Human Resources - Family and Medical Leave

Human Resources


Contact Information

General Information:
(860) 832-1756
Davidson - Room 201

Christine Derwitsch
Phone: (860) 832-1756
Fax: 959-255-8790



Monday      8:00 am to 5:00 pm

Tuesday      8:00 am to 5:00 pm

Wednesday 8:00 am to 5:00 pm

Thursday    8:00 am to 5:00 pm

Friday        8:00 am to 5:00 pm


Family and Medical Leave

Personal illness or family illness leaves occur when an employee is away from work for a block of time or requires intermittent or reduced schedule leave.

Employees who meet the qualify requirements may be eligible for State FMLA or Federal Leave.

Federal FMLA

  • Eligible after one year of employment and after working 1,250 hours or more in previous 12-months

  • Up to 12 weeks of leave during 12-month FMLA period

  • Continued eligibility for state contributions toward health insurance (directly billed as needed)

State FMLA

  • Eligible after at least 3 months of state service

  • Up to 12 weeks of leave within a 12-month period for all reasons except:

    • Up to 26 weeks of leave in a single 12-month period to care for a covered servicemember with a serious injury or illness

    • Up to 2 additional weeks of leave during the 12-month period for a serious health condition resulting in incapacitation that occurs during a pregnancy

  • Continued eligibility for state contributions toward health insurance (directly billed as needed)

Note: Leaves for employees with end date positions will not be extended beyond the end date.

Families First Coronavirus Response Act 

Families First Coronavirus Response Act Employee Rights

Families First Coronavirus Response Act (FAQ's)


Complete the Employee Request and Intent to Return to Work forms to initiate the leave process. Return forms to Norma Rivera in Human Resources, Davidson Hall, Room 201.

Employee Request Form (HR-1)

Employee Medical Certificate (P-33A)

Caregiver Medical Certificate (P-33B)

Intent to Return to Work (HR-3)

Employees must provide Fitness for Duty certification (last page of Medical Certification, P-33) to Human Resources prior to returning to work.

FMLA Resources

Employee Rights & Responsibilities Under the FMLA

Statewide Family and Medical Leave Policy

Norma Rivera, at (860) 832-2305, for FMLA information

Sick Leave Bank Application Forms

AAUP & Management/Confidential SLB Application Form

  • See AAUP contract Article 13.3; see M/C HR Policies Article 8.5.3.

SUOAF SLB Application Form

  • See SUOAF contract Article 24.2.10.