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County Of Sonoma › Administrative Support & Fiscal Services › Human Resources › Employee Resources › Administrative Policy Manual › Section IV Procedures for Use of Medical Leave
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4-10 Medical Leave Policy - Section IV: Procedures for Use of Medical Leave

Human Resources Disability Management 750

Section IV: Procedures for Use of Medical Leave

The purpose of this section is to provide information to employees to successfully manage their medical leave. This section explains how to begin the process of requesting a medical leave, identifies the type of documentation to include in the request, describes how to schedule or extend a medical leave, explains what is needed to return to work from a medical leave, and discusses requests for continuation of health benefits.

  1. Employee Notifies Department of Leave Need: To trigger FMLA/CFRA/CPDL leave protections, an employee must inform (verbally or in writing) their supervisor of the need for FMLA/CFRA/CPDL-qualifying leave and, if known, the anticipated timing and duration of the leave. The employee may do this by either requesting FMLA/CFRA/CPDL leave specifically, or explaining the reasons for leave that would allow the department to determine that the leave is FMLA/CFRA/CPDL-qualifying. For example, the employee might explain that:
    1. The leave is for their own serious medical condition or is related to their pregnancy.
    2. The leave is to care for a qualifying family member.
    3. They have a new child and are requesting leave to bond with the child.
    4. The leave is due to a qualifying exigency caused by a covered military member being on active duty or called to active duty status.
    5. The leave is to care for a family member who is a covered servicemember with a serious injury or illness.

Calling in “sick,” without providing the reasons for the needed leave, will not be considered sufficient notice for FMLA/CFRA/CPDL leave under this policy. An employee must respond to the County’s lawful questions to determine if absences are potentially FMLA/CFRA/CPDL qualifying, and provide sufficient medical documentation, as discussed in section 4. B.

If an employee fails to explain the reasons for FMLA/CFRA/CPDL-qualified leave, the leave cannot be approved. When an employee seeks leave due to FMLA/CFRA/CPDL-qualifying reasons for which the County has previously provided FMLA/CFRA/CPDL protected leave, they must specifically reference the qualifying reason for the leave or the need for FMLA/CFRA/CPDL leave. NOTE: “Reason” does not mean “diagnosis”. Refer to section 2. A. for FMLA/CFRA/CPDL-qualifying reasons.

When the need for leave is foreseeable, an employee must provide 30 calendar days’ advance notice of the need to take FMLA/CFRA/CPDL leave. When 30 calendar days’ notice is not possible, or the approximate timing of the need for leave is not foreseeable, an employee must provide the County notice of the need for leave as soon as possible under the facts and circumstances of the particular case.

An employee who fails to give 30 calendar days’ notice for foreseeable leave without a reasonable explanation for the delay, or otherwise fail to satisfy FMLA/CFRA/CPDL notice obligations, may have FMLA/CFRA/CPDL leave delayed or denied.

The County may retroactively designate leave as FMLA/CFRA-qualifying leave with appropriate written notice to the employee and where prior lack of designation does not cause harm or injury to the employee.

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  1. Employee Submits Required Documentation: At the time of the leave request, a Request for Leave of Absence form must be completed by the employee or by their department’s human resources personnel on the employee’s behalf. The employee must also submit a completed medical certification or note from their medical provider (or from their qualifying family member’s medical provider, in the case of leave to care for a family member) containing the required information. Generally, the employee must provide the requested information within 15 calendar days, unless it is not practical to do so despite the employee’s diligent good faith efforts. The department will inform the employee if the documentation provided is incomplete or insufficient and will provide the employee at least 7 calendar days to cure deficiencies. The failure to cure deficiencies or otherwise fail to submit requested medical certification in a timely manner may result in the County not being able to approve FMLA/CFRA/CPDL leave.

    County-provided medical certification forms are available for the various types of leave covered under this policy and provide the necessary questions to the healthcare provider to determine if leave is FMLA/CFRA/CPDL qualifying. The employee may submit their health care provider’s own form/medical note as long as it contains the required information.

    If the department has a good faith, objective reason to doubt initial medical certifications regarding the employee’s own serious health condition, it will consult with the Human Resources Disability Management unit and may require the employee to obtain a second opinion at the department’s expense. If the opinions of the initial and second health care providers differ, the department may, at its expense, require the employee to obtain a third, final and binding certification from a health care provider designated or approved jointly by the department and the employee. The department will reimburse the employee for any reasonable “out of pocket” travel expenses incurred to obtain second or third medical opinions.
    1. Medical Certifications/Notes for non-military FMLA/CFRA/CPDL Leave: Medical certifications for both an employee’s own medical condition/disability and for family members’ medical condition/disability must include:
      1. The date, if known, on which the serious health condition commenced.
      2. The probable duration of the condition.
      3. An estimate of the amount of time the health care provider believes the employee needs to care for themselves, or the qualifying family member.
      4. A statement that, due to the serious health condition, the employee is unable to work. When the leave is requested in order for the employee to care for a qualifying family member, a statement that the serious health condition of the family member warrants participation of the employee to provide care during a period of treatment and/or the need to provide direct care to the family member.
      5. Under no circumstance will the County inquire about or require information that identifies the serious health condition involved. The employee may identify the nature of the serious health condition, at the employee’s option.
    3. Certifications for Military FMLA/CFRA Leave:
      1. Upon request, the first time an employee seeks leave due to qualifying exigencies (FMLA/CFRA) arising out of covered active duty or call to active duty status of military members, the department may require the employee to provide:
        1. A copy of the military member’s active duty orders or other documentation issued by the military indicating the military member is on covered active duty or call to active duty status and the dates of the military member’s active duty service.
        2. A certification from the employee setting forth information concerning the nature of the qualifying exigency for which leave is requested.
        3. The employee shall provide a copy of new active duty orders or other documentation issued by the military for leaves arising out of qualifying exigencies as a result of a different covered active duty or call to active duty status of the same or a different military member.
      2. When leave is taken to care for a covered servicemember with a serious injury or illness (FMLA Only), the department will require the employee to obtain certification or a medical note completed by an authorized health care provider of the covered servicemember. In addition, and in accordance with the FMLA regulations, the County may request that the certification/note submitted by the employee set forth additional information provided by the employee and/or the covered servicemember confirming eligibility for such leave.
  2. Leave Approval Authority for Longer Duration Medical Leave Requests: Requests for medical leaves less than six months duration are submitted for consideration to the department head/designee. Requests for medical leaves of six months or longer in duration require approval by department heads/designee and the Human Resources Director/designee. This differs from FMLA/CFRA/CPDL leaves, which are statutorily mandated and must be granted for all eligible employees. However, these leaves still require the appropriate documentation for approval.

    An employee who is not on approved leave is considered absent without official leave, which could subject the employee to disciplinary action.
  3. Cooperating in the Scheduling of Leave: When planning medical treatment for an employee or family member or requesting to take leave on an intermittent or reduced schedule work basis, the employee must consult with their supervisor or designee and make a reasonable effort to schedule treatment so as not to unduly disrupt the County’s operations. The employee must consult with their supervisor or designee prior to the scheduling of treatment in order to work out a treatment schedule which best suits the needs of both the department and the employee, subject to the approval of the applicable health care provider. When the employee takes intermittent or reduced work schedule leave for foreseeable planned medical treatment for the employee or a family member, including a period of recovery from a serious health condition, or to care for a covered servicemember, the department may temporarily transfer the employee to an alternative position with equivalent pay and benefits for which the employee is qualified and which better accommodates recurring periods of leave.
  4. Using Paid Leave during Unpaid FMLA/CFRA/CPDL Leave: The use of paid time off during unpaid family/medical leave time does not extend the length of FMLA/CFRA/CPDL leaves, and the paid time off runs concurrently with the FMLA/CFRA/CPDL Leave.
    1. If an employee requests FMLA/CFRA/CPDL leave due to their own serious health condition/disability or to care for a covered family member with a serious health condition (including Military Caregiver FMLA), they must first use accrued paid sick leave for otherwise unpaid leave, but they may elect to reserve a balance of 40 hours of accrued sick leave. The employee may choose to use accrued vacation or compensatory time off for unpaid FMLA/CFRA/CPDL leave once their sick time is exhausted or reduced as described above, as allowed under their applicable union contract/Salary Resolution.
    2. If an employee requests CFRA leave to bond with a newborn, adoptive or foster child, they may first use any accrued vacation or compensatory time off for unpaid family/medical leave as allowed under their applicable MOU/Salary Resolution. The employee may not use accrued sick leave for the purposes of bonding with a newborn, adoptive, or foster child.
    3. A leave of absence in connection with a workers’ compensation injury/illness or for which an employee receives short term or long term disability benefits shall run concurrently with FMLA/CFRA leave, except for those Safety personnel members on authorized on 4850 leave which does not run concurrently. Upon written request, the department may allow the employee to use accrued paid time off to supplement any paid workers’ compensation or short term disability benefits consistent with the type of applicable leave, applicable union contract/Salary Resolution, and County policy. Certain union contracts or the Salary Resolution may require use of accrued sick time to supplement paid workers’ compensation benefits; please refer to the appropriate union contract or Salary Resolution for more information.
  5. Medical Recertification: Depending on the circumstances and duration of FMLA leave, the department may require an employee to provide recertification of medical conditions giving rise to the need for leave every thirty days. For chronic or long-term conditions, the County may require certifications every six months.

    For leave that also qualifies under CFRA, recertification will be requested only when a prior medical certification has expired or is about to expire and the employee requests additional leave. Conditions indicated as permanent/long-term/ongoing will not need to be recertified, though the department may check-in with the employee on a yearly basis to see if their leave needs have changed. The department will notify the employee if recertification is required and will give them at least 15 calendar days to provide medical recertification. No medical recertification will be required for military caregiver leave.

    In general, the employee is responsible to notify the department if their leave needs change, and the department may seek updated certification if the employee’s leave usage does not correspond to the certification on file.
  6. Reporting Changes to Anticipated Return to Work Date: If an employee’s anticipated return to work date changes and it becomes necessary for the employee to take more or less leave than originally anticipated, the employee must provide the department with reasonable notice of the employee’s changed circumstances and new return to work date. If an employee gives the department unequivocal notice of their intent not to return to work, the County’s obligation to maintain health benefits (subject to COBRA requirements) and to restore their positions will cease.
  7. Return to Work Medical Certification: An employee returning to work from a FMLA/CFRA leave that was taken because of their own serious health condition must provide their department a medical certification/medical note confirming the employee is able return to work. A clearly defined end date on the initial certification/medical note will suffice, or the employee may provide a separate certification/medical note indicating their ability to return to work prior to the end of the leave.
  8. Paying Employee’s Share of Health Insurance Premiums:
    1. If, during a leave, the County is continuing to pay the County portion of benefit plan premiums in accordance with section 2. C. 2. a. and/or 2. C. 2. b. of this policy, and an employee is using paid time during the medical leave, the County will deduct the employee’s shares of the premium as a regular payroll deduction.
      1. If the employee is unpaid or has insufficient paid time to cover the employee share of the premium, and the employee desires to continue health benefits while on medical leave, the employee must pay their portion of the premium directly to the Auditor-Controller’s Office.
        1. Please note the County’s obligation to maintain health care coverage ceases if the employee’s premium payment is more than 30 days late. Please see the applicable MOU/Salary Resolution for details. If benefit coverage lapses, the employee and/or the employee’s dependents may be eligible to enroll in COBRA benefits and the employee will be notified of their COBRA rights and eligibility as appropriate.
    2. If, during a leave, the County is no longer paying the County portion of benefit plan premiums in accordance with section 2. C. 2. c., the employee will either pay the full premium directly to the Auditor-Controller’s Office or will be notified of their COBRA right to continue group health insurance benefits at the employee’s cost, in accordance with negotiated union contract or Salary Resolution provisions.