How do I apply for a Family Care Leave?

To apply for a Family Care Leave under the Family and Medical Leave Act (FMLA), you will need to:

  1. Complete and submit the Leave of Absence Application form to the Disability Management Office.
  2. Your family member’s health care provider must complete and submit the Family Member’s Serious Health Condition form to the Disability Management Office.

    Completed forms may be faxed or mailed to the DMO:
    Fax: 517-241-9926
    Mail: Disability Management, PO BOX 30002, Lansing, MI 48909

  3. Notify your supervisor of your request for time off and follow your department's normal timekeeping procedures until the DMO has approved your leave.
  4. DMO will:
    • Email your supervisor & 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 must start your leave earlier than anticipated, you should contact the DMO as soon as practicably possible at 877-766-6447 (Select Option #2). Untimely notice or incomplete forms may delay the processing of your leave.