Taking Family or Medical Leave Policy


Effective: July 1, 2010

Western is committed to supporting employees when they face difficult work/life issues that require the use of leave. This policy applies to all faculty and staff and covers leave requests related to:

  • An employee's own serious medical condition
  • A serious medical condition for an eligible family member or significant other
  • Maternity and parental related leave (including foster care and adoption)
  • Military family leave, and
  • Domestic violence leave

Due to the complex nature of the laws, a Frequently Asked Questions webpage was created to address more specific details as it pertains to a particular type of leave and employee group.



POLICY                   Taking Family or Medical Leave                                  POL-U5410.03        

PROCEDURE         Requesting Family or Medical Leave                            PRO-U5410.03A       

PROCEDURE         Reporting Intermittent Family or Medical Leave             PRO-U5410.03B       


Required Forms


All employees requesting leave for a medical or family situation that is expected to require more than ten days of leave must 1) complete the Leave Request Form and 2) provide supporting documentation as listed below.


Leave Type                                               Required Documents

Maternity or Paternity                                    Pregnancy Certification

Injury/ Illness - Self                                       Medical Certification - Self

Injury/ Illness - Family/domestic partner-         Medical Certification - Family

Adoption or Foster Care                                         Verification from placement agency

Military Family Leave                                               Military Orders



If your absence was the the result of your own medical condition, you must provide a Medical Release to Human Resources prior to resuming duties. It may also be necessary to provide a copy of your job description to your healthcare provider for review. Please review your FMLA Designation Notice for more information.

If your absence was a result of a work-related injury, contact the University Claims Manager to coordinate your return to work. (Ph: 360.650.3947)


Related Resources

Domestic Violence Leave for Victims and Family Members

Worker's Compensation Program

Shared Leave Program

Accommodating Persons With Disabilities Policy

Qualified Domestic Partnership Registration - State


Applicable Federal and State Laws

Federal Medical Leave Act - Federal

Family Care and Family Leave - State

Pregnancy, Childbirth and Pregnancy Related Conditions - State

Family Medical Leave Act - Military/Federal

Military Spousal Leave of Absence Law - State



Mika Greathouse

Disability Administrator

Ph: 360.650.3771

Confidential Fax: 360.788.0071

Click here to view Frequently Asked Questions


Page Updated 11.08.2013