How do I apply for a Maternity Leave?

To apply for a Maternity Leave, you will need to:

Complete and submit the Application for Leave of Absence form to the Disability Management Office (DMO).
Your health care provider must complete and submit the Certification of Employee's Serious Health Condition form to the DMO.  This form medically substantiates your pregnancy and provides the medical details of your time off.
Completed forms may be faxed or mailed to the DMO:

Fax: 517-241-9926
Mail: Disability Management, PO BOX 30002, Lansing, MI 48909

Notify your supervisor of your time off and follow your department’s normal timekeeping procedures until the DMO has approved your leave.
DMO will:

  • Email your supervisor and HR office of your request for leave.
  • Mail you a letter providing your available FMLA entitlement.
  • Mail you a letter of approval or denial of the leave request.

If you need to start your leave earlier than anticipated, you should contact the DMO as soon as possible at 877-766-6447, option 2.

Untimely notice or incomplete forms may delay processing of your leave of absence.