The Family and Medical Leave Act allows up to 12 weeks of unpaid leave for an employee’s own serious health condition, or that of a qualifying family member (parent, spouse or child); or for the birth, adoption or foster care placement of a child. A child is defined as a biological, adopted, or state approved foster child, stepchild, or legal ward; under 18 years of age or incapacitated.
Qualifying Exigency Leave allows up to 12 weeks of unpaid leave to address certain qualifying exigencies arising from the fact that the employee’s spouse, son, daughter or parent is a covered military member on active duty, or call to active duty, in support of a contingency operation.
The FMLA also includes the Military Caregiver Leave entitlement permitting eligible employees up to 26 weeks of leave during a single 12 month period to care for a covered servicemember with an injury or illness incurred in the line of duty.
Eligibility Employees who have worked for the City for at least 12 months and have been in pay status for at least 1250 hours during the previous 12 months.
Schedules FMLA may be taken consecutively, intermittently (disconnected periods of less than 12 weeks), or on a reduced schedule (some leave being taken, such as each week, on a regular basis).
All forms can be faxed to: 316-858-7734, or emailed to: FMLA@wichita.gov, or dropped of at City Hall, 2nd Floor at the HR reception desk.
For basic FMLA, print either the "Employee FMLA Packet" or the "Family Member FMLA Packet," which is located under the Medical Certification Forms column, complete and submit the form to HR, you will receive a response from HR within 5 business days from the date we receive the form in our office.
- Next, either your or your family member's physician needs to complete the Medical Certification portion of the packet.
- Return the physician's medical certification to HR within 15 days from the date of your request. Failure to return the necessary medical certification may result in the loss of FMLA protection.
For Maternity/Paternity Leave click on the link titled "Request for Maternity or Paternity Leave," which is under the Medical Certification Forms column, complete, print and turn in the completed form to HR. You will receive a reply from HR within 5 business days.
· Medical certification is not required for leave to bond with a newborn child or a child placed for adoption or foster care.
· Medical certification is required for FMLA leave for incapacity due to pregnancy (or to care for a pregnant spouse who is incapacitated), for the mother’s serious health condition following the birth of the child, or for the newborn child’s serious health condition.
For Military Family Medical Leave, print and complete the appropriate military certification form and return it to HR within 15 days.
All forms are also available in the HRD. Contact the HRD with any questions about the Family and Medical Leave Act. Phone (316) 268-4531.
Employee Serious Health Condition FMLA Packet
Family Member Serious Health Condition FMLA Packet
Request for Maternity/Paternity Leave
Certification for Serious Injury or Illness of a Covered Servicemember - Military
Certification of Qualifying Exigency
Request to Change Health Benefits Due to FMLA
Notice of Status Change in FML