How do I apply for an Intermittent Leave or a Reduced Schedule Leave?

To request an Intermittent Leave or Reduced Schedule Leave, you will need to:

  • Complete and submit the (CS-1838) Leave of Absence Application form to the Disability Management Office (DMO).
  • You must include the reason for the leave, the start and duration of your leave and how you would like to use your leave credits during the leave.

For your personal illness, your health care provider will need to complete and submit the (CS-1837) Medical Certification of Employee's Serious Health Condition form to the DMO. This form medically substantiates your need for the leave and provides the medical details of your time off. For a family member’s illness, have the family member’s health care provider must complete the (CS-1839) Family Member’s Serious Health Condition form which must be submitted to the DMO.
Once the DMO receives the required forms, they will be used to evaluate your request.

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

Follow your department’s normal call in procedures. Once the DMO receives your application and medical certification, you and your supervisor will be notified by email and mail of the status of your leave request.

If you must start your intermittent leave or reduced schedule leave earlier than anticipated, you should contact the DMO as soon as practicably possible at 877-766-6447, option 2.

Untimely notice or incomplete forms may delay the processing of your request.