Family and Medical Leave Act
Forms - Instructions/Info re: forms
The federal Family and Medical Leave Act (FMLA) applies when an eligible faculty or staff member takes time off from work for his or her own serious health condition (see "What is a Serious Health Condition?" below) or for other qualifying events listed later in this section. The faculty or staff member, his or her supervisor, and the University are all required to follow FMLA law. USNH policies are inclusive of FMLA requirements.
FMLA provides eligible faculty and staff members with up to twelve weeks of leave in a twelve-month period for specific qualifying events. The twelve month period is defined as a "rolling" 12-months measured backward from the date FMLA leave is used.
FMLA leave can be taken intermittently when the reason is a serious health condition (see "What is a Serious Health Condition?" below). Intermittent means the faculty or staff member would take time off periodically and/or work a reduced schedule because of the qualifying event.
- Birth and first year of care of the faculty or staff member's child;
- Placement of a child with the faculty or staff member for adoption or foster care;
- The faculty or staff member has a serious health condition** making them unable to perform the essential functions of their job;
- The faculty or staff member is needed to care for a spouse, child, or parent, with a serious health condition (see "What is a Serious Health Condition?" below);
- The leave is U.S. Military-related, either:
- To care for a family member (spouse, parent, child, or next of kin, i.e., nearest blood relative) who has incurred a serious injury or illness in the line of active duty in a U.S. Military Service; or
- To deal with a qualifying exigency. A qualifying exigency is a short-term notice of deployment where there is a need to attend military events and related activities, or to make arrangements in preparation for the deployment, either for the faculty or staff member or his/her family member (spouse, parent, or child).
To be eligible, faculty and staff must meet both of the following criteria:
- Be employed in a status or adjunct capacity for at least twelve months in total, and
- Have worked for at least 1,250 hours during the preceding twelve months at the time of the request.
To qualify for a military-related FMLA leave, the faculty or staff member must meet the eligibility criteria above and must be the spouse, parent, child, or “next of kin” (nearest blood relative) of a member of the US Armed Forces, including the National Guard and Reserves.
To secure an approved FMLA leave, a faculty, staff or adjunct staff member is required to:
- Provide a notice of 30 days to their supervisor when the leave is foreseeable, for example, for a planned medical treatment;
- Provide as much notice as soon as possible when 30 days is not practical - ordinarily no less than one to two working days;
Consult with their supervisor when the leave will be taken intermittently (meaning periodic absences or a reduced work schedule), and make reasonable efforts to schedule time away from work so as not to unduly disrupt the department's operation;
- Complete a Request for Leave of Absence form and give to supervisor for approval; and
- Have appropriate Certification form (a, b or c ) completed according to instructions on the form, and returned to UNH Human Resources office. Certification forms contain confidential medical information and should go directly to Human Resources for that reason. (Periodic certification updates may be required during the FMLA leave.)
- Use the Certification of Health Care Provider form when the reason for the leave is a serious health condition (see "What is a Serious Health Condition?" below), either of the faculty or staff member, or for their spouse, parent or child.
- Use the FMLA-Certification-Military-Family-Member form when the reason is to care for a family member (spouse, parent, child, or next of kin, i.e., nearest blood relative) who has incurred a serious injury or illness in the line of active duty in the U.S. Military Forces.
- Use the FMLA-Certification-Military-Qualifying-Exigency form when the reason is to deal with a qualifying exigency. A qualifying exigency is a short-term notice of deployment where there is a need to attend military events and related activities, or to make arrangements in preparation for the deployment.
Leave Records (applies to staff and fiscal-year faculty)
- Complete Time/Leave records:
- USNH policy requires use of accrued paid leave for absence under FMLA leave, except if the qualifying event is also a work-related injury or illness.
- For details on leaves in general, please visit the Leaves page
- If there is not enough paid leave to cover the absence period, the remaining FMLA leave is unpaid. However, faculty and staff may be able to retain up to 10 days (pro-rated for part-time appointments) of Earned Time or Vacation/Personal Leave and elect instead to go unpaid for that time (see USY V.C.16)
- An intermittent FMLA leave, where absence is periodic and also unpaid, may cause the faculty or staff member to be placed in a “partial leave status” (meaning a reduction in employment percent time) when he/she has run out of paid leave.
- Family Leave: Up to 10 days of sick leave/sick pool can be accessed directly when the qualifying event is to care for a family member with a serious health condition. This is referred to as “Family Leave” (for sick leave, see USY V.A.4.12; for sick pool, see USY V.A.4.10.5).
During the leave
During the leave, the faculty or staff member must update their supervisor of any changes in the expected return to work date, and provide updates of medical certifications as needed to Human Resources.
Benefits deductions continue to occur in the paycheck for paid FMLA leave. If the faculty or staff member exhausts accrued leave, unpaid leave applies. For unpaid leave the employee must make benefit payment arrangements with the University System Benefits Office (603-862-0932). Failure to pay benefit premiums while on unpaid FMLA leave will cause cancellation of benefits.
Short Term Disability
If the faculty or staff member purchased a private Short Term Disability plan, he/she should contact that vendor directly to access the benefit.
Return to Work
When ready to return to work, the faculty or staff member must provide the supervisor with a written medical release in advance of the return to work date. This medical release is required, and the faculty or staff member cannot return to work without it. The medical release must include the return to work date along with any work accommodations (e.g., part time work, physical restrictions, etc.)
Please note: Leave for the faculty or staff member’s own illness that extends beyond the FMLA leave period may involve applying for Long Term Disability benefits (see USY V.A.8), and/or paying the full cost of benefit premiums when the faculty or staff member will be unpaid for more than 120 days (see USY V.C.16).
- Sign and approve the faculty or staff member’s completed Request for Leave of Absence form and forward it to Human Resources.
- Make sure the faculty or staff member submits the appropriate Certification form to Human Resources.
- Address reassignment of work and/or hire temporary staff if appropriate.
- Coordinate the completion of appropriate leave records.
- Communicate with the Business Service Center (BSC): regarding:
- Leave start and return to work dates.
- Unpaid leave dates.
- During the leave, contact the faculty or staff member for updates on the expected date of return and other related matters. Request an update of a Certification form to be sent to Human Resources if:
- The faculty or staff member requests an extension of the leave;
- Circumstances change regarding the illness or injury.
- For more information on handling medical issues of direct reports please review "How to Handle Medical Issues of Employees".
- Before the return to work for the faculty or staff member’s own serious illness, obtain from him/her a written medical release that approves the return to work. This medical release is required, and the faculty or staff member cannot return to work without it. The medical release must provide the return to work date along with any work accommodations (e.g., part time work, physical restrictions, etc.)
- Submit the return-to-work medical release to Human Resources no later than the return to work date.
- Notify the Business Service Center (BSC) of the faculty or staff member’s return to work date, and that a medical release has been submitted to Human Resources.
- Upon receiving a copy of the Human Resources letter confirming approval of FMLA leave, initiate steps to place the faculty or staff member on FMLA leave in BANNER. (There is currently no mechanism for generating an EPAF for intermittent FMLA leave.)
- For unpaid leave, generate the appropriate payroll document
- Return to work. Once notified by either Human Resources or the supervisor that the faculty or staff member has submitted a written medical release to return to work, initiate a return-to-work EPAF. If notification comes from the supervisor, the BSC should remind the supervisor to submit the medical release to Human Resources.
A Serious Health Condition is 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 either prevents the qualified family member from participating in school or other daily activities.
Subject to certain conditions, the continuing treatment requirement may be met by a period of incapacity of more than 3 consecutive calendar days combined with at least two visits to a health care provider or one visit and a regimen of continuing treatment, or incapacity due to pregnancy, or incapacity due to a chronic condition. Other conditions may meet the definition of continuing treatment.
Examples of situations which do NOT meet the definition of "serious medical condition" include:
- routine eye exams
- cosmetic surgery (unless complications develop)
- the common cold
- the flu
- upset stomach
- minor ulcers
- minor headaches
- routine dental or orthodontia problems
- periodontal diseases
- An employee's absence due to substance abuse does not qualify unless the employee is receiving treatment for substance abuse by a health care provider.
For more information please contact UNH Human Resources: 862-0501 (voice), 862-3227 (TTY) for more information.
USNH Family and Medical Leave policy
The above FMLA information is intended to provide a summary only. Refer to USNH policy on Family and Medical Leave (FMLA) for complete information.
Medical Leave for EMPLOYEE - Exempt Employees (includes Maternity Leave)
Medical Leave for EMPLOYEE - Operating Staff (includes Maternity Leave)
Medical Leave for EMPLOYEE'S IMMEDIATE FAMILY - Exempt Employees (includes Parental Leave)
Medical Leave for EMPLOYEE'S IMMEDIATE FAMILY - Operating Staff (includes Parental Leave)