Care for yourself and your family
Family and medical leave (FML) helps you focus on what matters most when you need to temporarily shift attention from your job to take care of yourself or a family member.
As an employee of the State of Connecticut, you may be eligible for any of the following family and medical leave entitlements:
- Federal FMLA
- CT FMLA
- SEBAC Supplemental Leave
- Pregnancy Disability Leave
- Organ Donor Leave
- Bone Marrow Donor Leave
These leaves allow you to balance your work and family responsibilities while taking job-protected leave for certain family and medical reasons. Read below for more information about these leaves, how to begin the process, and more.
Important resources
The following policies and guidelines provide State employees and human resource professionals with information about the family and medical leave entitlements available.
DAS general letter 39 – FML entitlements (PDF)
Family and Medical Leave Entitlements Manual
Federal Department of Labor FMLA Poster
CT Department of Labor CTFMLA & CTPL Poster
Pregnancy Discrimination and Accommodation Notice
Getting started: employee responsibilities
Contact agency HR
Do you need to take job-protected leave for medical or family reasons? The first thing you should do is contact your agency human resources liaison for leave administration:
- If you work for a State of Connecticut executive branch agency participating in HR Centralization, start your request in the UKG Employee Portal or contact the appropriate DAS Benefits and Leaves Pod assigned to your agency.
- If your agency isn’t in the executive branch or you aren’t sure, please contact your agency’s human resources office.
Standard family and medical leave
- Personal medical leave: Leave for an employee who has their own illness or injury; any period of incapacity due to their pregnancy or prenatal care; the donation of an organ; or the donation of bone marrow.
- Caregiver leave: Leave for an employee whose family member has a serious health condition.
- Bonding leave: Leave for an employee to: bond with a newborn child; process the adoption or bond with a newly adopted child; or process the placement of, or bond with, a newly placed foster child.
Forms for standard leave
These forms provide you with information, help us better understand your leave needs, and grant us permission to use your accruals during your unpaid leave if desired. Use them to request job-protected leave for your own serious health condition, as a caregiver to a qualified individual with a serious health condition, or for bonding leave.
Employee Request Form: FMLA-HR-1
Employee's Intent to Return to Work: Form FMLA-HR-3
Statement of Qualifying Family Relationship: Form FMLA-HR4
Employee Medical Certificate: Form P-33A
Caregiver Medical Certificate: Form P-33B
Military caregiver and exigency leave
- Caregiver for current service member: Leave for an employee whose spouse, son, daughter, parent, or next of kin has a serious injury or illness while on covered active duty.
- Caregiver for a veteran: Leave for an employee whose spouse, son, daughter, parent, or next of kin is a covered veteran who incurred a serious injury or illness while on covered active duty.
- Qualifying exigency leave: Leave for an employee due to a “qualifying exigency” because their spouse, son, daughter, or parent is on covered duty. See DAS General Letter 39 (PDF) for specifics.
Forms for military caregiver and exigency leave
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Use this to apply for leave because of the foreign deployment of your spouse, son, daughter, or parent.
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Use this form when you apply for leave to care for a covered veteran with a serious illness or injury.
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Used to apply for leave to care for a family member who is a covered veteran with a serious injury or illness.
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Use this to document your relationship to the person you’ll provide care for.
After you apply: human resources responsibilities
How HR follows up
HR will review the forms you provided and will notify you of your eligibility for job-protected leave as well as your rights and responsibilities. If approved, HR will:
- Send the approval coding to you and your manager/supervisor
- Coordinate your leave processing with payroll/benefits
If your request is not approved, HR will issue a denial with supporting justification.
Please contact your HR leave specialist with any questions.
Forms for HR use
Notice of Eligibility and Rights and Responsibilities: Form FMLA-HR2a
Designation Notice: Form FMLA-HR2b
Core-CT Coding: Form FMLA-HR2c
The Supervisor's role
How to help the process
Supervisors are important partners in the leave process. They are often the first to know that an employee may have a qualifying reason for family or medical leave. Supervisors are responsible for:
- Contacting Human Resources as soon as possible even if employees don’t specifically use the term “FMLA.”
- Reminding employees to follow agency call-out procedures while their leave approvals are pending and ensure employees are properly coding their time sheet once leaves are approved.
- Tracking an employee’s leave usage to make sure they aren’t overusing their approved leave and communicate any usage concerns to HR.
Supervisors don’t accept medical documents or contact medical providers directly.
Additional resources
It is important to understand that family and medical leave entitlements vary by circumstance. We encourage employees and HR professionals to use our resources before deciding or providing guidance about family and medical leave or related benefits. These resources include: