Medical Documentation

Employees are required to submit medical documentation for leaves related to serious health conditions. 

Information for Employees

When requesting leave for a serious health condition (defined below), a medical documentation form will be sent to you from our leave administration vendor Workpartners. (Forms are also provided below.) You will have 15 days to submit your completed documentation.

  • If you do not provide your completed documentation within 15 days, you will be placed on a Leave of Absence without Pay (LWOP).
  • If you provide medical documentation within 15 days but it is not sufficient, you will be provided a 7-day extension. If sufficient medical documentation is not received by day 22, you will be placed on LWOP.
  • Please be aware any documentation received after day 30 will result in a denial of the leave and pay. 

If you have questions about medical documentation, please contact Workpartners at 1-833-852-2207 (TTY users, please call 711 and provide the Workpartners telephone number).

The PFMLA defines a serious health condition as a physical or mental condition that prevents one from doing their job either because they are unable to, or because they need time to get treated or recover from treatment. A Serious Health Condition is an illness, injury, impairment, or physical or mental condition that involves (a) inpatient care in a hospital, hospice, or residential medical facility; or (b) continuing treatment by a Healthcare Provider.

The term Serious Health Condition includes any period of incapacity due to pregnancy or for prenatal care, and for childbirth and recovery from childbirth ("maternity leave").

Because an illness that extends beyond three days may qualify as FMLA, serious illnesses should be reported to Workpartners as soon as possible.

Information for DLC Administrators

Once Workpartners has been notified of an employee’s serious illness, a medical form will be sent to the employee. From the date of that letter, the employee will have 15 days to provide the completed medical documentation to Workpartners. The table below shows actions that may be taken related to the submission of the documentation. DLC actions are highlighted in yellow.

TimeframeAction(s) Taken
If the medical documentation is received within 15 days

If the documentation is complete and sufficient, the employee will go on Serious Illness Leave (at 100%) or Serious Illness Reduced Pay (at 80%), if elected. 

If the documentation is submitted but is not sufficient, the employee will be given seven days to obtain the missing information. If the updated medical documentation is received within the seven-day period, the employee will be paid at the Serious Illness or Serious Illness Reduced Pay (SIRP) rate they elected, retroactive to their first day of absence.

If the medical documentation is not received within 15 days

On day 16 (or day 22 after the 7-day extension for insufficient documentation), Workpartners will deny the leave and notify Payroll to place the employee on leave without pay (LWOP).

If the medical documentation is received after day 15 but before day 30

When Workpartners receives sufficient medical documentation, they will begin leave payment on that day. The employee will be paid retroactively at the State Rate between days 16 (or day 22 after the 7-day extension for insufficient documentation) and the date the documentation was received.

Workpartners will send a return file to Payroll to end the employee's LWOP.

If no medical documentation is received within 30 days

The leave request will be denied, the case will be closed by Workpartners, and the employee will be returned to active status.

If the employee has not returned to work:

  • If the employee does not return, the DLC must submit an action to place the employee back on LWOP.
  • The DLC may send a letter to the employee advising them that they are expected to return to work.

If the employee submits documentation after 30 days, there will be no retroactive pay.