Need Time? Guidelines for Leave of Absence

Employees are required to notify HR if they will be absent for four (4) or more full consecutive days in order for a determination to be made as to whether the absence qualifies under the FMLA. Approved FMLA begins on the first day of the absence. FMLA is unpaid time off. Paid time is determined by individual employee contracts.

Employees may take a leave of absence for one of the following reasons:LOA

  1. Birth of employee's child and to care for newborn child;
  2. Placement of a child with employee for adoption or foster care;
  3. To care for spouse, child or parent who has a serious health condition;
  4. When the employee's own serious health condition renders the employee capable of performing the functions of his/her job;
  5. Military Family Leave Entitlements (see Department of Labor website)

If the employee is not eligible for FMLA leave, they may request a personal or medical leave of absence. Medical and personal leave of absences requires the employee to follow the same instructions and provide the same documentation.

Step 1: Eligibility Requirements

To be eligible for FMLA, employees must have been employed by Rochester Community Schools for at least 12 months and worked 1,250 hours during the 12 month period preceding the commencement of the leave.

Step 2: Required Paperwork

Employees are asked to submit the Request for Leave of Absence to the HR Benefits Coordinator as soon as possible to begin the leave process. A meeting to discuss the leave of absence is recommended 30-60 days prior to first date of leave. A Certification of Healthcare Provider must be completed and returned 30 days prior to leave, if foreseeable.


Request for Leave of Absence **COMPLETE FIRST**

WH-380-E - Certification of Healthcare Provider for Employee

WE-380-F - Certification of Healthcare Provider for Family Member

WH-384 - Certification for Qualifying Exigency Military Family Leave

WH-385 - Certification for Serious Injury or Illness of Current Service Member

WH-385V - Certification for Serious Injury or Illness of Veteran for Military Caregiver


Step 3: Notice of Eligibility and Rights & Responsibilities

If the the employee does or does not meet the requirements for FMLA, the HR Benefits Coordinator will provide the Notice of Eligibility and Rights & Responsiblities paperwork to the employee within 5 days of when the employee submitted the FMLA paperwork. 

Step 4: Designation Notice

The HR Benefits Department will provide the employee with a Designation Notice for the following reasons:

  • Certification of Healthcare Provider has been received and FMLA is approved
  • Employee needs to provide additional clarification to determine if the event qualifies under FMLA
  • The event does not qualify for FMLA and is not approved
  • Your have exhausted your FMLA leave entitlement in the applicable 12 month period

Step 5: Staff member's return from Leave of Absence

All employees are required to submit a "release to work" from their health care provider. This doctor's note needs to be submitted to the HR Benefits Department prior to the employee's first day back to work.