Family Medical Leave (FMLA) & Medical Certification Requirements


The Family and Medical Leave Act of 1993 (FMLA) guarantees that covered employees will be allowed to use a total of up to 12 weeks of annual leave, sick leave or leave without pay, as appropriate, within a 12-month period, for any of the following reasons:

  • to care for the employee's child after birth, or placement for adoption or foster care;
  • to care for the employee's spouse, child or parent who has a serious health condition;
  • for a serious health condition which makes the employee unable to perform his/her job.
  • a qualifying exigency arising out of the fact that your spouse, son or daughter, or parent who is a Covered Military Member on active duty or call to active duty status in support of a contingency operation.
  • Military caregiver leave because you are the spouse, son or daughter, parent, or next of kin of a Covered Service Member with a serious injury or illness.

Eligibility Requirements


Covered employees are individuals who:

  • have been employed by the State of Louisiana for at least 12 months and
  • have worked at least 1250 hours during the 12-month period immediately preceding the commencement of the leave.

Required Documents and Notification

  • An employee may apply for leave covered under the FMLA by completing the appropriate spaces on the FMLA Request/Notification Form.
  • Thirty days advance notice must be provided when the leave is foreseeable.
  • Medical certification to support the request is required.
  • Medical release to return to work is also required.
  • Employees must maintain regular contact with their supervisor.
  • Recertification may be requested every 30 days.
  • View AgCenter PS-34 for details on medical certification.

AgCenter FMLA Supervisor Checklist

AgCenter FMLA Employee Checklist

For use by the unit: Monthly FMLA Check Up

Employee Rights Under the FMLA

9/4/2024 3:45:37 PM
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