North Carolina State Seal

DOC Personnel

DOC Human Resources logo

Family Medical Leave

                                                           Level A conformance icon, W3C-WAI Web Content Accessibility Guidelines 1.0

Family Medical Leave entitles eligible employees to take up to 12 weeks (480 hours) of leave (paid or unpaid) in a 12-month period for:

(1)    the birth of a child and/or to care for the newborn child;
(2)    the placement of a child with the employee for adoption or foster care;
(3)    the care of a child, spouse, or parent who has a serious health condition;
(4)    the employee's own serious health condition;
(5)    a qualifying military exigency leave for families of covered service members.

Family Medical leave also entitles eligible employees to take a total of 26 work weeks of leave (paid or unpaid) during a 12-month period for:

(1)    Military Caregiver Leave (also known as Covered Service Member Leave) - to care for a covered service member who has a serious injury or illness incurred in the line of duty  on active duty for which he or she is undergoing medical treatment, recuperation , or therapy; or otherwise in outpatient status; or on the temporary disability retired list.

It is the employer’s responsibility to designate Family Medical Leave when an employee is out of work due to a Family Medical Leave qualifying event. However, the employee must provide sufficient medical documentation to include, but not limited to, a beginning and ending date of disability and appropriate medical facts regarding the condition and need for leave.

When the employee returns to work, the employer must return them to the same or like position and shift assignment, pay, schedule, and benefits.

For more information, please refer to the FML Quick Reference Guide.

FMLA Designation Letters and Applicable Forms Description
 MS Word icon Provisional FMLA Designation Letter Letter provisionally designating FMLA pending receipt of additional medical documentation to support FMLA absence.
 MS Word icon Formal FMLA Designation Letter Letter formally designating FMLA once supporting medical documentation has been received and verified.
 MS Word icon FMLA Withdrawal Letter Letter used to withdraw a provisional FMLA designation.  (Note:  This letter can be revised to reflect the specific situation).
 MS Word icon FMLA Expiration Letter Letter used to notify employee of the expiration of the FMLA benefit and to advise employee of their insurance continuation options.
PDF icon  WH380 E Certification of Health Care Provider form for Employee's Serious Health Condition.
PDF icon  WH380 F Certification of Health Care Provider form for Family member's Serious Health Condition.
PDF icon  WH381 Notice of FMLA Eligibility and Rights & Responsibilities.
PDF icon  WH384 Certification of Qualifying Exigency for Military Family Leave.
PDF icon  WH385 Certification for Serious Injury or Illness of Covered Service Member - for Military Family Leave.
 MS Word icon LOA Request Form Leave of Absence Request Form.
 MS Word icon FML Worksheet Tool that can be used to manually monitor the usage of the Family Medical Leave benefit.



Q: Are all employees eligible for Family Medical Leave?

A: No. In order to be eligible for Family Medical Leave you must have been employed by state government for 12 months and have been in pay status for at least 1040 hours prior to the Family Medical Leave qualifying event.

Q: Why do I need Family Medical Leave when I have sick and vacation leave?

A: Your sick and vacation leave does not necessarily guarantee your same or like position, pay, and shift assignment upon returning to work - Family Medical Leave does.

Q: What happens to my health insurance if I am exhausting my Family Medical Leave entitlement and I am placed on Leave Without Pay?

A: Under the Family Medical Leave Act an employee is entitled to guaranteed paid health insurance premiums for the 12-week FML period. However, any portion of the health plan premiums that you paid prior to Family Medical Leave you must continue to pay.

Q: Can I exhaust my sick and vacation leave then begin exhausting my 480 hours of Family Medical Leave?

A: No. An employee cannot exhaust paid leave for any period of time and then be placed on LWOP and be entitled to begin exhausting the 480 hours of FML.

Q: The mother of my child is going to take off work for the first 3 months after the birth of our child. Can I take off work the next 3 months to take care of our child?

A: Yes. Family Medical Leave allows parents to take time from work to care for a newborn provided the leave is taken within a 12-month period following birth.


DOC Personnel Home | DOC Home | NC General Assembly | State Personnel | State Personnel Manual
© 1995-2009 North Carolina Department of Correction. All rights reserved.