Family and Medical Leave Act (FMLA) Protection

The Employee's Guide to the Family and Medical Leave Act:  The full FMLA handbook for employees published by the United States Department of Labor.

FMLA Posters:

• Employee Rights Under the FMLA Poster - English

• Employee Rights Under the FMLA Poster - Spanish

Anytime you request leave that may be eligible for protection under the Family and Medical Leave Act  (FMLA), you must sign a "FMLA Notification of Company Procedures and EE Rights/Obligations Form" (found below) and provide sufficient documentation to determine whether NKY will designate the leave as protected FMLA leave. You must provide the details and/or documentation as soon as is practicable upon making the request. Designating leave as FMLA leave is NKY Health’s option upon receipt of details about the leave. 

The HR Administrator must receive the signed "FMLA Notification of Company Procedures and EE Rights/Obligations Form" from you within the following timeframe(s):

• On the day you request leave for a planned FMLA-protected absence

• Within seven business days of the start of an unplanned FMLA-protected absence

• Any time you are re-certifying your need for FMLA-protected leave (NKY Health requires re-certification every six months for FMLA-protected leave pertaining to serious health conditions.)

You may need to submit additional forms/documentation  depending on the reason you are requesting leave.  (Refer to the "FMLA Forms/Documentation You Must Submit" section below.)

Remember that the FMLA leave exists for your protection. The law guarantees that when you return to work after a qualified and approved FMLA-protected absence, you will return to the same or equivalent position. (Sick leave and annual leave alone do not provide this same legal guarantee.)

For the complete FMLA Policy, refer to Section 5.12 and subsections of NKY Health's Guide to Personnel Policies.

When you request leave, your supervisor may ask questions or email instructions to you about next steps you must take to help NKY Health determine whether the leave is protected by the FMLA and should be designated as such.  

After you submit FMLA-related forms to Human Resources, they will email information about the status of your request.  

Please check your fname.lname@nkyhealth.org email for instructions and to find out whether your request is approved, denied or more information is needed.  Please read each email and the attachments completely and comply with all the instructions therein. 

(See the How to Submit Forms/Documents to HR page for detailed instructions about how to submit the form(s) and any supporting documentation.)

Human Resources must receive the signed "FMLA Notification of Company Procedures and EE Rights/Obligations" form from you for any FMLA leave within the following timeframe(s):

• On the day you request leave for a planned FMLA-protected absence

• Within seven business days of the day you start of an unplanned FMLA-protected absence

• Any time you re-certify your need for FMLA-protected leave (usually every six months)

In addition:

• When the leave is due to a health condition (your own or of someone you need to care for), then you must provide a completed “Certification by Health Care Provider” form that NKY Health provides. Please download this form, complete ALL the employee sections,  and take it with you to the doctor/provider when you consult her/him about the health condition so it  can be completed immediately. Check the completed form BEFORE sending it to the HR Administrator to make sure that the information the doctor/provider writes is consistent with your  understanding and provides details about when and how long you will miss work.  NOTE: This form is not needed if you are requesting contiguous time off to bond with a new baby starting with the date the baby is born but is needed if you request leave to give birth and want to save "bonding leave" for later.

• When you return to work after missing a "chunk of time" due to your own serious medical condition, you must produce a note from your health care provider indicating you are fit for duty and noting any restrictions or stating "no restrictions."  NKY Health does not provide a standard form for this;  the note can be on the health care provider's form, letterhead or prescription pad.

• When the leave is to bond with a new baby starting with the day the baby is born, then you request the leave via email to your supervisor with a cc to hr@nkyhealth.org indicating the expected due date (the first day you will miss work) and the date you anticipate returning to work. (Note that the protected leave ends the day you return to work.) After the baby is born,  you must provide proof of the baby’s birth, indicating  your name as the parent and the date the baby was born. This must be on a hospital or doctor’s/provider’s letterhead. (Sorry but photos of the baby will not suffice.)  

• When the leave is to bond with an adopted or foster child then you must request the leave via email to your supervisor with a cc to hr@nkyhealth.org indicating the first day you anticipate missing work and the date you anticipate returning to work. (Note that the protected leave ends the day you return to work.) As soon as the court provides it, you must provide a copy of the court order placing the child with you including the date the child was placed. 

• When the leave is due to a qualifying military exigency, then you must email your supervisor with a cc to hr@nkyhealth.org with a request for the leave.  The request must include the date(s), amount of time, and reason(s) you will miss work and be accompanied by proof of the call to active duty. Additional documentation may be requested.

You can find the forms below.  (See the How to Submit Forms/Documents to HR page for detailed instructions about how to submit the form(s) and any supporting documentation.)

• When you return to work after missing a "chunk of time" due to your own serious medical condition, you must produce a note from your health care provider indicating you are fit for duty and noting any restrictions or stating "no restrictions."  NKY Health does not provide a standard form for this;  the note can be on the health care provider's form, letterhead or prescription pad.  (See "How to Submit Forms/Documents to HR" for detailed instructions about how to submit the form(s) and any supporting documentation.)

• When you cannot return to full-duty, you must notify your supervisor in advance and  provide documentation describing details about your specific restrictions and estimating how long they will last.  NKY Health will work with you on a case-by-case basis to determine whether your job can accommodate a light duty assignment or whether you will need to remain off work until you are no longer restricted.  

6/8/2023

• Added Revision Log.