University of Southern Indiana

Leaves of Absence

Occasionally, an employee may need to be absent from work for an extended period because of illness, disability or other compelling reasons. To request a leave of absence, an employee should complete a Personal Leave of Absence Request Form or an FMLA Leave Request Form and submit the form to Human Resources.

For more information on leaves, please refer to the University Handbook, Leaves of Absence Policy, Section D.7 and Parental Leave Policy D.13.

Submit Leave Forms here.  


Frequently Asked Questions

  • Do I need to take FMLA if I have plenty of sick time available?

Sick time is not job protected leave. Sick time is not intended as earned time off with pay and will not be granted except for bona fide illness and medical appointments.  

  • What is the Family Medical Leave Act (FMLA)?

The FMLA is a federal law that provides up to 12 weeks (450 hours) of unpaid, job protected leave for eligible employees.

  • Who is eligible for FMLA?

Employees compensated through payroll that have worked 12-months and 1,250 hours prior to their leave of absence.

  • How are my 12 weeks (450 hours) calculated?

Eligible employees’ FMLA is calculated on a “rolling” 12-month period. It is measured backward from the date of any FMLA leave usage. (Each time an employee takes FMLA leave, the remaining leave is the balance of the 12 weeks not used during the 12 months immediately before the FMLA leave is to start.)

Example: Archibald Eagle has taken FMLA on May 1 using 75 hours (2-weeks). Archibald has 375 hours (10-weeks) remaining of FMLA job protected time.

  • What reasons would I need to take FMLA job protected leave?

Your own serious medical condition

♦Birth and bonding of a newborn child, adoption, foster

♦You are needed to care for a family member due to a serious medical condition. Family member is your: Spouse, Parent, Child Under 18, Child 18 years or older and incapable of self-care because of a mental or physical disability

♦A qualifying exigency arising out of the fact that your family member is on covered active duty or has been notified of an impending call or order to covered active-duty status. Your family member on covered active duty is your: Spouse, Parent, Child of any age

♦You are needed to care for your family member who is a covered service member with a serious injury or illness. You are the service member’s: Spouse, Parent, Child, Next of Kin

  • What constitutes as a “serious medical condition”?

A “serious health condition” is defined as an illness, injury, impairment, or physical or mental condition that involves inpatient care or continuing treatment by a health care provider.

  • What qualifies for FMLA?

Inpatient (overnight stay) in hospital

♦Incapacity Plus Continuous Treatment: A period of incapacity of more than three consecutive, full calendar days that involves either:

Ο Two or more in-person visits to a healthcare provider for treatment within 30 days of the first day incapacity unless extenuating circumstances exit. The first visit must be within seven days of the first day of incapacity; or,

Ο At least one in-person visit to a health care provider for treatment within seven days of the first day of incapacity, which results in regimen of continuing treatment under the supervision of the health care provider. For example, the health provider might prescribe a course of prescription medication or therapy requiring special equipment.

♦Pregnancy

♦Chronic Conditions: Any period of incapacity due to or treatment for a chronic serious health condition, such as diabetes, asthma, migraine headache. A chronic serous health condition is one which requires visits to a health care provider (or nurse supervised by the provider) at least twice a year and recurs over an extended period of time. A chronic condition may cause episodic rather than a continuing period of incapacity.

♦Permanent or Long-term Condition: A period of incapacity which is permanent or long-term due to a condition for which treatment may not be effective, but which requires the continuing supervision of a health care provider, such as Alzheimer’s disease or the terminal stages of cancer.

♦Conditions Requiring Multiple Treatments: Restorative surgery after an accident or other injury; or, a condition that would likely result in a period of incapacity of more than three consecutive, full calendar days if the patient did not receive the treatment.

  • How do I request FMLA?

Obtain an FMLA Request Form here

  • How much notice do I give my employer (USI) for a FMLA Leave Request?

You are required to provide the University 30 days advance notice for any foreseeable leaves. Provide as soon as possible for unforeseeable notices.

Faculty are required to provide the University at least a one semester notice for foreseeable leaves due to their course schedules.

  • What if I have more than one “serious medical condition”?

Employees may have more than one approved FMLA. Each “serious medical condition” must be individually assessed and certified by their healthcare provider specialist(s).

Each “serious medical condition” may apply to the employee, their qualifying family member(s), or a combination of these factors.

For example, an employee is under a healthcare provider’s care with chronic migraines and attends counseling sessions with a psychiatrist. Employee needs to apply FMLA for each “serious medical condition”. If both FMLA cases are approved, employee will be assigned FMLA Self #1 and FMLA Self #2 to maintain confidentiality.

  • How do I call in for an FMLA intermittent absence?

You need to notify your supervisor (direct report) when missing work for FMLA in advance, if possible. Otherwise, notification must be communicated at the same time you would notify your supervisor of any regular absence. You must state your absence as FMLA. Do not provide your confidential medical information. If you have more than one approved FMLA, state FMLA Self #1, FMLA Family #2, e.g., so the FMLA usage is applied to the appropriate certified FMLA case.   

  • Do I need to call in my absences daily during my approved consecutive FMLA?

No. Once you and your department have received the FMLA Designation approval letter/email from Human Resources-Benefits, it will state the approved begin leave date and expected return to work date.

  • Do I need to provide human resources and/or my department a doctor’s excuse?

You will only need to provide human resources your release to return to work documentation from a consecutive leave of absence and/or inpatient (overnight) hospitalization.

  • Does Human Resources have a release to return to work documentation form for my healthcare provider to complete?

No. The release to return to work documentation needs to have the following information on your healthcare provider’s letterhead:

♦Employee Name

♦Release to return to work date

♦No restrictions or if restrictions (Light Duty), listing the restrictions (Examples: lift no more than 10 lbs, no standing, remote work, etc.)

♦If restrictions, must state how long restrictions are in place (Examples: until next follow-up appointment on MM-DD-YYYY or 1 week from current date, etc.)

  • Where do I submit my release to return to work documentation?

 Email documentation here or fax at 812-228-5068.

  • I had an outpatient procedure done or encountered a non-work injury (e.g., car/bicycle accident) and/or have work restrictions. What should I do?

Contact the ADA Coordinator in Human Resources at 812-625-4583 for potential work accommodations.

  • How do I complete my leave of absences through payroll for an FMLA intermittent absence?

The University requires employees to use their available accrued paid time concurrently (at the same time) of their approved FMLA job protected leave(s). The Leave of Absence policy states that for the employee’s own serious health condition, the employee must first use all accumulated sick leave, compensatory time, and earned vacation prior to being placed in a non-pay status. Must be recorded on a quarter of an hour basis regardless of the employee's status. Please note that this includes salaried employees.

Support staff (hourly non-exempt) employees must report their FMLA usage on their bi-weekly timesheets. Mark an “X” in the FMLA column to the absent day(s). Write the number of hours in the paid column(s). Total must equal 7.5 hours. For those that turn their time in via email, please write “FMLA” on dates and times for your FMLA usage.

Administrative staff and faculty member (salary exempt) employees must report their FMLA usage on their ‘Monthly Payroll Absence Report’. Mark an “X” in the FMLA row to the absent day(s). Write the FMLA days/hours in the comments section. For FMLA purposes, each workday is 7.5 hours. For those that turn their time in via email, please write “FMLA” on dates and times for your FMLA usage.

  • How do I complete my leave of absences through payroll for an FMLA consecutive absence?

Employees on a consecutive FMLA are not required to complete timesheets/monthly absence reports during their leave of absence. Their departments will note “FMLA” on the recaps and human resources will calculate their paid time off while on job protected leave.

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