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Family and Medical Leave Act 

The Family and Medical Leave Act (FMLA) is a federal law that provides eligible employees up to twelve (12) workweeks or 480 hours of unpaid. job protected leave.  During an FMLA approved absence, eligible employees will continue to receive their employer paid health benefits, and will be reinstated to the same or an equivalent job upon their return.  Eligible employees may take up to twelve (12) workweeks of FMLA within a twelve month period, measured forward from the first date FMLA Leave begins.

Eligible employees may also take up to twenty-six (26) workweeks of FMLA Leave during a single twelve month period to care for a servicemember or veteran with a serious injury or illness when eligible employees are the spouse, parent, son or daughter, or next of kin of the servicemember.

Eligible employees are employees who have been with the College at least twelve months and have worked at least 1,250 hours during the previous twelve month period.

Eligible employees may take FMLA Leave for twelve (12) workweeks in a twelve month period defined by College Policy 434, for one or more of the following:

  • The birth of a child, and to care for the newborn child within one year of birth
  • The placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of birth
  • To care for the employee's spouse, child, or parent who has a serious health condition
  • A serious health condition that makes the employee unable to perform the essential functions of his or her job
  • Any qualifying exigency arising out of the fact that the employee's spouse, son, daughter, or parent is a covered military member on "covered active duty"

Eligible employees may take FMLA Leave for 26 workweeks in a twelve month period defined by College Policy 434, for the following:

  • To care for a covered servicemember or veteran with a serious injury or illness if the eligible employee is the servicemember's spouse, son, daughter, parent, or next of kin (military caregiver leave)

Information Regarding FMLA Leave:

College Policy 434: Family Leave

Procedure 434-1: FMLA Request

Employee Family and Medical Leave (FMLA) Packet

Employee Rights Under the Family and Medical Leave Act (FMLA)

UA Cossatot GINA Notice

Military Guide

Family and Medical Leave Act (FMLA) Forms:

UA Cossatot FMLA Request Form

UA Cossatot FMLA Procedures Acknowledgement Form

Certification of Health Care Provider for Employee's Serious Health Condition (Form WH-380-E)

Certification of Health Care Provider for Family Member's Serious Health Condition (Form WH-380-F)

Certification of Adoption or Foster Care Placement

Certification for Serious Injury or Illness of a Current Service Member for Military Family Leave (Form WH-385)

Certification for a Serious Injury or Illness of a Veteran for Military Caregiver Leave (Form WH-385-V)