Cedarburg School District

Family Medical Leave Act (FMLA) Overview

The Family and Medical Leave Act (FMLA) and the Wisconsin Family Leave Act (WFMLA) provide eligible District employees with up to twelve weeks of protected absence or leave per FMLA year when the employee or a covered family member experiences a “serious health condition,” or when an employee requests time to bond with a child after the child’s birth, adoption or foster care.  FMLA and WFMLA regulations provide certain return rights to the same or equivalent position, employer-paid health benefits even if on unpaid leave, and rights to non-discrimination. 

For more information regarding employee leave entitlements, rights and responsibilities under FMLA and WFMLA please review the FMLA Notice of Rights or contact the Human Resources Department.

US DEPARTMENT OF LABOR WEBSITE

US DEPT OF LABOR - EMPLOYEE RIGHTS AND RESPONSIBILITIES

Eligibility

For FMLA eligibility, District employees must have been employed with the Cedarburg School District for at least 12 months (the months need not be consecutive) and must have worked at least 1,000 hours to qualify for WFMLA and 1,250 hours to qualify for FMLA during the one year immediately preceding the effective date of each absence or leave. 

“Qualifying” for FMLA/WFMLA is different from FMLA “Eligibility”.  The qualifying reasons must be a serious health condition; a new child in the family; or a qualifying family member being on active military duty.  The FMLA process starts at the time that the employee provides sufficient information to indicate that the request for the absence is based on reasons that would qualify under FMLA/WFMLA.  It is important to remember that the qualifying FMLA information must be provided within fifteen (15) days of the date the request for leave is planned to commence, or within fifteen (15) days of the employee going on leave in cases of medical emergency due to unforeseen circumstances. If you fail to provide a timely Certification, your leave request or your continuation for leave may be denied until the required Certification is provided.

Forms

CSD FAMILY AND MEDICAL LEAVE REQUEST FORM

US DEPARTMENT OF LABOR - EMPLOYEE'S CERTIFICATION OF HEALTHCARE PROVIDER

US DEPARTMENT OF LABOR - FAMILY MEMBER'S CERTIFICATION OF HEALTHCARE PROVIDER

RETURN TO WORK FORM (Physician's form is acceptable)

Job Description: If your physician requires a job description, please contact Human Resources to request a copy of the description for your job classification.