COVID-19 Related Leave Options
Please see the most recent guidance from President Drake regarding your COVID-19 Related Leave Options. Additional information for Staff and Academic employees available below. Should you have any questions regarding your leave options, please contact email@example.com for further assistance.
Types of Leave
A leave of absence occurs when an employee requests time away from work for any number of reasons: personal, medical, pregnancy disability, or military.
To get a general overview of the Leave of Absence process, we recommend that supervisors and managers take the Leave of Absence Training.
Family Medical Leave Act (FMLA)
Family medical leave is the terminology used by University of California campuses and ANR for medically related leaves which includes the Family Medical Leave Act, as well as the Pregnancy Disability Leave Act and the California Family Rights Act.
As soon as you have knowledge of an employee's possible need for Family and Medical Leave, please email firstname.lastname@example.org and include the following information:
- Employee’s name and location
- Supervisor’s name
- Reason for leave
- Leave type needed (i.e. intermittent, reduced or block) – if known
- Leave start and end dates – if known
- Best method of contact for employee and/or requester (i.e. phone number or email)
NOTE: please do NOT provide confidential information about the employee’s injury or illness.
Once your request is received by the Leave Coordinator, a leave packet will be sent out to the employee and supervisor with further instructions. Some documents that may be included in the leave packet include the following:
Designating a leave as FMLA (Download all documents here):
- Department Checklist – This is to keep you on track, it’s not necessary to turn this form in.
- Employee Checklist – This is to keep the employee on track and is not necessary to turn in.
- Staff Leave Request Form – For the employee to fill out and you to approve.
- Designation Notice – For the Leave Coordinator to fill out (after the employee completes the staff leave request form). The employee should be provided a copy along with the Notice of Eligibility and Rights and Return to Work Certification Form.
- Notice of Eligibility and Rights – For the Leave Coordinator to fill out and return to the employee. It lets the employee know what is required of them and why they qualify/do not qualify for FMLA.
- Medical Certification (Select appropriate form) - Most FMLA leaves require a medical certification from a licensed health care provider. Most health care providers use their own forms, but UCD has forms of their own that are available for use if necessary.
- Declaration of Relationship – To be completed when requesting FMLA leave to care for a family member with a serious health condition or for parental leave.
- Exempt Employee Workweek Agreement (Taken On A Reduced Schedule or Intermittent Basis) – To be completed ONLY by exempt employees requesting FML leave on an intermittent or reduced schedule basis. The employee will need to complete the form and you will need to approve it.
- Return to Work Certification – The employee will need to verify their eligibility to return to work, with a doctor. This form is requested from the employee; however, a doctor’s note will suffice. Check the box on the Designation Notice to notify employee.
- Intermittent Leave Tracking Sheet – In certain instances, FMLA may be taken on an intermittent basis. This form will assist you in the tracking the amount of FML that an employee has taken in the calendar year.
- Sample Letters – 18 different letter templates for your use. These assist you with the employee notification process. If you need assistance determining which letter to use, please contact the SPU.
- FML Factsheet - For the employee’s information.
Lincoln Financial (Formerly Known as Liberty Mutual)
Absence from Work (PPSM 2.210) Policy