Family and Medical Leave

In general, the Family and Medical Leave Act (FMLA) is a federal law that provides up to 12 weeks unpaid, job-protected leave to employees for certain family and medical reasons. Kentucky State Government also offers enhanced Family Medical Leave (FML) benefits in some areas.

To be eligible for family and medical leave, an employee must have:
1. Completed at least twelve months of state service; and
2. Worked or been on paid leave for at least 1,250 hours in the twelve months immediately preceding the first day of family and medical leave.

Application for Family and Medical Leave (Employee completes this and gives to the supervisor or human resource officer) Employee Rights and Responsibilities Under the Family and Medical Leave Act (For employees to review)

FMLA Cover Letter (For employer use)

Forms

The following FMLA forms will expire on February 15, 2015. To access the forms, please see the links provided to the Department of Labor's website. The Department of Labor's website is external to the Personnel Cabinet.    
Notice of Eligibility and Rights and Responsibilities (Employer completes this form and gives to employee)
Designation Notice (Employer completes this form and returns to employee)
Certification of Health Care Provider for Employee’s Serious Health Condition
(Employee has appropriate health care provider complete form and return to supervisor or human resource officer)
Certification of Health Care Provider for Family Member’s Serious Health Condition
(Employee has appropriate health care provider complete form and return to supervisor or human resource officer)
Certification of Qualifying Exigency for Military Leave
(Employee completes the appropriate information on form and return to supervisor or human resource officer)
Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
(Employee has the appropriate health care provider for the Veteran to complete form and return to supervisor or human resource officer)
Certification for Serious Injury or Illness of a Current Servicemember – for Military Family Leave
(Employee has appropriate health care provider complete form and return to supervisor or human resource officer)

Employee Handbook

For more information, please refer to the Family and Medical Leave section of the Employee Handbook.

Related KY Administrative Regulation

101 KAR 2:102, Section 3
101 KAR 3:015, Section 3

Contact

Donna Shelton
FMLA Coordinator
Office of Employee Relations
State Office Building
501 High Street, 3rd Floor
Frankfort, KY 40601
502.564.0348