Family Medical Leave (FMLA) Policy

Duke provides Family and Medical Leave (FML) to assist staff in their efforts to balance the operational needs of the workplace with personal needs. Duke’s policy is intended to complement leaves under applicable federal and/or state laws.

For more detailed information, please see Work Absences: Leaves of Absence.

*In this document, "Department Representative" can be the Employee's Supervisor, Department Manager, or HR Representative. The designated person is unique to each Department's internal FMLA process.



Time off (consecutive days or intermittent) is available for personal serious illness; births and adoptions; the care of a child, parent, spouse or registered same-sex partner with a serious health condition; or to care for injured or ill service member (Military Family Leave).

  • Family Medical Leave may not exceed 12 weeks within a rolling 12-month period.
  • Military Family Leave may not exceed 26 weeks within a 12 month period.
  • "Intermittent leave" is understood as time off in increments shorter than 12 consecutive weeks. Intermittent leave may be taken for the care of a spouse, registered same-sex partner, child, or parent who has a serious health condition - or for a staff member's own serious health condition. Neither the care of a child following birth or the adoption or placement of a child with a staff member for foster care may be taken intermittently. Maternity Leave may only be taken on an intermittent basis if medically necessary.


FML entitles eligible staff to time away from work for up to a total of 12 weeks (26 weeks to care for an ill or injured service member or covered veteran) within a rolling 12-month period. FML may be taken for the following reasons:

  • The care of a child following birth or the adoption or placement of a child with a staff member for foster care;
  • The care of a family member (spouse, registered same-sex partner, child, or parent) who has a serious health condition;
  • Staff with health conditions serious enough to cause inabilities in normal work performance.
  • The care of a spouse, son, daughter, parent, or next of kin with a serious illness or injury sustained in the line of duty on covered active duty.
  • An eligible employee with a military member serving in the National Guard or Reserves, or Regular Armed Forces manages their affairs while the member is on active duty in support of a contingency operation. This provision provides 12 workweeks of FMLA job-protected leave available for: (1) Short-notice deployment; (2) Military events and related activities; (3) Childcare and school activities; (4) Financial and legal arrangements; (5) Counseling; (6) Rest and recuperation; (7) Post-deployment activities; (8) Parental care; and (9) Additional activities not encompassed in the other categories, but agreed to by the employer and employee.

During the leave period, the position is held for the staff member’s return. However, staff must have been employed for at least 12 cumulative months during the last seven years and must have worked for at least 1,250 hours during the 12-month period prior to the leave. The 12 months during which the staff member must have been employed do not have to be consecutive.

Note: The use and interpretation of the word "family" as stated herein is applicable only to the "Family and Medical Leave" segments of this manual.

Request for Leave

  • Staff requesting maternity, paternity, or adoption leaves should provide their departments with no less than 30-days notice prior to the date on which the leave is to begin – except in cases in which the date of a birth or adoption placement requires the leave to begin earlier than the 30-day notice. In such cases staff members are expected to provide such notice as soon as  practical.
  • Staff requesting illness and/or injury leaves or leaves to care for seriously ill family members should make a reasonable effort to schedule treatment so as not to unduly disrupt department operations. Such leaves are also subject to the approval of a health care provider. If at all practical, the staff member should provide at least 30 days notice prior to the date on which the leave is to begin.
  • A staff member who is eligible for family medical leave and the reason for the absence qualifies for family medical leave; the time will be attributed to family medical leave. If the staff member declines family medical leave coverage, the absence will be designated as “unscheduled” in compliance with the attendance policy.
  • The Request for Leave of Absence  (Form 1001) should be submitted to Duke Corporate Payroll (Box 90484, Durham, NC 27708).

Use of Accrued Time

Any accrued time in the form of vacation, sick leave, discretionary/designated holidays, or Paid Time Off (STB/LTB/COB) must be used prior to taking an unpaid leave of absence.  Employees are not required to use accrued leaving during periods of time when receiving benefits from the Duke Voluntary Short Term Disability Plan.  The use of accrued time or the short-term disability benefit will not lengthen the duration of the leave.

Job Guarantee*

At the end of the Family Medical Leave period (12 weeks) or at the end of the Military Family Leave period (26 weeks), the staff member will normally return to his or her former position. However, if during the leave, Duke was required to fill this position for operational reasons, the employing department will be responsible for placing the returning staff member in a position of equal status and pay.

*Under the FMLA, “key employees” may be excluded if restoring their job would represent a grievous economic injury to the company. A “key employee” is defined as an employee among the highest paid (10% of all employees of the company).

Additionally, there may be other circumstances when a regular hourly-paid staff member may not be reinstated. Such would be the case if the staff member would have been laid off whether he or she was on family medical leave or not.

Benefits Continuation

Duke will continue to pay the employer's share of the cost of health care premiums during the leave period (12 or 26 weeks).

The staff member should contact the Benefits Office at 684-5600 to determine the procedure for payment of his or her share under group insurance plans should he or she go on unpaid status.

Vacation, Sick Leave, Holiday, and PTO Accrual

Vacation, sick pay, holidays, and PTO will not accrue during any period of unpaid leave.

  • Hourly-paid staff who have insufficient accrued time must have time without pay recorded on their time cards by a payroll representative.

Continuous Service Credit

Length of service accrual is continuous during the leave.

Further Information and Available Forms

Please contact Duke’s Staff & Labor Relations office at 684-2808 (P.O. Box 3904, 1527 Duke South Clinic Building, Durham, NC 27710) or the Leaves of Absence website for detailed information on procedures and forms.

Using Family Medical Leave Intermittently or on a Reduced Schedule

Staff may take leaves intermittently or on a reduced schedule because of a serious or chronic health condition of their own, a family member’s, or for Military Family Leave. Health care provider verification is needed when using intermittent leave for a serious or chronic health condition.

For an intermittent leave or a leave on a reduced schedule, there must be a medical need for the leave – as distinguished from voluntary treatments and procedures – such that the medical need can be best accommodated through an intermittent or reduced-leave schedule. Staff needing such schedules must attempt to schedule their leave so as to create minimum disruption to the department's or unit’s operations. Only the amount of leave actually taken is counted toward the 12 weeks of FML. Where a staff member normally works an abbreviated or part-time schedule, the amount of leave to which the staff member is entitled is determined on a pro-rata basis.

For example:

If a staff member works 30 hours per week, he or she is entitled to a prorated total of 12 weeks of FML in a fiscal year [or 360 hours (30 x 12 = 360)]. If a staff member works 20 hours per week, he or she is entitled to a prorated total of 12 weeks of FML in a fiscal year [or 240 hours (20 x 12 = 240)].

Any intermittent leave or leave on a reduced schedule must be charged against the total hours to which a staff member is entitled in a given 12-month rolling period.

In the case of monthly-salaried staff who take FML intermittently or on a reduced-leave schedule, the staff member and "Department Representative" must agree on the staff member’s normal schedule or average hours worked each week so as to determine the amount of leave to which the staff member is entitled. The actual number of hours is calculated as indicated in the example above. The "Department Representative" must put the agreement in writing and maintain the document in accordance with FML recordkeeping requirements.

A staff member may be temporarily transferred to an alternative position with equivalent pay and benefits in order to accommodate better the recurring periods of planned intermittent or reduced-schedule leaves.

Family Medical Leave Definitions

Please refer to the table below for a list of FML words and phrases and their definitions.


A biological, adopted, legal ward, foster-care, step-child, or child of a person standing in loco parentis ("in place of a parent") who is either under 18 years of age or is 18 years of age or older and incapable of self-care because of a mental or physical disability at the time the leave is to commence. (Note: There is no requirement that the child live with the staff member or be a legal dependent of the staff member.)


A husband or wife as defined by North Carolina state law.

Registered Same-Sex Partners

Two individuals of the same sex who live together and are registered with the Duke Benefits Office as being Same-Sex Spousal Equivalents.


A biological parent, adoptive parent, step-parent, or an individual who stands inloco parentis to a child.

Intermittent Leave

Leave taken in separate blocks of time due to a single illness or injury as opposed to a leave taken in one continuous period of time. “Intermittent Leaves” may be taken in hours, days, or weeks.

Reduced-leave Schedule

A leave schedule that reduces a staff member’s regularly scheduled number of working hours per workweek or workday.

Serious Health Condition

An illness, injury, impairment, or a physical or mental condition resulting in either:

  • A period of incapacity or treatment in connection with or consequent to inpatient care in a hospital, hospice, or residential medical care facility; or
  • A period of incapacity of more than three consecutive calendar days that involves subsequent or continuing treatment by or under the supervision of a health care provider.

Note: A chronic health condition also qualifies as a serious health condition even if a staff member or family member does not receive treatment and if it does not last three days (for example: asthma or severe morning sickness).

Caution: Unless complications arise, ailments such as the common cold, the flu, ear aches, upset stomachs, minor ulcers, and headaches (other than migraines) are not considered as serious health conditions and do not qualify for FML.

Covered Service Member

Service member who is recovering from a serious illness or injury sustained in the line of duty on covered active duty.

Eligible Employee for Military Medical Leave

Spouse, son, daughter, parent, or next of kin of covered service member.

Continuing Treatment by Health Care Provider

A serious health condition involving continuing treatment by a health care provider who must provide:

  • Treatment two or more times or treatment on at least one occasion that results in a regimen of continuing treatments under the health care provider's supervision.
  • Pregnancy or prenatal care. This treatment qualifies the staff member even if she does not receive treatment and even if her care does not last three days.
  • Treatment for a chronic health condition that requires periodic visits for treatment, treatment that continues over an extended period of time, or treatment for episodic rather than continuing incapacities (for example: asthma, diabetes, and epilepsy).
  • Treatment for a permanent or long-term condition for which such treatment may not be effective (for example: Alzheimer's, severe stroke, or the terminal stages of a disease).
  • Treatment either for restorative surgery after an accident or injury or for a condition that would likely result in an incapacity of three or more days if not treated (for example: cancer, severe arthritis, or kidney disease).
  • Treatment for allergies or mental illnesses resulting from stress (but only if these conditions meet all of the other criteria of a serious health condition).
  • Treatment for substance abuse. (Note: Absences due to a staff member’s use of a substance rather than treatment for addiction do not qualify for FML).

Health Care Provider

A doctor of medicine or osteopathy who is authorized to practice medicine or surgery (as appropriate) by the state in which the doctor practices. For example, this may also include podiatrists; dentists; clinical psychologists; optometrists; chiropractors (limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by an x-ray as existing); nurse practitioners and nurse-midwives who are authorized and are performing under the scope of their practice as defined under state law; clinical social workers; and Christian Science practitioners listed with the First Church of Christ, Scientist in Boston, Massachusetts (any additional certification may be required).

Also included in this category are health care providers who practice outside of the United States and any other health care providers from whom the Duke-group health care benefits manager will accept as certified for treating serious health conditions that warrant benefit claims.

Family Medical Leave Designated Responsibilities

Please refer to the table below for information concerning Family and Medical Leave Actions.

FML Action"Department Representative"Staff Member
Notification and Inquiry

It is the "Department Representative's" responsibility to inquire sufficiently about a staff member’s request for extended time away. If the staff member chooses not to tell the "Department Representative" what the nature of the request is, the "Department Representative" should direct the employee to submit the Certification of Health Care Provider (Form 1002) directly to Employee Occupational Health and Wellness (EOHW).

If the leave has already begun, the "Department Representative" must mail the form to the staff member. If there is any change in the information contained on the form, the "Department Representative" must update the form and return it to the staff member within a reasonable period of time.

To help balance the personal needs of the staff member and the business needs of the department or unit, the staff member should – in foreseeable situations – make every effort to provide the "Department Representative" with at least thirty days written notice.

When unforeseen events require FML, staff must give as much notice as possible. Notice may be given either in person or by phone when medical emergencies are involved and may be given orally by the staff member’s family member.
ApplicationApplication for Family and Medical Leave is made through the department head and/or entity or department Human Resources representative with a Leave of Absence Request Form (Form 1001).

• It will be the responsibility of the department to keep accurate records of the amount of leave time taken and to make sure that the staff member understands that his or her 12 weeks has begun to count toward the rolling, 12 months. 
In order to take a leave, a staff member is responsible for providing his or her "Department Representative" with Certification of Health Care Provider (Form 1002). This information is to include the following:
• The date on which the serious health condition commenced.
• The probable duration of the condition,
• The appropriate medical facts.
• Certification that the staff member is unable to perform the functions of his or her position – or in the case of the serious illness of a family member – that the staff member is needed to care for the family member. 
Paid or Unpaid FMLThe "Department Representative" is to review the staff member’s accrued time off (vacation, sick leave and/or holidays) in order to ensure accrued time is used before any unpaid leave is taken.

The "Department Representative" is to ensure that the staff member's time-reporting documents are accurate and complete. 
The staff member is responsible for using any accrued time off (vacation, sick leave, and/or holidays) prior to taking an unpaid leave of absence. 
Return to Work – Job HeldPeriodically, a "Department Representative" is expected to check in with the staff member on leave to report his or her status and intention to return to work.

If the staff member informs the "Department Representative" that he or she:

• intends to return to work, the staff member should provide the "Department Representative" with written documentation informing of the date of return to work.

- requests for a Reasonable Accommodation should refer the employee to Disability Management Services.

• does not intend to return to work – thus giving the "Department Representative" the right to terminate the employment relationship and, in so doing, end the staff member’s family medical leave after the staff member is notified in writing. 
Upon expiration of the leave, it will be the staff member’s responsibility to notify the department to schedule his or her return to work. Should the staff member fail to do this, his or her job can be filled by a regular staff member according to standard procedure. If the FML requested is for the staff member’s own serious health condition, he or she may be required to present medical certification upon return stating that he or she is able to return to work to perform the functions of the job.
Return to Work – Job Not HeldA staff member returning from an extended leave (in excess of 12 weeks) whose job has not been held may apply for a transfer through the Recruitment Office. The Recruitment Office will refer the staff member to position openings for which he or she is qualified.A staff member returning from an extended leave whose job has not been held, may apply for a transfer through the Recruitment Office. The Recruitment Office will refer the staff member to position openings for which he or she is qualified.