FMLA & SPF Absences

FMLA/SPF Absence is a paid or unpaid absence from work with benefits due to the serious health condition of an employee, the serious health condition of a qualifying family member when the employee is attending to the medical needs of the family member, or for the birth, adoption or foster care placement of a child.

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• Certifications
• Notices
• Requests
• Additional Resources
• Contact Us

Certifications

The following certifications are to be completed by the health care provider only. NOTE: Please consult with your agency FMLA/SPF Coordinator to determine eligibility before printing the forms.

• Employee Serious Health Condition Certification (FMLA)
• Family Member Serious Health Condition Certification (FMLA)
• Adult Child Certification of Disability (FMLA)
• Serious Injury or Illness of a Current Service Member Certification
• Serious Injury or Illness of a Veteran Certification
• Military Exigency Certification

Notices

• Notice to Employees (FMLA)
• Notice to Employees (PSCOA)
• Notice to Employees (PSTA)

Requests

Completed by the employee to request an FMLA/SPF Absence.  The completed request form is submitted to the agency FMLA/SPF Coordinator.

• FMLA Forms Request
• Request for FMLA Absence
• Request for FMLA Absence (Non-Permanent Employees)
• Request for Intermittent or Reduced Time Unpaid FMLA Absence After 12 Weeks
• Request for Military Caregiver Absence
• Request for Military Exigency Absence

Additional Resources

• Agency FMLA Specialist Contact List
• FMLA/SPF checklist for supervisors
• FMLA Frequently Asked Questions
• Notice regarding health benefits while on leave without pay
• MD 530.30 Sick, Parental and Family Care Absence, Military Exigency Absence and Military Caregiver Absence: establishes policy and procedures for the application of sick, parental and family care (SPF) absences, military exigency absence and military caregiver absence under the Family and Medical Leave Act of 1993 (FMLA).
• FMLA Poster: a notice explaining the provisions of the FMLA.
• Absence Management Training for supervisors, both web-based and classroom, can be found through LSO.

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