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«ASU Office of Human Resources | Benefits Design & Management Revised 12.31.14 BIRTH/PLACEMENT FOR ADOPTION OR FOSTER CARE/ BONDING FAMILY MEDICAL ...»

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OHR END-USER DOCUMENTATION OVERVIEW

BIRTH/PLACEMENT FOR ADOPTION

OR FOSTER CARE/ BONDING

FAMILY MEDICAL LEAVE ACT (FMLA)

BENEFITS DESIGN & MANAGEMENT

Sheree Barron, Director

Office of Human Resources

ASU Office of Human Resources | Benefits Design & Management Revised 12.31.14

BIRTH/PLACEMENT FOR ADOPTION OR FOSTER CARE/ BONDING FAMILY

MEDICAL LEAVE ACT (FMLA)

TABLE OF CONTENTS

(Click on the section heading to link to appropriate page) Purpose

Objectives

Overview

Definition: Employee Eligibility

Definition: Reason for Leave of Absence

Definition: Duration and Type of Leave of Absence

Definitions

Step 1 Determine Leave Process

Step 2 Receive or Issue Leave of Absence Request Form

Step 3 Determine Employee Eligibility for FMLA

Step 4 Issue the FMLA Notice of Eligibility with Rights & Responsibility

Step 5(a) (EE birth mother) Include the FMLA Certification of Health Care Provider

Step 5(b) (EE birth mother) Include Authorization for Release of Health Information

Step 5(c) Others) Include the Employee Acknowledgement

Step 6 Authenticate or Clarify the Certification of Health Care Provider

Step 7 Issue the FMLA Designation Notice

Step 8 (EE birth mother) Include the Health Care Provider Release to Return to Work

Step 9 Verify Receipt of Documentation

Step 10 Begin the ADA Case Management Process

Step 11 Issue the Leave of Absence Status Change Form

Coordination of Benefits

Time Reporting, Intermittent Leave and Compassionate Transfer of Leave

MORE INFORMATION

Process Checklist

Forms and Policy References

–  –  –

Purpose This document outlines the basic information you will need to approve and

process an employee’s request for the following type of leave:

–  –  –

Overview The forms required for leave administration have been designed to provide the mandated information required by ASU policy and/or federal regulations.

–  –  –

Step 1 Determine Leave Process To effectively manage leaves, it is important to understand the process in your particular Dean or VP area. Contact your Dean or VP for confirmation.

Centralized:

One person, (e.g., a Department Leaves Representative, Business Operations Manager, or HR Liaison) handles all aspects of the process for your Dean or VP area.

Decentralized:

Each separate division (e.g., an office, unit, department, or team) within your Dean or VP area handles the entire process for the employees in that particular section.

Hybrid:

The process is handled individually by each separate division but channeled through one main authority in your Dean or VP area.

Step 2 Receive or Issue Leave of Absence Request Form (PDF) When the need for leave is foreseeable, an employee is required to give at least a 30day written notice. If the leave is required due to a medical emergency or other unforeseeable event, the employee must provide as much notice as is practicable under the circumstances.

 Department receives Leave of Absence Request Form

-or Department issues Leave of Absence Request Form In the case of employee’s inability to complete the necessary paperwork, the department leaves representative should complete the form immediately upon determining the employee will be absent longer than three (3) consecutive calendar days.

Complete the Employee and/or Supervisor sections, as applicable Indicate date form issued to employee on copy and place in employee’s leave file IMPORTANT: Confidential leave and medical information must be kept in a secured and separate file from the department personnel files. Departments will be audited periodically to ensure compliance.

Fax copy to Disability & Leaves Program Management Unit at 480.993.0007

–  –  –

Within five (5) business days, the department leaves representative must respond to

the employee’s request by:

 Determining employee's FMLA eligibility (See Step 3)  Completing the department portion of the following applicable forms  Issuing the following applicable forms to the employee (in person, via email or US Mail)

–  –  –

Step 3 Determine Employee Eligibility for FMLA

To be eligible for FMLA, the employee must:

1) Have been employed for at least 12 months AND

2) Have worked at least 1250 hours during the 12 months immediately prior to the requested leave date AND

3) Have not already exhausted his/her FMLA entitlement.

Eligibility Requirement #1 Verify that the person has been an Arizona University System (Arizona State University, Northern Arizona University, The University of Arizona, or Arizona Board of Regents) employee for at least 12 months.





* Months do not need to be consecutive (e.g., 3 months in 2010 + 2 years 2005-2006) * Employment prior to a break-in-service of seven (7) years or more should not be counted unless the employee was on active duty with the National Guard or Reserve or there was a written agreement of intent to rehire the employee after the break in service.

–  –  –

If the person is a transfer employee within the Arizona University System, please contact your department's Leaves Management Partner for assistance in determining eligibility for this first requirement.

–  –  –

At this point, if the employee is not eligible for FMLA, the department may choose to offer Extended Leave of Absence (staff), Health Related Leave with Pay (faculty/sick), or Leave of Absence without Pay (faculty). See the End-User Document Overview For ASU Leave: Birth/Placement for Adoption or Foster Care/Bonding (Non-FMLA).

–  –  –

Eligibility Requirement #2 Verify that the employee has worked at least 1250 hours during the 12 months immediately prior to the requested leave date.

 Unpaid hours off do not count  Paid time off under a leave benefits plan (e.g., sick, vacation or holiday) do not count  Hours taken for National Guard or Reserve duty do count  Hours worked as a student worker do count  Furlough hours do count  If an employee works multiple jobs, worked hours are added together and all do count

–  –  –

If the total number of worked hours is at least 1250, the employee has met the second part of the eligibility requirement.

If the person is a transfer employee from the Arizona University System, please contact your department's Leaves Management Partner for assistance in determining eligibility for this second requirement.

At this point, if the employee is not eligible for FMLA, the department may choose to offer Extended Leave of Absence (staff), Health Related Leave with Pay (faculty/sick), or Leave of Absence without Pay (faculty). See the End-User Document Overview For ASU Leave: Birth/Adoption/Foster Care/Bonding (Non-FMLA).

Eligibility Requirement #3 Determine the amount of FMLA leave the employee has already taken, if any, since the last anniversary month. The anniversary month is the month designated in the Last Start Date (See Eligibility Requirement #1). If rehired, the Last Start Date becomes the FMLA anniversary month

–  –  –

Subtract the amount of FMLA time already taken since the last anniversary date from the 12-week entitlement to determine how many weeks the employee has remaining to use.

If the person is a transfer employee within the Arizona University System, please contact your department's Leaves Management Partner for assistance in determining eligibility for this second requirement.

–  –  –

At this point, if the employee is not eligible for FMLA, the department may choose to offer Extended Leave of Absence (staff), Health Related Leave with Pay (faculty/sick), or Leave of Absence without Pay (faculty). See the End-User Document Overview For ASU Leave: Birth/Placement for Adoption or Foster Care/Bonding (Non-FMLA).

Step 4 Issue the FMLA Notice of Eligibility with Rights & Responsibility for Birth/Placement for Adoption or Foster Care/Bonding (PDF) with supporting forms This is the first notice to be given to the employee upon receipt (or issuance) of a leave request. This notice gives conditional leave approval, information about the employee’s eligibility for FMLA leave, details the employee’s specific responsibilities and explains any consequences for the employee failing to meet those responsibilities.

Complete the form, as applicable Mail to the employee along with the appropriate supplemental forms (see Steps 5).

Indicate date form issued to employee on copy and place in employee’s leave file IMPORTANT: Confidential leave and medical information must be kept in a secured and separate file from the department personnel files. Departments will be audited periodically to ensure compliance.

–  –  –

Step 5(a) (EE birth mother) Include the FMLA Certification of Health Care Provider for Employee’s Pregnancy (PDF) This form (given only to the employee birth mother) requests the necessary medical information from the employee’s health care provider to substantiate the need for leave.

This form should be completed by the health care provider 30-45 days prior to the beginning of the leave. If the form is completed earlier and it becomes necessary to change the leave date, a second documentation may be required.

Complete Section I You must allow the employee at least 15 calendar days to return the certification Attach a job description, with essential functions Mail the certification to the employee with the Notice of Eligibility (See Step 4) Instruct the employee to complete Section II Instruct the employee to give the entire form to the health care provider, asking him/her to complete Section III and to return the form, as indicated Indicate date form issued to employee on copy and place in employee’s leave file IMPORTANT: Confidential leave and medical information must be kept in a secured and separate file from the department personnel files. Departments will be audited periodically to ensure compliance.

Fax copy to the Disability & Leaves Program Management Unit at 480.993.0007

–  –  –

Step 5(b) (EE birth mother) Include Authorization for Release of Health Information (PDF) This form (given only to the employee birth mother) provides health care provider(s) with the employee's authorization to discuss protected medical information with ASU. While authorization is not mandated by FMLA law, most health care providers require it. OHR recommends that the department have the employee complete the form prior to the leave rather than wait until its use may be necessary.

Mail the authorization to the employee with the Notice of Eligibility (See Step 4) Request the employee complete the form and return to department leaves representative Indicate date form issued to employee and place a copy in employee’s leave file IMPORTANT: Confidential leave and medical information must be kept in a secured and separate file from the department personnel files. Departments will be audited periodically to ensure compliance.

Fax copy to the Disability & Leaves Program Management Unit at 480.993.0007 Step 5(c) Others) Include the Employee Acknowledgement for Leave of Absence (Birth/Placement) and Parental Leave Benefits (PDF) Whereas the Certification of Health Care Provider is used to authenticate the birth mother's need for leave, this form is used to require other employees to validate their entitlement to this leave by agreeing to provide documentation of the event. Additionally, ASU policy states that the university reserves the right to require substantiation of the birth or adoption

–  –  –

 Complete the supervisor section, as applicable  Mail to the employee with the Notice of Eligibility (See Step 4)  Instruct the employee to complete the employee section and return the form to you  Indicate date form issued to employee on copy and place in employee’s leave file IMPORTANT: Confidential leave and medical information must be kept in a secured and separate file from the department personnel files. Departments will be audited periodically to ensure compliance.

 Fax copy to the Disability & Leaves Program Management Unit at 480.993.0007 Step 6 Authenticate or Clarify the Certification of Health Care Provider If the employee submits a complete and sufficient certification, no additional information may be requested from the health care provider.

If the certification is considered either incomplete or insufficient, the employee must be notified, via the Designation Form (Step 7), and given (7) calendar days to cure any deficiency. (A certification is considered incomplete if an item is not filled in; it is considered insufficient if the information is vague, ambiguous, or nonresponsive.) If it is necessary to either clarify and/or authenticate the certification, the department leaves representative may contact the provider. Authentication means providing the health care provider with a copy of the certification and requesting verification that the information is complete and authorized by the provider who signed it. Clarification means a need to

–  –  –

understand the handwriting on the certification or the meaning of a response.

Contact with the health care provider by the employee's direct supervisor is prohibited by FMLA law.



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