Family & Medical leave (Federal and Wisconsin) provides you with the right to take job-protected leave with continued benefits when you need time off from work to care for yourself or a family member who is seriously ill, care for a newborn or newly adopted child, or to care for a family member who is called to active duty in the military.  You can find out the eligibility rules, forms and publications, entitlement period, and substitution of paid leave.

In order to be paid while on FMLA/WFMLA you may use any earned paid leave you have available to you. If you do not have enough earned leave to cover the period, you will need to go without pay. If the period of time off will include any unpaid leave longer than one week, please view the benefit impacts of going without pay via the UW System Leave of Absence webpage. Note that you must provide information on what you would like to do with your insurances prior to going without pay by completing the Unpaid LOA Insurance Selections Form. Email the Selections form and direct any questions regarding benefit impacts to benefits@uwss.wisconsin.edu.

W/FMLA Forms and Important Information:

• Eligibility Criteria and resources
• Employee FMLA Request Form – employee completes and email completed form directly to hroffice@uwosh.edu
• Certifications of Health Providers – Physician’s office should fax directly to HR at 920.424.2021
  • Employee’s Serious Health Condition
  • Family Member’s Serious Health Condition
  • Qualifying Exigency for Military Family Leave
  • Serious Injury or Illness of Current Servicemember Military Caregiver Leave
  • Serious Injury or Illness of Veteran for Military Caregiver Leave
• Other Responsibilities and Information

Based on the eligibility requirements, if your situation does not qualify you for Federal FMLA and/or WI FMLA, please refer to the Leave of Absence (paid or unpaid) section for more details.

W/FMLA Steps for Employees

1. Employee requests W/FMLA (Employee Request for Medical Leave) and has their health care provider complete a certification for the medical leave reason (whichever certification form is applicable to the employee’s request). Employee is also responsible for reading over the “Other Responsibilities and Information” sheet that is linked.
2. Once HR learns of an employee’s request for FMLA, HR will send the employee a notice of their eligibility and rights under FMLA.
3. Forms are submitted to the Office of Human Resources for determination (HR will reach out to employee if they are missing forms or need additional information). Forms can be submitted in person or:
   • Emailed to: hroffice@uwosh.edu
   • Faxed to: 920-424-2021
4. After all necessary paperwork is received, HR will send the designation notice (approval or denial letter) to the employee and provide the supervisor of notification.
5. It is the employee’s responsibility to enter in their own leave and indicate “FMLA” in the requester comments section of the absence request.
6. Return to Work Instructions:
   • An employee who is out for their own serious health condition is required to provide HR and their supervisor with a return to work slip from their health care provider, preferably 2 days before the return date. NO WORK CAN BE DONE UNTIL THIS IS RECEIVED.
   • An evaluation of the restrictions, if any, is required to determine if modifications to the employees duties is possible.

Do not hesitate to contact Human Resources (hroffice@uwosh.edu; 920-424-1166) to answer any questions you may have.

A Leave of Absence (paid or unpaid) may be requested if you do not meet Federal or Wisconsin FMLA eligibility or the reason for the leave does not fall under FMLA protection.

Leave of absences (LOA) can be paid or unpaid and are granted with the understanding that upon expiration the employee is entitled to return to their position or one of like nature for which the employee is qualified. Submission of the LOA Request alone does not guarantee approval and, if applicable to the reason for the request, the Human Resources approval review will not occur unless medical documentation is provided.

If the period of time off will include any unpaid leave longer than one week, please view the benefit impacts of going without pay via the UW System Leave of Absence webpage. Note that you must provide information on what you would like to do with your insurances prior to going without pay by completing the Unpaid LOA Insurance Selections Form. Email the Selections form and direct any questions regarding benefit impacts to benefits@uwss.wisconsin.edu.

A Leave of Absence (LOA) may be requested for the following reasons:

• Medical (requires physician certification – reference the FMLA certification forms)
• Educational
• Exceptional Personal Reasons
• Maternity, Paternity, or Adoption
• Filling Another UW Position
• Other

It is important to be specific in providing an explanation for the leave as it will assist with the determination of approval or denial.

• Visit here for details related to a non-medical reason to request a leave of absence.University Staff Temporary and Project Appointments are not eligible for non-medical LOA.
• If the reason is specific to a paid Faculty Sabbatical, visit here for the process. You do not complete the LOA request for Faculty sabbatical.

LOA (paid or unpaid) Steps for Employees

1. Employee requests (LOA Request Form) and has their health care provider complete a certification for the medical leave reason (whichever FMLA certification form is applicable to the employee’s request). Physician certifications should be faxed directly to HR at 920.424.2021.
2. After all necessary paperwork is received and reviewed, HR will send the approval or denial letter to the employee and provide the supervisor with notification.
3. It is the employee’s responsibility to enter in their own paid leave and indicate “Approved LOA” in the requester comments section of the absence request.
4. Return to Work Instructions:
   1. An employee who is out for their own serious health condition is required to provide HR and their supervisor with a return to work slip from their health care provider, preferably 2 days before the return date. NO WORK CAN BE DONE UNTIL THIS IS RECEIVED.
   2. An evaluation of the restrictions, if any, is required to determine if modifications to the employees duties is possible.

Do not hesitate to contact Human Resources (hroffice@uwosh.edu; 920-424-1166) to answer any questions you may have.