Family and Medical Leave Act (FMLA)

The Eligibility Requirements and Application Process for FMLA

Leave Options for Employees Impacted by COVID-19

- Employer Paid Sick Leave (EPSL) and Emergency Family Medical Leave Expansion (E-FMLE)
- Short term/Long Term Disability
- Family Medical Leave (FML), which you can learn more about below.
- Leaves of Absence (LOA)
For more details about these leave options, please visit the Time Away from Work website.

FMLA provides for up to 12 weeks of unpaid leave to eligible employees for the following qualifying reasons:

  • Serious health condition makes the employee unable to perform the functions of his/her job;
  • Incapacity due to pregnancy, prenatal medical care or childbirth;
  • To care for the employee’s child after birth or placement for adoption or foster care;
  • To care for the employee’s spouse, son or daughter, or parent who has a serious health condition; and
  • Military Family Leave for a qualified exigency.

FMLA provides for up to 26 weeks of Military Family Leave to care for an injured or ill service member or veteran.

Leave under this policy is unpaid although employees with earned sick and/or annual leave are required to use this paid leave while on Family and Medical Leave.

 

Eligibility

An employee who has been employed at least 12 months by FCPS and has at least 1,250 hours of service with FCPS during the previous 12-month period.

 

Calculation of Leave Year

FCPS will measure the 12-month period as a rolling 12-month period measured backward from the date an employee uses any FMLA leave under the policy. The 12-month period will begin with the first use of FMLA in the previous 12-months.

Complete these forms if you're requesting FMLA for your serious health condition.

  • HR-126

    Request for a Foreseeable Family Medical Leave

  • HR-146

    Certification of Health Care Provider for Employee's Serious Health Condition (Family and Medical Leave Act)

Complete these forms If you're requesting FMLA to care for a family member's serious health condition.

  • HR-126

    Request for a Foreseeable Family Medical Leave

  • HR-147

    Certification of Health Care Provider for Family Member's Serious Health Condition (Family and Medical Leave Act)

Complete these forms if you're requesting FMLA due to military-related circumstances.

  • HR-126

    Request for a Foreseeable Family Medical Leave

  • HR-148

    Certification for Serious Injury or Illness of Covered Servicemember--for Military family Leave (Family and Medical Leave Act)

  • HR-149

    Certification of Qualifying Exigency for Military Family Leave (Family and Medical Leave Act)

Your completed FMLA paperwork must be sent to the FCPS Disability and Leave Unit for review.

Department of Human Resources
Office of Benefit Services, Disability and Leaves Unit
8115 Gatehouse Road, Falls Church, VA 22042
FAX (571) 423-5013
Email: DisabilityandLeaves@fcps.edu

Important: Your worksite supervisor/ principal need to sign your FMLA form as an acknowledgement your leave request. The Disability and Leaves Unit will receive and confirm your leave request. If approved, the Disability and Leaves Unit will send written approval to both you and your worksite supervisor/ principal. Completion of the FMLA paperwork does not imply or promise the employee’s eligibility for an FMLA. 

 

Questions

For assistance with your FMLA request, please contact the Disability and Leaves Unit at 571-423-3200, option 1, or email DisabilityandLeaves@fcps.edu.

 

For More Information

Review the IDM Handbook and the Benefits While on Leave of Absence (LOA) packet on the Benefits Publications & Resources website.

Refer to Regulation 4835: Family Medical Leave.

Review the The Employee’s Guide to the Family and Medical Leave Act, published by the U.S. Department of Labor.

HR Connection

Question for Human Resources? Submit it through the HR Connection portal or call 571-423-3000 or 1-800-831-4331.