Forms and Resources

Resources

Guides, Charts, and Calculators

• Time Off and Leave Summary
• Conversion Chart for Minutes to Tenths of Hours
• University Leaves - Quick Reference Guide
• Civil Service Accrual Calculator, 37.5hrs
• Civil Service Accrual Calculator, 40hrs
• FML UIC Process Flow Chart
• Leave of Absence Procedure
• Leave of Absence Responsibility Matrix

Letters

• FML Approval, Intermittent
• FML Approval, Provisional Intermittent
• FML Approval of Time, Birth
• FML Approval of Time, Employee
• FML Approval of Time, Temporarily Reduced Schedule
• FML Denial, Non-Qualifying Family Member
• FML Denial, Time Exhausted
• FML Denial, No 1250hrs

Forms / Approval Process

Blood/Blood Platelet Donor

Leave time for donation should be arranged at a time that is workable for both employee and the department. When requesting leave, please provide your supervisor with as much advanced notification as is possible.

Disability

To apply for disability, contact ER/HR.

Disaster Service Volunteer

Employer approval will be granted upon supervisor's receipt of certification and documentation of agency request. The Disaster Service Volunteer Leave Act states that, "Leave under this act shall not be unreasonably denied for services related to a disaster within the United States or its territories."

Election Judge Leave

The employee must provide his/her supervisor or department with written request for this leave at least 20 days in advance.

Family Military Leave

Employee must provide certification from the proper military authority as documentation when requesting leave. If leave will be longer than 5 days, the employee should give at least 14 days notice. If leave will be less than 5 days, the employee should give advance notice as is practicable.

Family and Medical Leave Policy (FML UIC Process Flow Chart)

Policy ( PDF )

Employee Rights and Responsibilites ( PDF | RTF )

Application ( PDF | RTF )

Medical Certification
Is required in addition to the FMLA application if leave is due to a serious health condition of the employee or family member.

• • For Employee’s Serious Health Condition: ( PDF | RTF )
  • For Family Member’s Serious Health Condition: ( PDF | RTF )
  • For Serious Injury or Illness of Covered Servicemember: ( PDF | RTF )

Certification of Qualifying Exigency for Military Family Leave ( PDF | RTF )
Is required in addition to the FMLA application if leave is due to a qualifying exigency.

Funeral/Bereavement

Upon request, eligible employees are granted funeral leave when informing their supervisor of the need.

Illinois Volunteer Emergency Worker Job Protection Act

The employee must make a reasonable effort to notify his/her employer that he/she may be absent or late to work.

The employer has the right, following the employee's absence, to request that the employee provide a written statement from the supervisor or acting supervisor of the volunteer fire department or governmental entity that the volunteer emergency worker serves. This document should state that the employee responded to an emergency and indicate the time and date of the emergency.

Jury Duty

Civil Service employees shall request jury duty leave from their appropriate supervisor. Employees are expected to report to work whenever their services are not required by the court during their normally scheduled workday and call their supervisors for report-to-work instructions unless earlier arrangements were approved.

For academic employees, arrangements for jury duty leave are made between the department head and the employee.

Military Leave

Employees should receive approval from their appropriate supervisor or campus executive officer. Such leave will be granted whether or not within the State and whether or not voluntary.

Organ/Bone Marrow Donor

Medical documentation of the proposed organ or bone marrow donation is required for approval. Documentation should be submitted to your supervisor with as much advanced notification as possible.

Parental

Employees requesting parental leave should seek approval from their appropriate supervisor.

School Conference and Activity Leave

Before attending a school conference or activity, the employee must provide an employer with a written request for leave at least seven days in advance. In emergency situations, no more than 24 hours notice is required.

Shared Benefits

Withdrawal Application Form

Sick

Employees should receive approval from their supervisors to charge absences against accumulated sick leave. An employee's supervisor may require the employee to provide evidence to substantiate the reason for the absence, including a physician's certificate or FMLA medical certification, if applicable. The use of sick leave for family and medical leave (FML) or victims economic security and safety leave (VESSA) purposes does not extend the FMLA or VESSA entitlement.

Departmental procedures for notification that sick leave benefits need to be used may vary. Contact your immediate supervisor for the particular procedures in your department.

Special Leave for Civil Service Employees

Requests for special leave must be in writing and approved by the campus Human Resources office.

• Such leaves may be approved for sufficient cause, such as:
  • Employees who want to accompany a spouse on a sabbatical leave.
  • Employees who have exhausted sick and disability benefits and family and medical leave who are still unable to return to work.
  • Employees engaged in public interest work or in furthering their education.

Vacation

Departmental procedures for requesting the use of vacation leave may vary. Contact your immediate supervisor for the particular procedures in your department.

Victims Economic Security and Safety Act

VESSA Application ( PDF | RTF )

Voting - General or Special Election

Prior to the day of the election, the employee must provide his or her supervisor/department with a written request, and show his/her voter registration card as proof of eligibility to vote in the designated election.

Voting - Primary Election

Prior to the day of the primary election, the employee must provide his or her supervisor/department with a written request, and show his/her voter registration card as proof of eligibility to vote in the designated primary.

Worker’s Compensation

1. Immediately contact your supervisor to report the incident
2. Complete a University of Illinois Employee’s Injury Report Form and Family and Medical Leave Application, if an absence from work occurs.
3. Promptly seek medical care if appropriate.

For more information about Worker’s Compensation including brochures and flyers, visit the Worker’s Compensation section of the OBFS website.