Family and Medical Leave
**Please note: The information on this webpage is intended for Executive Branch state employees. For information outside of state government, please contact the US Labor Department Wage and Hour Division at 502.582.5226.
In general, the Family and Medical Leave Act (FMLA) is a federal law that provides up to 12 weeks unpaid, job-protected leave to employees for certain family and medical reasons. Kentucky State Government also offers enhanced Family Medical Leave (FML) benefits in some areas.
Eligibility for FMLA
To be eligible for family and medical leave, an employee must have:
1. Completed at least twelve months of state service; and
2. Worked or been on paid leave for at least 1,250 hours in the twelve months immediately preceding the first day of family and medical leave.
Employee Rights and Responsibilities Under the Family and Medical Leave Act (For employees to review)
FMLA Cover Letter (For employer use)
Application for Family and Medical Leave (Employee completes this and gives to the supervisor or human resource officer)
HIPAA Authorization Form (Agencies may use to request authentication or clarification of FMLA certification paperwork provided by employees)
Forms
To access the following FMLA forms, please see the links provided to the Department of Labor's website. The Department of Labor's website is external to the Personnel Cabinet.
Notice of Eligibility and Rights and Responsibilities (Employer completes this form and gives to employee)
Certification of Health Care Provider for Employee’s Serious Health Condition
(Employee has appropriate health care provider complete form and return to supervisor or human resource officer)
Certification of Health Care Provider for Family Member’s Serious Health Condition
(Employee has appropriate health care provider complete form and return to supervisor or human resource officer)
Certification of Qualifying Exigency for Military Leave
(Employee completes the appropriate information on form and return to supervisor or human resource officer)
Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (Employee has the appropriate health care provider for the Veteran to complete form and return to supervisor or human resource officer)
Certification for Serious Injury or Illness of a Current Servicemember – for Military Family Leave
(Employee has appropriate health care provider complete form and return to supervisor or human resource officer)
Designation Notice (Employer completes this form and returns to employee)
Employee Handbook
For more information, please refer to the
Family and Medical Leave section of the Employee Handbook.
Related KY Administrative Regulation
101 KAR 2:102, Section 3
101 KAR 3:015, Section 3
Contact Information
Kentucky State Office Building
501 High Street, 3rd Floor
Frankfort, KY 40601
For inquiries, submit an email to
Nila.Meeks@ky.gov. Please include your contact information.
