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Family and Medical Leave Act of 1993 (FMLA) Tracking Form This form is to be used to track FMLA qualifying absences. Employee Name Emplid Department FMLA Benefit Year Month 1 2 3 4 5 6 7 8 9 10 11.

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Employees are entitled to 6 months of leave within a 5-year period. An appointing authority may grant an eligible employee an absence without pay up to 6 months. For Non-FMLA leaves, you must submit the following two forms to the Disability Management Office (DMO):

Under the Family and Medical Leave Act (FMLA) , you may be entitled to up to 12 work weeks of Family Care Leave during a 12 month period.

Employees may take up to 12 weeks of leave in a 12-month period for a serious health condition, bonding with a new child, or qualifying exigencies. This leave renews every 12 months, as long as the employee continues to meet the eligibility requirements set out above.

To apply for a medical leave of absence: Submit your application: Online, or. Print, complete and fax an Application for Leave of Absence. Have your treating physician complete one of the following: FMLA Certification of a Serious Health Condition, or. Non-FMLA Medical Certification. Not sure if you qualify under the FMLA?

To be eligible for FMLA, you must have 12 months of employment with the State of Michigan (does not need to be consecutive) and you must have physically worked 1,250 hours within the previous 12 months.

(2) Except as otherwise provided in subsection (3), an eligible employee must accrue paid medical leave at a rate of at least one hour of paid medical leave for every 35 hours worked. An employer is not required to allow an eligible employee to accrue more than 1 hour of paid medical leave in a calendar week.

Michigan workers have up to 12 weeks FMLA in a 12-month time frame for health conditions, new babies, or other circumstances. These weeks renew every year as long as the worker meets eligibility requirements.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232