Supervisor: FML Procedures and Forms

Consult the FMLA Leave Process Flowchart for a visual overview of these steps.

STEP 1: Employee Request

Employees initiate the process by providing their supervisor or the departmental human resources representative with the Employee Request for Family and Medical Leave form. This form documents the anticipated timing and duration of the leave, and whether the employee anticipates taking continuous, intermittent, or reduced work schedule leave.

Employees may submit their FML request and all related information directly to the Division of Human Resources instead of their departments if they would prefer. Contact the Division of Human Resources leave advisers or your Senior HR Partner with any questions.

When the need for FML is foreseeable, employees must give at least 30 calendar days’ advance notice of the need for leave. In the case of a medical emergency or unforeseeable event, employees must give verbal notice as soon as practicable to their supervisor or the department human resources representative. The employee then submits a completed Employee Request for Family and Medical Leave form within 15 calendar days, absent extenuating circumstances.

An employee must provide additional notice and submit a new Employee Request for Family and Medical Leave form:

  • If circumstances of the initial leave change;
  • To extend the original FML request; or
  • To initiate a new request for FML.

You may require the employee to provide periodic updates on his or her status and intent to return to work.

If an employee does not submit a request form in the time frames listed above, you may delay the start of the FML and handle any absences during the delay period according to the normal departmental attendance policy or practice.

Employee Request for Family and Medical Leave (employee completes)

STEP 2: Eligibility Notice

Within 5 business days following an employee’s request for FML, you must determine whether the employee meets eligibility requirements, appears to have a qualifying reason for taking FML, and has an available balance of FML hours. You may initially notify the employee verbally, but must confirm the information in writing using the Notice of Eligibility and Rights & Responsibilities forms. Contact the Division of Human Resources leave advisers for assistance with determining eligibility.

Notice of Eligibility and Rights & Responsibilities form (supervisor or departmental human resources representative completes)

STEP 3: Certification

The employee is required to obtain a certification of a serious health condition or qualifying exigency except for pregnancy. For the employee’s or family member’s serious health condition, the healthcare provider completes the certification. For a qualifying exigency for military family leave, the employee completes the form and provides the requested documentation. You may request certification at a later date if there is reason to question the appropriateness of the leave or its duration. FML may be postponed if the employee does not provide complete information in a timely fashion.

For a certification of the employee’s own illness, provide the employee with a job description or statement of the essential functions of the employee’s position. The healthcare provider reviews the job description and specifies what functions the employee is unable to perform and what limitations the employee may have and for what duration. The certification should not contain the employee’s diagnosis or any other protected health information. The employee must return a complete and sufficient certification within 15 calendar days.

Upon receipt of the employee’s certification, determine whether it is complete, with assistance from the Division of Human Resources as needed. You may ask the employee to remedy any deficiencies in the documentation within 7 calendar days. Under no circumstances should you contact the employee’s healthcare provider directly.

You may request recertification if the employee requests an extension of leave, if the employee’s or family member’s health situation changes, if you receive information that casts doubt upon the justification for the leave, or if the employee’s intermittent leave extends beyond 6 months without exhausting available FML hours.

Certification forms appropriate to the various types of FMLA leave:

STEP FOUR: Designation Notice 

After determining that the certification is complete and sufficient, you will complete the Designation Notice form to inform the employee whether the leave is approved as FML. You can also use the Designation Notice to document that the employee has failed to provide sufficient documentation to approve FML, or to document that the employee has used all available FML hours.

When employees are requesting leave for their own surgery or a serious medical event, you should require they provide a fitness-for-duty certification on returning to work. This document states whether the employee can perform the essential functions of the job or whether any functional limitations may exist. To require such certification, check the relevant box in the middle section of page 1 on the Designation Notice. The employee’s physician completes the fitness-for-duty certification.

During the time the employee is using approved FML, federal law prohibits supervisors from interfering with the employee’s leave.

Designation Notice (supervisor or departmental human resources representative completes)

STEP FIVE: Reinstatement/Return to Work 

The employee must either return to work on (or before) the first scheduled workday after the approved FML ends or must request additional leave before that date. When the employee returns to work as expected, reinstate the person to the same position held when the leave commenced or to a position with equivalent benefits, pay, and other terms and conditions of employment. Retaliation against an employee who takes FML is prohibited by federal law.

If you required a fitness-for-duty certification, then the employee must provide this certification, completed by the healthcare provider, on or before the return-to-work date. You should delay the employee’s return to work until this certification is received.

If the employee’s position or appointment is scheduled to terminate prior to the expiration of FML (e.g., due to reduction in force/layoff, nonrenewal) irrespective of the employee’s use of FMLA leave, then the employee is not entitled to reinstatement.

Employees who require additional leave from work beyond the basic leave or military family leave entitlement may request to use any remaining accrued paid time or to receive an unpaid leave, subject to approval by the responsible administrator. Department representatives are encouraged to consult with a leave adviser or their Senior HR Partner in the Division of Human Resources when this occurs.

The Americans with Disabilities Act (ADA) requires employers to take reasonable steps to accommodate an employee’s disability. In the context of FML, examples of reasonable accommodations are additional leave beyond the FML entitlement or modifications to job duties or work schedule. Employees should file a request with the University’s Disability Resource Center as soon as they believe an accommodation may be required.

Voluntary Termination

Employees on FML are considered to have voluntarily terminated employment if they:

   Advise the University of their intention not to return to work, either during or at the conclusion of the FML; or

   Do not return to work upon the expiration of FML and have not requested and been granted

  1. the use of any remaining accrued paid leave;
  2. an unpaid leave; or
  3. a leave as a reasonable accommodation under the ADA.

Do you need more assistance? 

Main Campus, Satellite Offices and UA Health Sciences - Tucson 
Email: leaves@arizona.edu

UA Health Sciences Phoenix 
Email: hr-phx@arizona.edu