Taking Time From Work: FMLA and Paid Leave Options

Author: Christina Bach, MBE, LCSW, OSW-C, FAOSW
Content Contributor:  Bipartisan Policy Center (2024). State paid family leave laws across the U.S.. Retrieved from https://bipartisanpolicy.org/explainer/state-paid-family-leave-laws-across-the-u-s/, 7 March 2024.
Last Reviewed: March 24, 2022

What is FMLA?

Under the Family and Medical Leave Act (FMLA) of 1993 an employee can take unpaid time off of work due to the serious medical condition of the employee or a family member. A “family member” can be a spouse, parent, or child. Some employers might include more people as “family members.” FMLA time off gives “job protection.” This means that your job is there for you when you return from FMLA leave. When using FMLA, it is good to have clear communication and teamwork between the employer, employee, and medical team.

FMLA also provides time away from work and job protection for military family members during deployment of the employee’s spouse, son, daughter, or parent under the Military Family Leave Provisions included in the Family and Medical Leave Act.


The goal of FMLA is to improve the work-life-family balance, improve the employee’s quality of life, and help with financial security and stability. FMLA helps employees feel like they do not have to choose between their jobs and their own well-being, or the well-being of a close relative who is sick. FMLA covered time applies to both mental and physical illnesses of the individual/family member.

Which employers must offer FMLA and who qualifies?

  • Private employers with 50 or more employees must offer FMLA to their employees,
  • Employees must also have worked at least 12 months in their jobs and 1250 hours within the previous year (this is about 31.25 hours per week). This means you probably will not be eligible for FMLA in your first year at a job.
  • Public agencies (federal, state, or local) must provide FMLA coverage, regardless of the number of employees.
  • Schools, public or private, must provide FMLA, regardless of the number of employees.
  • Some states have different requirements for employers and FMLA. Be sure to check with your human resources office.

What is a serious medical condition?

A serious medical condition is one that:

  • You or your family member stays in a hospital or extended care facility overnight.
  • You or your family member are unable to work for 3 days or more.
  • You or your family member needs ongoing medical care for a chronic health condition.
  • Pregnant women who give birth and families who adopt a child may also use FMLA.

How does FMLA work?

A qualified employee can take up to 12 weeks (60 workdays or 480 work hours) of unpaid time per year under FMLA. This can be taken at one time or intermittently, meaning you can take time as needed with proper notice and planning with your employer. For example, you receive chemotherapy on Thursdays, so you take Thursday and Friday off under FMLA time and also have the weekend to recover. You then return to work as scheduled on Monday. You have used 2 days (16 hours) of FMLA time.

Be sure to check with your human resources representative at your job about specific FMLA rules, forms, and processes. The earlier you know you will need to use FMLA time, the better. Most employers recognize that health issues often come up unexpectedly. They cannot deny you FMLA time based on when you apply for leave. However, FMLA standards require the employee to provide documentation to the employer within fifteen (15) days of the time off.

If you have sick or vacation time, your employer should work with you to use this time with FMLA so that you have income. Your employer should also work with you to use short and long-term disability pay, along with FMLA, if this benefit is offered by your job.

What is so great about unpaid leave?

FMLA has nothing to do with getting paid. FMLA serves to protect your job. Your employer cannot hire someone else for your position while you are out on FMLA protected time. When you return from FMLA leave, you are also entitled to:

  • The same position or an equivalent position.
  • The same benefits and shift as your previous position.
  • Maintaining your health insurance coverage.

Knowing you have a job to return to after finishing cancer treatment can bring some peace of mind. If you are a caregiver, knowing you have protected time to care for a loved one can help you balance supporting yourself and meeting the needs of your loved ones.

Using FMLA to Your Advantage

Multiple family members can take intermittent FMLA to care for the same family member with a serious medical condition. For example, Jane is coping with colon cancer. She requires assistance getting to her chemotherapy appointments 1 day every three weeks and care for the three days after she receives chemotherapy. She schedules her chemotherapy for Thursdays. Her daughter Sue accompanies her to treatment on Thursday (1 FMLA - covered day for Sue, intermittent leave); her son Mike stays with her on Fridays and through the weekend (1 FMLA - covered day for Mike, intermittent day).

Delegate tasks and use calendar or scheduling tools/apps to help manage family needs. Discuss with your healthcare team to come up with a plan to maximize FMLA time for all family members to meet the caregiving needs of your family member.

Are there options for paid leave?

There may be options for paid leave from work, depending on where you live.

Some states offer options for paid time away from work.

  • Kin-care Laws: California, Georgia, Illinois, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, Texas, Vermont, and Washington have state laws that require employers to let employees use paid time off (like sick time) to care for a family member.
  • Paid Leave Laws: Paid leave is not always offered by employers. Maine and Nevada have laws that require employers to give a minimum amount of paid leave for employees.
  • Paid Family and Medical Leave: There is no federal law that requires this. There are some states that have Paid Family and Medical Leave Programs. Each state has its own rules for who can get it, how long you can get benefits, and how much you are paid.
    • States with mandatory paid family leave: California, Colorado, Connecticut, Delaware, Massachusetts, New Jersey, New York, Rhode Island, Washington (state), Oregon, and Washington, DC.
    • States with Voluntary (employers must opt in) family leave: Texas, Arkansas, Tennessee, Alabama, Florida, Virginia, New Hampshire, Vermont.
    • States with mandatory paid leave coming soon: Minnesota, Maryland and Maine.

No matter where you live, you should talk with your employer about options for using paid time off (PTO). Some employers also permit co-workers to donate their accrued PTO to each other to assist in caregiving/illness situations.

You can also talk to your employer about ways to support you by changing your work hours or working from home.

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