Certifying and Reporting Paid Medical Leave

A. Medical Leave

Medical Leave Request

For Self

The faculty member or academic professional and administrative (P&A) employee requests from the responsible administrator/supervisor at the earliest opportunity leave to be away from work for a physical or mental health condition that prevents the performance of any portion of work duties. A request for leave to undergo a medical procedure to donate bone marrow or to donate an organ or partial organ to another person must be accompanied with a health care provider's written verification.

When medical leave is based on the employee’s own health condition, and the leave is expected to or does reach two weeks, the employee must call The Standard Insurance Company, referred to as The Standard, to file a claim for benefits and must provide the required documentation to certify the leave. The Standard phone number is1-888-414-0377; the TTY phone number is 1-800-735-1232.

For Dependent Child

At the earliest opportunity, the faculty member or P&A employee requests from the responsible administrator/supervisor leave to be away from work to care for or arrange care for a dependent child because of a physical or mental health condition or for the child’s medical or dental appointments.

For Immediate Family Member

At the earliest opportunity, the faculty member or P&A employee requests time away from work to care for or arrange care for an immediate family member because of a serious health condition as defined in the related Administrative Policy: Medical Leave and Disability Benefits, or when there is a need to accompany such person to a medical or dental appointment.

B. Documentation of Leave

Reporting

The faculty member or P&A employee is to provide appropriate documentation of the number of days away from work that are covered by paid medical leave in increments of whole or half days based on the individual's regularly scheduled work time and according to departmental and/or campus, college, or administrative unit procedures. Form UM 506 – Absence Card may be used to document medical leave days taken. In the reason column, usage of days whether for self, dependent child, or immediate family member care should be noted. Refer to Appendix B for a sample of documentation of paid medical leave for other than self.

The responsible administrator/supervisor is to ensure that use of medical leave is appropriately documented and tracked for uses of paid medical leave for self, dependent child, or immediate family member as defined under the policy. Oversight of reporting, appropriate documentation, and tracking of all medical leave usage is the responsibility of the department and campus, college, or administrative unit.