Leaves of Absence

Family and Medical Leave Act (FMLA) Information Posters: Click on the English or Spanish PDF to learn about employee rights and qualifying reasons under FMLA leave.

• English PDF
• Spanish PDF
• Fact Sheet #28E

ELIGIBILITY CRITERIA: 

• Have worked for the employer for at least 12 months;
• Have at least 1,250 hours of service in the 12 months before taking leave;

FMLA FORMS:

Certification of Healthcare Provider for a Serious Health Condition

• Employee’s serious health condition, form WH-380-E – use when a leave request is due to the medical condition of the employee.
• Family member’s serious health condition, form WH-380-F – use when a leave request is due to the medical condition of the employee’s family member.

Certification of Military Family Leave

• Qualifying Exigency, form WH-384 – use when the leave request arises out of the foreign deployment of the employee’s spouse, son, daughter, or parent.
• Military Caregiver Leave of a Current Servicemember, form WH-385 – use when requesting leave to care for a family member who is a current service member with a serious injury or illness.
• Military Caregiver Leave of a Veteran, form WH-385-V – use when requesting leave to care for a family member is who a covered veteran with a serious injury or illness.

PREGNANCY DISABILITY FOR FULL-TIME EMPLOYEES:

Pregnancy Disability Leave (PDL) Information: Click on the link below to learn about employee rights under PDL.

• PDL Baby Bonding

ELIGIBILITY CRITERIA FOR PDL: 

• Employees are eligible for up to four months or 17 1/3 weeks of job-protected leave per pregnancy upon hire. Time off will be determined based on the individual employee’s doctor recommendation.
• Full-time employees may take leave under PDL even if they do not meet the eligibility criteria for FMLA/CFRA.

RETURNING FROM PDL OR PFL:

Employees are required to submit a medical release note to HR before they can return to work. The medical release note must specify if the employee is released on full or modified activity. 

CA BENEFITS FOR PART-TIME FACULTY:

Part-time faculty may qualify for income replacement benefits through the EDD programs of Disability Insurance (DI) and California Paid Family Leave (PFL).  https://www.edd.ca.gov/disability/pfl_mothers.htm

 CRITERIA FOR DI & PFL: 

Part-time faculty may apply for benefits through EDD (see eligibility requirements).

• You may be eligible for DI if you are unable to work due to non-work-related illness or injury, pregnancy, or childbirth.
• You may be eligible for PFL to:
  • Care for a seriously ill family member.
  • Bond with a new child.
  • Participate in a qualifying event because of a family member’s military deployment to a foreign country.
• Employees may use their PCCD accrued sick leave hours as income replacement during their leave.

RETURNING FROM PDL OR PFL:

Employees are required to submit a medical release note to HR before they can return to work. The medical release note must specify if the employee is released on full or modified activity. 

• Family Care (English)
• Family Care (Spanish)