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Family & Medical Leave Provisional Notification for Postdoctoral Fellows
(Including research fellows and clinical fellows in non-ACGME accredited programs) (Letter must be copied on department/division letterhead)
TO: ____________________________________ DATE: __________________
On _________________________, we became aware of your need to take family/medical leave due to:
Name: ______________________ Date of Birth: ________ Relationship: _______________ You notified us that you need this leave beginning on _________________ and that you expect leave to continue until on or about ___________________. You have a right under the Family and Medical Leave Act (FMLA) for up to twelve (12) weeks of unpaid leave in a twelve (12) month period (July 1st through June 30) for the reasons stated above, if eligible. The university requires that you substitute accrued paid leave for unpaid FMLA leave. Your health benefits will be maintained during any period of unpaid leave and you will be reinstated to the same position with the same pay, benefits, and terms and conditions of appointment on your return from leave. These points are discussed in more detail below. Based on the information available, it appears that the leave provisionally qualifies as Family and Medical Leave effective _____________________ (date). Should you have any questions concerning your obligations or rights under the University's Family and Medical Leave Policy, please contact (Training Program Director or Administrator.) If you fail to meet the obligations, the taking of Family and Medical Leave may be delayed or denied. CERTIFICATION: You will be required to furnish medical certification of a serious health condition or the serious health condition of a family member. Enclosed is a Certification of Health Care Provider to be completed by your or your family member's health care provider. This initial Certification must be submitted to the Office of Occupational Health Services, Houck 3 East, 600 N. Wolfe Street, Baltimore, MD 21205 within 15 days of this request, or by ______________. Upon receipt of the requested documentation, a final determination will be made. If the documentation you submit does not support Family and Medical Leave, or if you fail to provide the requested documentation, the leave will not be approved as Family and Medical Leave and university policies and procedures covering absences will be applied. The university may require subsequent Certifications during your leave at 30 day intervals or other reasonable times. A new Certification may be requested if the circumstances of your leave change. If you are taking leave on an intermittent or reduced leave schedule, Certification will be required every 12 months. LEAVE BALANCES: As of the date your leave commenced, you had _______ sick days and ________ vacation days remaining. If you are taking leave due to your own serious health condition, for prenatal care or birth of a child, leave will be charged first to any sick time you may have, then to vacation, then to leave without pay. In the event leave is for the birth of a child, once released by your physician, leave will be charged to vacation then to leave without pay. Please refer to Parental, Maternity and Adoption Leave Policy for Postdoctoral Fellows for information regarding paid leave. If you are taking leave due to the serious health condition of a family member (spouse, same sex domestic partner, child or parent), leave will be charged to not more than 12 sick days, then to vacation, then to leave without pay. If you are taking leave due to the adoption of a child, or placement of a child with you for foster care, you will be eligible for six weeks of leave (5 weeks adoption and 1 week parental), then vacation leave, and finally leave without pay. If both parents are members of the house staff or fellows, only the parent who is the primary caregiver would be eligible for the six week paid leave. For postdoctoral fellows who are not paid through JHU, reference to paid leave, including sick time, vacation leave, parental leave and adoption leave refer to the time allotment only and do not confer any right for paid leave unless provided by another source. MAINTENANCE OF BENEFITS: Your health benefits will be maintained under the same condition as if you continued to work. RETURN TO WORK: During leave, you may be required to report periodically on your status and intention to return to work. If the circumstances of your leave change and you are able to return to work earlier than the date indicated above, we ask that you notify us at least two work days prior to the date you intend to report for work. As stated above, you should notify the appropriate authority at least two weeks prior to the expiration of the leave of your intent to return to work and, in any event, must provide a minimum of two days notice of readiness to return to work. If the reason is due to your own serious health condition you must provide a written release from your Health Care Provider stating that you are fit to return to work. This release must be taken to the Occupational Health Services Office in the Phipps Building, 3rd Floor, (410) 955-6211. The Occupational Health Office will give you clearance to return to your job. If such release to return is not submitted, your return to work may be delayed until the release is provided. IMPORTANT NOTICE: Trainees should be aware that the amount of leave taken may affect their ability to meet the requirements of a certifying board, if applicable, and should be discussed with the training program director. If you engage in other employment during this leave, you may be considered to have violated the terms of the leave and have voluntarily terminated your appointment with the university. Please keep this letter as part of your records. You will receive an FML Determination confirming approval or denial of your request for leave. Also, please refer to the attachment outlining your rights and obligations under Family and Medical Leave. If you have any questions about this policy, please contact me or the department administrator, (NAME). Sincerely, (Training Program Director) cc: Levi Watkins, Jr., M.D., Office of Postdoctoral Programs Attachments: Certification of Health Care Provider |
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