
to work. The employee should provide the release to their supervisor and a copy to the
Page 13 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
HR/FMLA Liaison on or before their scheduled return-to-work date. The employee’s
supervisor should notify the HR/FMLA Liaison that the employee has returned to work.
5. Restricted Work Status: If an employee is unable to return to full duty, and there are any
restrictions on the employee’s schedule or work functions, the employee must provide the
department with at least 48 hours advanced notice of the restrictions. The HR/FMLA Liaison
shall contact the employee’s supervisor immediately to determine whether the restrictions
can be accommodated within the employee’s current position/assignment, and if not,
whether other positions/assignments are available that can accommodate the restrictions.
The HR/FMLA Liaison will then notify the employee whether they may return to work with
restrictions. If there is no available work within the employee’s Department that can
accommodate the employee’s work restrictions, the employee may continue on FMLA
Leave until: 1) their FMLA entitlement is exhausted, 2) the employee is able to return to full
duty without restrictions, or 3) work becomes available that can accommodate the
employee’s work restrictions, whichever comes first.
6.4. Supervisors shall notify their FMLA Coordinator or HR/FMLA Liaison when employees
actually return to work. If an employee has not been previously approved to return to work,
the supervisor shall direct the employee to contact the FMLA Coordinator or HR/FMLA
Liaison and shall not allow the employee to work. If an employee does not return to work on
the expected return date, the supervisor shall immediately notify the FMLA Coordinator or
HR/FMLA Liaison.As stated above, employees who take Intermittent Leave generally
cannot be required to provide a release to return to work. However, the HR/FMLA Liaison
may request a release for employees who take Intermittent Leave every 30 days if
“reasonable safety concerns” exist. A “reasonable safety concern” is a reasonable belief
that there is a significant risk of harm to the employee or others. If this situation applies, the
HR/FMLA Liaison must state on the Designation Notice that the employee will be required
to submit a release to return to work unless one has already been submitted within the past
30 days.
D. Recertification: FMLA Coordinators or HR/FMLA Liaisons shall require an employee to
recertify the need for FMLA leave when:
1. Under the circumstances described below, the HR/FMLA Liaison shall require recertification
from employees on either continuous or Intermittent Leave:
2.1. The circumstances described in the employee’s current Certification change significantly
(e.g., duration of the illness, nature of the illness, increase in the number of anticipated
absences).If the circumstances described in the employee’s current certification change
significantly (e.g., the duration of the illness, the nature of the illness, increase in the number
of anticipated absences) [note: FMLA leave for a different Serious Health Condition for the
same employee or for a different FMLA qualifying event for the same employee is not
covered by the original certification and will require its own certification and approval
process.]; or
3.2. If information is received that challenges the validity of the stated reasons for FMLA
leave.that, in the opinion of the HR/FMLA Liaison, casts doubt on the stated reason for
FMLA leave; or
Page 14 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
4.3. For Intermittent Leave Only: More than 12 months have elapsed since the original
Certification was signed by the Health Care Provider and the employee makes another
request for leave for the same qualifying reason.For employees with approved FMLA
Intermittent Leave only, if more than twelve (12) months have elapsed since the original
certification and the employee makes another request for leave for the same qualifying
condition.
V. FILLING EMPLOYEE POSITIONS/ EXTENSIONS OF LEAVE
. Unless a critical need or other exigent circumstance occurs, the Appointing Authority is required
to hold an employee’s position open until an employee exhausts their entitlement under the
FMLA.
VII. Any additional time off beyond an employee’s FMLA leave entitlement will be reviewed case-by-
case by the Appointing Authority. Refer HR2415 Employee Leave Policy for more information.
VIII. MILITARY-RELATED LEAVE UNDER THE FMLA
A. Additional and Amended Definitions for Military-Related FMLA Leave: For purposes of
qualifying for this type of military-related FMLA leave, all definitions stated in Section III above
will apply unless specifically changed below:
1. Child: Includes a biological, adopted, or foster child, stepchild, legal ward, or a child
for whom the Covered Service Member stood in loco parentis (in the place of a
parent), who is of any age.
2.1. Covered Active Duty: For members of a regular component of the Armed Forces this
means duty during deployment of the member with the Armed Forces to a foreign country.
For members of the reserve components of the Armed Forces (National Guard and
Reserves) this means duty during deployment of the member with the Armed Forces to a
foreign country under a Federal call or order to active duty in a contingency
operation.Covered Active Duty: For members of a regular component of the Armed Forces
this means duty during deployment of the member with the Armed Forces to a foreign
country. For members of the reserve components of the Armed Forces (members of the
U.S. National Guard and Reserves) this means duty during deployment of the member with
the Armed Forces to a foreign country under a call or order to active duty in a contingency
operation as defined in section 101(a)(13)(B) of title 10, United States Code.
3.2. Covered Service Member: A member of the Armed Forces, including a member of the
National Guard or Reserves, who is undergoing medical Treatment, recuperation, or
therapy, is otherwise in outpatient status, or is otherwise on the temporary disability retired
list, for a serious injury or illness. Also includes veterans who are undergoing medical
Treatment, recuperation, or therapy for a serious injury or illness, if they were a member of
the Armed Forces at any time during the period of 5 years preceding the date on which they
undergo the medical Treatment, recuperation, or therapy.Covered Service Member: A
member of the Armed Forces, including a member of the National Guard or Reserves, who
is undergoing medical treatment, recuperation, or therapy, is otherwise in outpatient status,
or is otherwise on the temporary disability retired list, for a serious injury or illness. Also
includes a veteran who is undergoing medical treatment, recuperation, or therapy for a
serious injury or illness if the veteran was a member of the Armed Forces at any time during
Page 15 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
the period of five (5) years preceding the date on which the veteran undergoes that medical
treatment, recuperation, or therapy.
4.3. Next of Kin: The nearest blood relative of the Covered Service Member, in this order
unless otherwise designated by the employee: blood relatives with legal custody, siblings,
grandparents, aunts and uncles, and first cousins.Next of Kin: The nearest blood relative of
the Covered Service Member, in this order unless otherwise designated by the employee:
blood relatives with legal custody, siblings, grandparents, aunts and uncles, and first
cousins.
5. Parent: A Covered Service Member’s biological, adoptive, step or foster father or
mother, or any other individual who stood in loco parentis to the Covered Service
Member.
6.4. Qualifying Exigency: A non-medical activity that is directly related to the Covered
Service Member’s Covered Active Duty or call to Covered Active Duty status. For an activity
to qualify as an exigency, it must fall within one of the categories below or be mutually
agreed to by the employer and employee.Qualifying Exigency: A non-medical activity that
is directly related to the military member’s Covered Active Duty or call to active duty status.
For an activity to qualify as an exigency, it must fall within one of seven categories of
activities or be mutually agreed to by the employer and employee. The seven categories of
qualifying exigencies are:
a. Short-notice deployment (leave permitted up to seven (seven (7)) days if the military
member receives seven (seven7) or less days’ notice of a call to Covered aActive dDuty)
b. Military events and related activities
c. Certain temporary childcare arrangements and school activities
d. Financial and legal arrangements
e. Counseling due to the active duty call or call to active duty
f. Rest and recuperation (leave permitted up to 15fifteen days for each instance of rest
and recuperation), and
g. Post-deployment military activities
7.5. Serious Injury or Illness: An iInjuriesy or illnesses incurred by the members in the line
of duty while on active duty in the Armed Forces that may render them member medically
unfit to perform the duties of their member’s office, grade, rank, or rating. Also includes any
injuriesy or illnesses that existed before the beginning of the member’s’ active duty and was
aggravated by service in line of duty on active duty in the Armed Forces that may render
them member medically unfit to perform the duties of their member’s office, grade, rank, or
rating.
B. Types and Amount of Leave: The FMLA also provides protected, unpaid military-related leave
for:
Page 16 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
1. Qualifying Exigency Leave: Any Qualifying Exigency arising from the foreign deployment
of an employee’s Spouse, Child, or Parent with the Armed Forces. Eligible employees are
entitled to take up to 12 weeks of unpaid leave for any Qualifying Exigency per consecutive
12 month period calculated as a “rolling” 12 month period measured forward from the date
of any FMLA leave usage. The employee will be required to provide written documentation
to confirm the Covered Service Members’ Covered Active Duty or call to Covered Active
Duty status.Any qualifying exigency arising out of the fact that the employee’s spouse, Child
or Parent is a military member on Covered Active Duty; and
2. Military Caregiver Leave: The care of a Covered Service Member with a serious injury or
illness if the employee is the Covered Service Member’s Spouse, Child, Parent, or Next of
Kin. Eligible employees are entitled to take up to a total of 26 weeks of unpaid leave in a
single consecutive 12 month period measured forward from the date of their first FMLA leave
usage. Military Caregiver Leave must occur within 5 years of the service member requiring
care.The care of a Covered Service Member with a serious injury or illness if the employee
is the spouse, Child, Parent, or Next of Kin of the Covered Service Member.
C. Amount of Leave: For any Qualifying Exigency, an eligible employee is entitled to take up to
12 weeks of unpaid leave per consecutive 12-month period calculated as a “rolling” 12-month
period measured forward from the date of any FMLA leave usage.
To care for a Covered Service Member with a Serious Injury or Illness as defined in this section
or when taken in combination with any other type of qualifying FMLA leave, an eligible employee
is entitled to take up to a total of 26 weeks of leave in a single consecutive twelve-month period
(measured forward from the date of the employee’s first FMLA leave usage). Such leave must
occur within five (5) years of requiring care.
D. Qualifying Exigency Leave: The certification of Qualifying Exigency will be required with
written documentation confirming a Covered Service Member’s Covered Active Duty or call to
Covered Active Duty status. Examples of permissible documentation may include:
1. Meeting acknowledgement for information briefings;
2. Document confirming appointment with counselor or school official; or
3. A copy of a bill for services for the handling of legal or financial affairs.
IX. Unless specifically changed by this Section IX, all other provisions and procedures of this policy
applicable to traditional, non-military leave also apply to military-related FMLA
leave.CONTINUATION OF HEALTHCARE BENEFITS COVERAGE AND COORDINATION OF
OTHER CARE PLANS
County Sponsored Benefits:
A. While employees are on FMLA leave, their enrollment in healthcare benefits will continue
during the period of approved leave in the same manner as prior to the approved leave. This
includes medical, dental, and vision benefits and coverage for Basic Life and Accidental Death
& Dismemberment. For employees in a paid leave status, premiums will continue to be
automatically deducted from their paycheck. Employees in an unpaid leave status will be
required to make payment of their share of premiums for any benefits coverage that they have
Page 17 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
elected. Employees must choose at the start of FMLA approved leave whether they wish to: 1)
pay their premiums directly to Employee Benefits in advance of the leave, 2) make payment
directly to Employee Benefits on the same bi-weekly payment schedule as if they were in a paid
leave status, or 3) whether they wish to have the County advance premiums, which will then be
collected in arrears from the employees’ future paychecks upon their return to work by doubling
the premium charges until the full debt is repaid. If employees do not notify Employee Benefits
of the option that they are choosing, Employee Benefits will select option 3 and collect the
charges in arrears upon the employees’ return to work.While an employee is on approved FMLA
leave, their enrollment in healthcare benefits must be continued during the period of approved
leave in the same manner as prior to the approved leave. This includes, for purposes of this
policy, medical, dental, and vision benefits. For employees in a paid leave status, premiums will
continue to be automatically deducted from their paycheck. Employees in an unpaid leave
status will be required to make payment of their share of premiums for any benefits coverage
that they have elected. Employees must choose at the start of the FMLA approved leave
whether they wish to: 1) pay their premiums directly to Benefits in advance of the leave, 2) make
payment directly to Benefits on the same bi-weekly payment schedule as if they were in a paid
leave status, or 3) whether they wish to have the County advance premiums, which will then be
collected in arrears from the employee’s future paychecks upon their return to work by doubling
the premium charges until the employee’s full debt is repaid. If the employee fails to notify the
County of the option that they are choosing, the County will select option 3 and collect the
charges in arrears upon the employee’s return to work.
In addition, County-sponsored benefits, such as Basic Life and Accidental Death &
Dismemberment (AD&D) coverage, will continue during any period of approved FMLA leave.
Continuation of other Voluntary Benefits Coverage: Employees are responsible for paying
benefit premiums during any period of approved FMLA leave. For employees in a paid leave
status, premiums will continue to be automatically deducted from their paycheck. Employees in
an unpaid leave status will be required to pay their share of their benefit premiums. Employees
may choose at the start of the FMLA approved leave whether they wish to: 1) pay their premiums
directly to Employee Benefits in advance of the leave, or 2) make payment directly to Employee
Benefits on the same bi-weekly payment schedule as if they were in a paid leave status.
Employees who do not make timely payments of premiums for voluntary benefits coverage may
have their coverage terminated.Continuation of other Voluntary Benefits Coverage:
B. Employees who have enrolled in other voluntary benefits coverage, such as supplemental life
insurance or prepaid legal services, are responsible for making payment of the premiums for
such coverage during any period of approved FMLA leave. For employees in a paid leave
status, premiums will continue to be automatically deducted from their paycheck. Employees in
an unpaid leave status will be required to make payment of their share of premiums for any
benefits coverage that they have elected. Employees may choose at the start of the FMLA
approved leave whether they wish to: 1) pay their premiums directly to Benefits in advance of
the leave, or 2) make payment directly to Benefits on the same bi-weekly payment schedule as
if they were in a paid leave status. Employees who fail to make timely payments of premiums
for voluntary benefits coverage may have their coverage terminated.
C. Workers’ Compensation and FMLA: When an employee qualifies for FMLA leave due to a
Serious Health Condition covered by workers’ compensation, they must use accrued sick leave
and vacation time (in that order) for the applicable waiting period before workers’ compensation
Page 18 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
benefits begin. Work-injury related absences and employees’ FMLA-qualifying leave run
concurrently. Employees may supplement their pay by using leave accruals while receiving
workers’ compensation benefits. Employees who do not supplement their pay will have their
accrued leave balances frozen after the applicable waiting period and will be considered in an
unpaid leave status for purposes of benefits coverage after the applicable waiting period (or
sooner if they do not have sufficient paid leave for the waiting period). Employees who
supplement their pay will be considered in a paid leave status for purposes of benefits coverage
provided that their supplemental pay is sufficient to allow for deductions of all benefits premiums.
If an employee qualifies for FMLA leave due to a Serious Health Condition covered by workers’
compensation, an employee must use accrued Sick Leave and Vacation time (in that order) for
the seven day waiting period before workers’ compensation benefits begin. Employees may
elect to sign a Supplemental Pay Agreement if they want to use leave accruals while receiving
workers’ compensation benefits. Whether the employee qualifies for and elects to sign the
Supplemental Pay Agreement, the work-injury related absence and an employee’s FMLA-
qualifying leave run concurrently. Employees who do not sign a Supplemental Pay Agreement
will have their accrued leave balances frozen after the 7-day waiting period and will be
considered in an unpaid leave status after the 7-day waiting period (or sooner if they do not
have sufficient paid leave for the waiting period) for purposes of benefits coverage (see Sections
A and B above). Employees who sign a Supplemental Pay Agreement will be considered in a
paid leave status for purposes of benefits coverage provided that their supplemental pay is
sufficient to allow for deductions of all benefits premiums. The Supplemental Pay Agreement
shall address how premiums will be collected/deducted.
D. Short-Term Disability and FMLA: When employees are approved for short-term disability,
they must use accrued sick leave and vacation time (in that order) during the applicable waiting
period before short-term disability benefits begin. When employees do not have sufficient sick
leave and vacation to cover the applicable waiting period, they will be placed on leave without
pay for the remainder of the waiting period until short-term disability benefit begins. Once
employees begin receiving short-term disability benefits, they may not use any leave accruals
and will be considered in an unpaid leave status for purposes of benefits coverage. Absence
from work while receiving short-term disability benefits and employees’ FMLA-qualifying leave
run concurrently.
If an employee is applying for short-term disability and is approved, he/she must use accrued
Sick Leave and Vacation time (in that order) during the applicable waiting period before benefits
begin. If the employee does not have sufficient Sick Leave and Vacation to cover the applicable
waiting period, the employee will be placed on Leave Without Pay for the remainder of the
waiting period until the Short Term Disability benefit begins. Once an employee begins receiving
short-term disability benefits, he or she may not use any leave accruals. Absence from work
while receiving Short Term Disability benefits and an employee’s FMLA-qualifying leave run
concurrently. Employees receiving Short Term Disability benefits will be considered in an unpaid
leave status for purposes of benefits coverage (see Sections A and B above).
Donated Leave and FMLA:
Page 19 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
E. Employees who receive Donated Leave during an approved FMLA leave may be considered in a paid leave status
provided their pay is sufficient to allow for deductions of all benefits premiums.
F.
Revision History
Revision
Version Date Description of Revision
1 03-2001 Initial version
2 04-24-2013 Changed the way the amount of leave is calculated and added language for
military-related leave under the FMLA (C-31-13-018-6-00)
Page 20 of 21

Policy Title: Policy Number: HR2413
FAMILY AND MEDICAL LEAVE ACT (FMLA)
APPROVED LEAVES OF ABSENCE Current Adoption Date: 08-21-2019
3 08-21-2019 Updated definitions, format, and language for consistency with the centralization
of FMLA for appointed departments (C-31-13-018-6-01)
Page 21 of 21