How do I apply for a Medical Leave?

To apply for a Medical Leave, you must:

  1. Complete and submit the Application for Leave of Absence form to the Disability Management Office (DMO).
  2. Have your health care provider complete and submit the Certification of Employee's Serious Health Condition form to the DMO. This form substantiates your medical condition and provides the medical details of your time off.
  3. Completed forms may be faxed or mailed to the DMO:
    • Fax: 517-241-9926
    • Mail: Disability Management, PO BOX 30002, Lansing, MI 48909
  4. Notify your supervisor of your time off and follow your department's normal timekeeping procedures until you receive notification that your leave has been approved by DMO.
  5. After receiving all necessary documentation 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 the processing of your leave of absence.