Family Medical Leave Act

Family and Medical Leave Act (known as FMLA) provides up to 12 unpaid weeks of job-protected leave per year for employees in certain situations.

Employee Rights & Responsibilities

Reasons an Employee Can Take FMLA Leave

• Birth, adoption, or placement of a foster child.
• For a serious health condition that makes the employee unable to perform the essential functions of their job.
• For any qualifying exigency arising out of the fact that an employee's spouse, child, or parent is on active military duty or call to covered active duty status.
• To care for a covered servicemember with a serious injury or illness (employee's spouse, child, parent, or next of kin).
• To care for a spouse, son, daughter, or parent with a serious health condition.

How to Apply

Complete the Request for a Leave of Absence form and return it to the designated person in your department.

Health Care Provider completes: (return to Human Resources Department)

• Certification for Serious Injury or Illness of a Current Servicemember for Military Family Leave
• Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
• Certification of Health Care Provider for Employee's Serious Health Condition
• Certification of Health Care Provider for Family Member's Serious Health Condition
• Certification of Qualifying Exigency for Military Family Leave

Pay

FMLA is an unpaid leave, unless the employee has leave accruals or is eligible for another program that would allow the employee to be paid by the City of Worcester while absent due to a serious health condition.