Family Medical Leave Act


The Family Medical Leave Act entitles eligible employees to take up to 12 work weeks (duty days) of unpaid, job-protected leave in a 12-month period for specified family and medical reasons, or for any “qualifying exigency” arising out of the fact that a covered military member is on active duty, or has been notified of an impending call or order to active duty, in support of a contingency operation. The FMLA also allows an eligible employee who is a spouse, son, daughter, parent, or next of kin of a covered service member with a serious injury or illness up to a total of 26 work weeks of unpaid leave during a single 12-month period to care for the service member.


Employees are eligible for leave if they have worked for Golden Rule at least 12 months and at least 1,250 hours over the past 12 months.

What are the qualifying events for taking FMLA?

  • For the birth and care of a newborn child of the employee
  • For the placement with the employee of a son or daughter for adoption or foster care
  • To care for a spouse, son, daughter or parent with a serious health condition
  • Or for qualifying exigencies arising out of the fact that the employee's spouse, son, daughter or parent is on active duty or call to active duty status as a member of the National Guard or Reserves in support of a contingency operation.


Under some circumstances, employees may take FMLA intermittently – taking leave in separate blocks of time for a single qualifying reason – or on a reduced leave schedule – reducing the employee's usual weekly or daily work schedule. When leave is needed for planned medical treatment, the employee must make a reasonable effort to schedule treatment so as not to unduly disrupt the employer's operation. If FMLA is for the birth and care, or placement for adoption or foster care, use of intermittent leave is subject to the employer's approval.

Please click here for more information on the Employee Rights under Family Medical Leave.


  • As soon as you know you need to take leave (at least 30 days for planned leave i.e. surgery, pregnancy), you must notify your campus about the need for leave and complete a Medical Leave Request Form and submit it to the Human Resources Department. You will be notified of your eligibility for FMLA within five business days.
  • If eligibility for FMLA is determined you must provide Medical Certification (click here for employee's form or click here for immediate family member's form )from your doctor to the Human Resources Department within fifteen calendar days.
  • Once you have been released to return to work, you are required to provide your doctor's note at least a day prior to your return to Human Resources to obtain a release note to take to your campus.

Please Note: It is the employee's responsibility to continue insurance policy premiums if the District is unable to deduct them from the employee's check.

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