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Human Resources

Family and Medical Leave


This website provides information to assist Fredonia employees and supervisors with understanding family and medical leave options and leave request process.  For additional assistance, or to request a leave consult for family or medical reasons please contact Human Resources at 716-673-3434. 

FMLA Overview


Request Process


Additional Resources


FMLA Overview

 The Family and Medical Leave Act (FMLA) is a federal law that provides eligible employees the right to take unpaid leave (or paid leave if charged to appropriate leave credits) for certain health and family-related reasons.  Employees cannot exceed a combined total of 12 workweeks of FMLA leave per calendar year for all qualifying reasons combined (excluding military caregivers). 

Per New York State policy the first 12 weeks of a qualifying absence in a calendar year will be designated as FMLA leave. Employees and supervisors must notify Human Resources when an absence (continuous or intermittent) falling under one of the qualifying categories is expected to last five or more days, regardless of whether accruals will be charged. Prompt notification is essential for Human Resources to notify employees of their FMLA status and advise on available leave options.

Notice to Employees of Rights and Responsibilities under the FMLA

Benefits provided through the FMLA do not replace or reduce benefits otherwise available under the Attendance Rules and negotiated agreements. FMLA leave is one of several family and medical leave benefits that may be available to New York State employees. Multiple elements of employment status including bargaining unit, pay basis, work schedule, and/or length of service are used to determine an individual's eligibility for specific family and medical leave benefits. When authorized, FMLA entitlement runs concurrent with other leave benefits provided by the Attendance Rules and negotiated agreements (i.e. sick, Workers' Compensation, pregnancy, childcare, etc.). Employees who are not eligible for FMLA-qualified leave may still be eligible for non-FMLA leave benefits in accordance with the Attendance Rules and applicable negotiated agreement policies.  Employees are encouraged to contact the HR Benefits Coordinator to discuss available leave options and process.

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Click HERE for a printable version of the Family & Medical Leave Guidelines


  • Birth of a son or daughter, and to bond with the newborn child;
  • Placement with the employee of a child for adoption or foster care, and to bond with that child;
  • Provide care for an immediate family member with a serious health condition (spouse, child, or parent – but not a parent “in-law”);
  • Medical leave when the employee is unable to work because of a serious health condition; or
  • Military family: exigency or caregiver


When a leave is FMLA-qualified, Fredonia employees are entitled to:

  • Up to 12 weeks of unpaid leave entitlement per calendar year (26 weeks for military caregiver)
    • Leave is paid only if employee elects to charge appropriate leave accruals. Use of paid leave accruals is subject to provisions of Attendance Rules and applicable Bargaining Agreement.
  • Maintenance of health benefits
    • If leave is paid, premiums will continue to be deducted from paycheck
    • If leave is unpaid, premiums will be billed at the same cost as active employees
  • Restoration to original or equivalent position upon return from FMLA leave


To be eligible, employee must have completed 12 cumulative months of NY State service; AND must have worked a minimum of 1,250 hours during the 52 weeks immediately prior to the start of leave.  Hours actually worked include overtime, but do not include holiday, vacation, sick and other paid or unpaid leave. 


  • Employee should request leave using the Family & Medical Leave Request Form a minimum of 30 days before leave begins.  For emergency leave, notify HR as soon as possible.
  • Absence due to reasons stated above may be designated as FMLA leave by Human Resources even if not requested by employee.
  • Medical Certification acceptable to management is required to support FMLA leave and the use of sick leave accruals.
  • Workers' Compensation leave runs concurrent with FMLA leave.
  • Employees are required to inform supervisor and HR Benefits Coordinator of changes to a leave status (i.e., early return, extended absence, etc.)

24 hours PRIOR to returning for work, an employee on medical leave must submit to HR a note from their health care provider stating they are cleared to work without restrictions, including the date.    Employees not able to return to work as anticipated are required to provide updated medical documentation to extend the leave.

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 Leave Request Process:

FMLA Process

Click HERE for the Family & Medical Leave Quick Guide, which details the process pictured above.

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Family & Medical Leave Request Form

Certification for Employee's Serious Health Condition (WH-380E)

Certification for Family Member's Serious Health Condition (WH-380F)

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Additional Resources:

Benefits Information for NYS Employees on Leave Without Pay 

CSEA Guide to Leave Benefits

Classified Staff Leave Regulations

FMLA Frequently Asked Questions

Professional Leave Regulations

UUP Family Leave Guide

Workers' Compensation Leave

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Page modified 5/26/16