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Step 1. Complete top part of Form #1

Once aware of an absence that may qualify under FMLA or to apply for FMLA for a new calendar year, ask the employee to complete the top part of Form #1, FMLA Leave Notice of Designation, Request, and Approval. If the employee does not wish to complete the form, you must initiate the process and complete as much of the top part of the form as possible. Explain the purpose of FMLA to the employee. For assistance, contact your campus human resources office. 

Step 2. Determine eligibility

Within 5 business days of receipt or initiation of Form #1, the department is to notify the employee if he or she is eligible for FMLA under the law. To be eligible, the employee must meet all of the requirements described below. The employee must have:

• Been employed at Indiana University for at least 12 months. Any portion of a week that the employee is on the payroll counts as a full week toward FMLA eligibility. Employment does not have to have been continuous, except that separate periods of employment in which the break in service exceeds 7 years are not used to determine FMLA eligibility.
• Worked at least 1,250 actual work hours during the 12-month period prior to the first day of the leave. Use only time actually worked in the calculations. Time paid but not worked (such as vacation, sick, etc.) does not count toward the 1,250 hours.
• The 1,250 work hour requirement also applies when an employee is reapplying for FMLA for a new calendar year. If the need for FMLA does not end with the end of a calendar year, the employee must have worked 1250 actual work hours in the prior calendar year to meet eligibility for FMLA coverage for the new calendar year. If eligible, the employee's FMLA entitlement will be for up to 12 weeks in the new calendar year. The department should start a new Form #1 for the new calendar year and request new medical certification, if for a serious health condition.
• Not already used 12 weeks of FMLA entitlement in the current calendar year.

Note:  Time in the military service covered under the Uniformed Services Employment and Reemployment Rights Act (USERRA) will count towards fulfilling the length of employment and hours of work requirements to be eligible for an FMLA leave. The 7-year break in service rule does not apply to military service.

Proceed to Step 3 (Determining qualifying reasons) if the employee meets all of these requirements. If the employee does not meet all of the requirements, then proceed to Step 7 (Denial of Leave).

Step 3. Determine qualifying reasons

Determine if the reason for the absence is one of the qualifying reasons listed below.

• Birth of a child and to care for a newborn child of the employee, spouse as defined by Indiana law.
• Placement with the employee of a child through adoption or foster care.
• Care for any of the following who has a serious health condition:  the employee’s spouse, the employee’s child under 18, or the employee’s parent.
• Care for the employee’s child 18 or older who has a serious health condition and is incapable of self-care because of a mental or physical disability.
• A serious health condition that renders the employee unable to perform the functions of their job.
• A qualifying exigency which occurs while the employee’s spouse, child, or parent is a member of a Reserve component or a retired member of the Regular Armed Forces or Reserves and is on active duty or on a Federal call to active duty.  Qualifying exigencies to manage the servicemember’s affairs are described on the DOL form Certification of Qualifying Exigency for Military Family Leave.
• Care for a covered servicemember who has suffered a serious injury or illness in the line of duty if the employee has a qualified family relationship with the covered servicemember. A qualified family relationship is a spouse, parent, child, or next of kin. Contact the campus human resources office to determine if a qualified family relationship exists as defined in the DOL form.

Proceed to Step 4 (Selecting reason and completing forms) if the employee meets any of these qualifying reasons. If the employee does not meet any of the qualifying reasons, proceed to Step 7 (Denial of leave).

If you are uncertain whether the reason or relationship is a qualifying one, contact your campus human resources office for assistance.

Step 4. Select reason for leave and complete appropriate forms

Qualifying Reason #1: Birth, adoption, or care of a newborn

If the absence is for the care of a newborn or the birth of the child of the employee, spouse as defined by Indiana law, or placement of a child for adoption or state foster care placement (with the employee) and the employee is eligible under the law, do the following:

• Complete the approval section of Form #1, FMLA Leave Notice of Designation, Request and Approval. Medical certification is not to be requested or required for normal births. If the absence is due to a health problem related to the pregnancy, proceed to Qualifying Reason #2: Serious health condition.
• Provide a copy of Form #1 to the employee and your campus Human Resources office within five business days of receipt or your initiation of Form #1.

Do not require medical certification for this reason, but non-medical certification (such as a birth certificate) is acceptable, if necessary, to substantiate an employee's claim.

Proceed to Step 5 (Record FMLA time)

Qualifying Reason #2: Serious health condition

If the absence is because of the employee's serious health condition, or to care for the employee's seriously ill spouse or parent of the employee who has a serious health condition and the employee is eligible under the law, do the following:

• Check "Leave of absence conditionally approved pending receipt of certification" on Form #1.

• Within five business days of initiation of Form #1, give the employee copies of Form #1 and the Medical Certification Form for the Employee #2E or for the Family #2F (to be fully completed and signed by the health care provider). Please convey to the employee that Form 2E or 2F must be fully completed by the health care provider for final approval of FMLA coverage to be granted and to prevent delay in the FMLA protection.

• Submit copies of both pages of the Form #1, to your campus human resources office.
• Within five business days of receipt of the completed Medical Certification Form #2E or #2F, make a final determination to approve or deny the FMLA coverage. If needed, your campus Human Resources office may review the medical certification if there is a question by either the employee or the department.
• When medical certification has been fully reviewed and final approval is determined, complete section 3 of Form #1. Provide a final copy to the employee and your campus human resources office. Contact your human resources office for assistance in reviewing medical certification, if needed.

If the approved FMLA is for the employee’s own serious health condition, also provide him/her with a copy of Form #3 Intent to Return and Fitness for Duty/Medical Release to be completed by the health care provider before the employee is permitted to return to work. Attach a copy of the essential functions of the employee’s position.

Proceed to Step 5 (Recording FMLA time)

Qualifying Reason #3: A Qualifying Exigency

If the FMLA is for a qualifying exigency to manage the servicemember’s affairs as described in DOL form Certification of Qualifying Exigency for Military Family Leave do the following:

• Complete section I of this form and request that the employee fully complete section II. Inform the employee that failure to provide the information requested on the form may result in a delay or denial of the request for FMLA leave.
• Within five business days of receipt of the completed DOL certification form, make a final determination to approve or deny the FMLA coverage.
• When the completed DOL form has been fully reviewed and final approval is determined, complete section 3 of Form #1. Provide a final copy to the employee and your campus human resources office.

Contact your human resources office for assistance in reviewing the certification, if needed.

Proceed to Step 5 (Recording FMLA time)

Qualifying Reason #4:  Care for a covered Servicemember

If the FMLA is for an employee to provide care for a covered servicemember, do the following:

• Provide the employee with a copy of the DOL form Certification for Serious Injury or Illness of Covered Servicemember for Military Family Leave (Family and Medical Leave Act). Request the employee to complete section I and to have an U.S. Department of Defense health care provider complete section II. Inform the employee that failure to provide a fully completed form may result in a delay or denial of the request for FMLA leave.
• Within five business days of receipt of the completed DOL certification form, make a final determination to approve or deny the FMLA coverage.
• When the completed DOL form has been fully reviewed and final approval is determined, complete section 3 of Form #1. Provide a final copy to the employee and your campus human resources office.

Contact your human resources office for assistance in reviewing the certification, if needed.

Proceed to Step 5 (Recording FMLA time)

Step 5. Record FMLA Time

During the leave period, keep track of the actual number of hours taken for each approved FMLA. Except for leaves to provide care for a covered service member, the maximum hours of leave taken as FMLA in any one calendar year cannot exceed 480 hours (12 weeks) (prorated by FTE).

• For Part-Time Employees, an FMLA leave is unpaid time off.
• For Staff employees:
  • Code time off (as a part of FMLA leave) with the appropriate coding on the payroll vouchers and attendance records.
  • During an FMLA absence, all available time off accruals are to be used before an employee is to be placed in an absent without pay status. This includes any leave accrued during an FMLA absence. An employee’s compensatory time must be used prior to the use of any other time off accruals.
  • An employee’s scheduled shifts will be counted for purposes of determining the amount of FMLA leave taken.
  • If the employee is absent without pay for more than 30 calendar days, an E-Doc must be initiated, placing the person on an unpaid leave of absence for the balance of the FMLA entitlement period. This will ensure that HR notifies the employee to make arrangements to continue necessary insurance premiums. When it is known that the period without pay will exceed 30 days, the department is to process the appropriate HRMS documentation to place the employee on a leave of absence for the balance of the FMLA leave.

Step 6. Prepare for the employee's return

• If Form #3 Intent to return and Fitness for Duty/Medical Release was given to the employee at the start of the FMLA, the employee must return the completed form signed by the health care provider before the employee can be allowed to return to work.
• If the employee checks on the form that he or she does not intend to return to work, the university’s obligations under the FMLA are complete and the employee is to be separated from employment. Contact the campus Human Resources office to discuss the appropriate termination code to use.

Step 7. Deny leave of absence if applicable

• If the reason is not a qualifying reason or the employee does not meet eligibility requirements, complete the "Leave of absence denied" portion of Form #1, FMLA Leave Notice of Designation, Request and Approval.
• Provide a copy of Form #1 to the employee and your campus Human Resources, within five business days of receipt or your initiation of the form.
• If the employee does not yet meet the eligibility requirements, track the time worked and advise the employee once eligibility requirements have been met (refer to Step #2 for requirements).
• Follow the university's personnel policy if you wish to grant a discretionary leave of absence.

Special Issues

1. All FMLA related documentation must be maintained within the department in a locked file, separate from other personnel files.
2. If both the mother and father of a newborn are IU employees, each will be entitled to up to 12 weeks FMLA-covered absence per calendar year, if meeting individual FMLA eligibility. This also applies to adoption and foster care placement. FMLA qualification extends until the child is one year of age or in the case of child placement, the child has been in the employee’s home for one year.
3. If the reason for FMLA changes or if the employee returns from FMLA-covered leave and then requests another FMLA, a new Form #1 must be submitted to determine eligibility requirements and qualifying reasons at the time of the new request.
4. If an FMLA-eligible employee who is absent for an FMLA qualifying reason, does not want the absence to be counted as FMLA covered leave and will not provide medical certification, do not approve the use of PTO, vacation, sick, or other paid time off.
5. FMLA should start immediately if an FMLA eligible employee who is under Worker's Compensation for a work related injury declines a modified position assignment offered under Worker's Compensation.
6. Whenever medical certification is unclear or the validity is questionable, contact your campus Human Resources office to discuss options permitted under FMLA regulations.