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Family and Medical Leave Act

In compliance with the Family and Medical Leave Act of 1993, as amended, (“FMLA or “the Act”) it is the policy of Austin Peay State University to provide eligible employees up to 12 workweeks of leave during a 12-month period for family or medial leave, to provide continued health insurance coverage during the leave period and to ensure employee reinstatement to the same or an equivalent position following the leave period.


When Should I Apply for FMLA?

When one is required to be out for more than three days due to a serious health condition for the employee or an immediate family member.

FMLA is available for the following reasons:

  • The birth of a child or placement of a child for adoption or foster care;
  • To bond with a child (leave must be taken within one year of the child’s birth or placement);
  • To care for the employee’s spouse, child, or parent who has a qualifying serious health condition;
  • For the employee’s own qualifying serious health condition that makes the employee unable to perform the employee’s job;
  • For qualifying exigencies related to the foreign deployment of a military member who is the employee’s spouse, child, or parent.

Employee Eligibility and Responsibilities

The employee must have completed 12 months of employment at the onset of the leave period and completed 1250 hours of work during the twelve month period. Employees who do not meet the 12-month employment requirement must complete the appropriate Absence Form for faculty or staff in addition to the required Physician's Certification Form for Employee.

  • Leave time taken such as annual leave or sick leave does not count toward the 1250 hours.

The following forms are required by the Office of Human Resources to be considered for FMLA designation. These forms may be submitted directly to the Office of Human Resources in Browning Room 002 or emailed to benefits@apsu.edu or humanresources@apsu.edu

  • Physician’s Certification Form for Family Member
    • The Physician’s Certification Form is not required to share a medical diagnosis.  Enough information must be provided for the employer to determine if the illness qualifies for FMLA designation and protection.
    • It is always good to include the job description for the employee for review by the physician regarding time away from work.

Supervisor Responsibilities

When an employee in the department is required to be out for more than three days due to medical reasons for the employee’s serious health condition or the serious health condition of an immediate family member, the application of FMLA must be addressed with the employee.  Have them contact the Office of Human Resources for clarification regarding the eligibility of the condition for FMLA designation.

What Happens After I Apply?


The Request for FMLA and the Physician’s Certification Form will be reviewed for eligibility for FMLA designation, and the Office of Human Resources will provide an FMLA Designation letter to the employee.

  • Payroll is notified to be aware of leave reporting to be expected during the FMLA period.

Leave Reporting During FMLA

Payroll will record the leave used for a consecutive period when the employee is not working as of the leave report due date.

  • If the employee has returned to worked as of the leave report due date, the leave will be reported according to the normal leave reporting rules of the department.

Returning to Work

Clearance with the Office of Human Resources by providing a release to return to work from the physician is required before returning to the department to work.

Frequently Asked Questions

In order to be eligible, an employee must:

  • have worked at Austin Peay for at least 1,250 hours during the 12 months prior to the start of the leave;
  • have worked at Austin Peay for at least 12 months. The 12 months of employment are not required to be consecutive in order. In general, only employment within seven years is counted unless the break in service is (1) due to an employee's fulfillment of military obligations, or (2) governed by a collective bargaining agreement or other written agreement. 
  1. First, you'll need to submit the Request for FMLA form. You'll need your supervisor's signature and a signature from HR on this form. Return this completed to benefits@apsu.edu
  2. Next, you'll need to fill out the Physician's Certification Form for yourself or the Physician's Form for a family member if you plan on taking leave to care for a family member.  Please note that there is a section of this form that needs to be completed by your health care provider. This form must be returned to benefits@apsu.edu
  3. Once your form has been reviewed, you will receive a letter signifying your approval or denial for FMLA leave.
  4. If approved, you should contact benefits@apsu.edu as you near your return to work to update us if your leave needs to be extended or modified.

No. The 1,250 hours include only those hours actually worked at Austin Peay.

You will get paid for any sick leave, annual leave, or compensatory time during your FMLA leave until those hours are exhausted.  The rest of your FMLA leave will be unpaid. Short-term disability and long-term disability are available to utilize with membership.  Eligible employees can request to borrow sick leave hours from the sick leave bank for this period.  More information about the sick leave bank can be found here. 

You can use FMLA for the following reasons:

  • For the birth of a son or daughter, and to bond with the newborn child (applicable to mothers and fathers);
  • For the placement with the employee of a child for adoption or foster care, and to bond with that child;
  • To care for an immediate family member (spouse, child, or parent - but not a parent "in-law") with a serious health condition;
  • To take medical leave when the employee is unable to work because of a serious health condition; or
  • For qualifying exigencies arising out of the fact that the employee's spouse, son, daughter, or parent is on covered active duty or call to covered active duty status as a member of the National Guard, Reserves, or Regular Armed Forces.

No. When it is medically necessary, employees may take FMLA leave intermittently - taking leave in separate blocks of time for a single qualifying reason - or on a reduced leave schedule. 

The most common include:

  • Conditions requiring an overnight stay in a hospital or other medical care facility; 
  • Conditions that incapacitate you or your family members (for example, unable to work or attend school) for more than three consecutive days and have ongoing medical treatment;
  • Chronic conditions that cause occasional periods when you or your family member are incapacitated and require treatment by a health care provider at least twice a year; and
  • Pregnancy (including prenatal medical appointments, incapacity due to morning sickness, and medically required bed rest)

Within five (5) business days, absent extenuating circumstances, of receiving the FMLA request and appropriate supporting documentation.