Family Member Health Leave
A serious health condition is an illness, injury, impairment, physical or mental condition of the employee’s spouse, parent, or minor child that also involves:
- Inpatient care in a hospital, hospice, or a residential medical care facility.
- More than three consecutive days of incapacitation plus continuing treatment by a health care provider.
- Incapacitation regarding pregnancy.
- Permanent or long-term conditions.
- Ongoing treatment for a condition that, if left untreated, would result in an incapacity of more than three calendar days.
An adult child who has a serious health condition (defined above) must also be “incapable of self-care" because of a mental or physical disability at the time that FMLA leave is to commence.
Intermittent Leave
Employees approved for intermittent leave to care for a family member are not required to submit a doctor’s note after each absence. Employees and supervisors are required to track and submit intermittent FMLA usage on the monthly Intermittent Family and Medical Leave Time Tracking Report (link requires VPN).
How to Apply
Submit BOTH items below via LeaveAdministration@UTSouthwestern.edu to Leave Administration for consideration of the FMLA request.
- A completed Family and Medical Leave Act Request Form (link requires VPN). (The employee’s supervisor may submit a request form on behalf of the employee if they are absent regarding one (1) night of their family member’s hospitalization or if the employee is absent for more than three (3) consecutive days because of their family member’s condition.)
- The completed first page of WH-380-F Certification of Health Care Provider for Family Member's own Serious Health Condition (link requires VPN), which then must be submitted to the family member’s treating provider. (Supervisors should never receive/retain this information.)
Questions about leave?
Leave Administration
214-648-9840