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HR – Procedure 338

Section 300
Proc. 338
Subject: Family and Medical Leave
Effective: 09/01/1996
Revision (2): 08/01/2019
To set forth procedures for the approval and use of Family and Medical Leave for regular staff.


  1. Request for FML by the Employee.
    • When an employee is going to be absent due to an eligible FML event, the employee must complete a Family and Medical Leave Request form (available from HR), and submit it to his/her supervisor for approval. The request is forwarded to HR for approval.
  2. Medical Certification Option.
    • A medical certification may be required to support the request for family and medical leave. This is to be completed by the physician and returned to HR.
  3. Recording FML Leave
    • An employee who takes leave that is designated as medical leave must first exhaust, in order, all unused compensatory time, sick leave, annual leave, and personal leave. However, an employee may opt to retain up to five (5) days or 40 hours of sick leave, whichever is less. Once the employee has exhausted his or her paid leave, he or she will go on unpaid leave for the remainder of the medical leave period.
  4. Maintaining the FML Leave Record; Reporting Deadline.
    • The department maintains a record of the dates of FML absences (whether the employee has accumulated and is using paid sick leave or not) on the employee’s timesheet. The twelve-week per twelve-month period allowed is measured from the first day of FML.
  5. Deeming FML When No Request is Made by the Employee.
    • If the department or Human Resources believes an employee’s absence qualifies for FML, and the employee has not requested it, the department or Human Resources should complete the Family and Medical Leave Request form and submit it for approval. Human Resources must then notify the employee in writing that the leave will be counted as FML with the time frame permitted by HR Policy 0338.

FORMS: (Contact UTSI Human Resources office for forms or see link below)
Family and Medical Leave (FML) Request Form
FML Medical Certification