FMLA Instructions

The Family Medical Leave Act (FMLA) is a federal law that protects an employee's position for up to 12 weeks under certain circumstances and when all required conditions have been met.

Time off under FMLA may be taken as continuous leave or on an intermittent basis. For some medical conditions a period of continuous leave is required followed by intermittent time (treatment visits, office visits, etc.) The physician must document such cases. Each type of leave is counted towards the 12 week maximum.

All forms listed in bold can be found at the Human Resources (HR) website under "Forms and Documents." You can also click on the form name and will be taken to the form at the HR Website for printing.

Eligibility Requirements:

To be eligible, staff must have worked a total of 12 months at Vanderbilt AND have worked 1250 hours in the previous 12 months.
Under the federal guidelines, leave under the FMLA is available for the following reasons: self illness, care of spouse, care of parent, care of child (18 or younger) or for the birth, adoption or foster placement of a child.
A staff member may receive up to 12 weeks of leave in any rolling 12-month period. Multiple FMLA requests may be granted during the rolling calendar year; however the maximum available is 12 weeks.
Two Vanderbilt staff members requesting FMLA for the same episode, must share the 12 weeks. For example: the birth of a child (both parents), sisters/brothers caring for parent, parents care for ill child.
Employees who do not meet the requirements for FMLA eligibility or exceed the 12 weeks maximum leave in a rolling calendar year, may be eligible for other types of leave and should contact their departmental Employee Relations representative.

Procedure to apply for FMLA: (self or family member's illness)

At the Human Resources (HR) website, read policy HR-012 (Leave of Absence Request Policy).
Submit to supervisor an FMLA Staff Member Leave of Absence Request Letter. You must submit your request 30 days prior to beginning the leave or in the case of an emergency, as soon as practical.
If you are requesting FMLA for yourself, your treating physician must complete the Leave Request for Employee's Medical Condition and submit this form to Occupational Health. If you are requesting FMLA to care for a family member (see list of eligible members), their treating physician must complete the Leave Request for Family Member's Medical Condition and submit the form to Occupational Health. The physician's office can send these forms directly to Occupational or you can hand deliver. Under NO circumstances should any member of management in your department ask for or accept either form.
Once Occupational Health receives your form, they will determine if your request meets the medical qualifications of FMLA. If it does, they send Employee Relations a Medical Determination Form. This form doesn't contain any medical information, just the amount of time requested off, effective date, and whether the condition is qualifying under the guidelines. Employee Relations determines if you meet the other eligibility requirements for FMLA (1250 hours worked and 12 months of employment). If all the requirements are met, Employee Relations will notify your supervisor of the status of your request.
Your supervisor will notify you in writing as to whether the leave request has been approved or denied. If the request is denied other options will be presented in this letter.
If you are returning from continuous FMLA leave for your own medical condition, you must have your physician complete the FMLA Request to Return from Leave of Absence form. Please submit this form to your supervisor or Occupational Health BEFORE returning to work.

Procedure to apply for FMLA/TPLA (Tennessee Parental Leave Act): (birth, adoption or foster placement)

If you are the legal mother or father you may be eligible for the Tennessee Parental Leave Act (TPLA) in addition to FMLA. All the same eligibility requirements for FMLA apply to TPLA. TPLA allows the legal mother or father four months of leave for birth, adoption or placement of a child. Both FMLA and TPLA run concurrently.

At the Human Resources (HR) website, read policy HR-012 (Leave of Absence Request Policy). Hr website HR-012
Submit to supervisor an FMLA Staff Member Leave of Absence Request Letter. You must submit your request 30 days prior to the estimated due date or in the case of an emergency, as soon as practical. If you are applying for TPLA you must submit your request 90 days prior to the estimated due date, or in the case of an emergency, as soon as practical. The request for TPLA can be separate or on the same form as the FMLA.
Ask the doctor to fill out the Leave Request for Employee's Medical Condition and submit this form to Occupational Health. Under NO circumstances should any member of management in your department ask for or accept either form.
Once Occupational Health receives your form they will determine if your request meets the medical qualifications of FMLA and notifies Employee Relations by sending a Medical Determination Form. This form doesn't contain any medical information, just the amount of time requested off and the estimated delivery date. Employee Relations determines if you meet the other eligibility requirements for FMLA. Employee Relations will notify your supervisor regarding the status of your claim.
Your supervisor will notify you in writing as to whether the leave request has been approved or denied. If the request is denied other options will be presented in this letter.

Pay and Benefits while on FMLA

While on FMLA you must utilize all accrued paid time available prior to going into an unpaid leave status . The exception is using Short Term Disability during your FMLA. Once STD starts, your accrual banks will not be used and you will continue to accrue time. Please contact Shirley Foster in benefits to learn more about STD.
While on leave, accrual usage must reflect the purpose of the leave. For example:

For self or family member's illness you must use, in order, all accrued sick time, vacation and personal days before going into an unpaid status.
For the birth mother of a well baby you can use sick time during the postpartum portion of the leave (usually 6-8 weeks). During the remaining portion of the leave vacation and personal time must be utilized prior to going into an unpaid status. If the baby is sick you must apply for a separate FMLA.
For the father of a well baby you must use, in order, all accrued vacation time and personal days before going on unpaid status. NOTE: If you are using FMLA to care for the birth mother or a sick baby, you must have the treating physician mark this on the Medical Provider Form. If approved you will use accrued sick time, vacation time and personal days.

Any staff member who is on an approved leave under the FMLA or TPLA will continue to receive benefits coverage under Vanderbilt's group health and dental care plans at the level and under the conditions that such coverage would have been provided if the staff member had continued working. Staff members who are on paid leave status will have the staff member's portion of the premiums paid through payroll deductions. If the staff member is on unpaid leave status, they need to contact the payroll office to make arrangements for submitting the benefit premiums.