How to Fill Out and Submit the LAUSD FMLA Form

To request Family and Medical Leave Act leave at LAUSD, download the correct FMLA form from the Integrated Disability Management website at disability.lausd.org, complete the employee section yourself, have a licensed healthcare provider fill out the medical certification, and return the packet to the IDM office by portal upload, email to fmla@lausd.net, or secure fax within 15 calendar days of the district’s request. The LAUSD FMLA form comes in several versions depending on why you need the leave, and using the wrong one is the fastest way to get your paperwork sent back.

Confirm You Qualify Before You Start

Both federal FMLA and California’s CFRA require that you’ve worked for LAUSD for at least 12 months before leave begins. Those months don’t have to be consecutive; prior district service counts as long as any gap was shorter than seven years.1eCFR. 29 CFR 825.302 – Employee Notice Requirements for Foreseeable FMLA Leave

Federal FMLA requires 1,250 hours of service in the preceding 12 months.2U.S. Department of Labor. FMLA Frequently Asked Questions For certificated staff, LAUSD uses a 130-workday standard for the preceding 12 months instead of a raw hour count.3Los Angeles Unified School District. Frequently Asked Questions – Certificated Assignments and Support Services CFRA has the same 12-month and 1,250-hour thresholds and applies to employers with five or more employees.4California Civil Rights Department. Family Care and Medical Leave: Quick Reference Guide

Pick the Right Form for Your Situation

LAUSD’s IDM office keeps separate FMLA forms depending on why you need leave. Match yours before you start writing anything in.

  • Your own serious health condition: use the form designated for employee medical leave. Your own healthcare provider completes the medical certification.
  • A family member’s serious health condition: use the family-care version. The medical certification must be signed by your family member’s provider, not yours.
  • Baby bonding, adoption, or foster placement: use the parental leave form. You’ll need a birth certificate, hospital certificate, or adoption papers. Under California law, CFRA bonding leave runs after any pregnancy disability leave, so a birth parent may take up to four months of disability leave plus 12 weeks of bonding.5California Civil Rights Department. PDL Baby Bonding6Los Angeles Unified School District. Leaves of Absences – Certificated Assignments and Support Services – Human Resources
  • Military qualifying exigency: use the exigency form when a family member’s active-duty deployment creates an urgent need, such as arranging childcare, attending military events, or handling financial and legal matters.
  • Military caregiver leave: use the caregiver form if you’re caring for a covered servicemember with a serious injury or illness. This entitlement runs up to 26 weeks in a single 12-month period, and the certification must come from the servicemember’s provider or from a Department of Defense or VA healthcare provider.7U.S. Department of Labor. Fact Sheet 28M(a): Military Caregiver Leave for a Current Servicemember

Every version is posted on the IDM site under Absence Management Resources and Forms.8Los Angeles Unified School District. Absence Management Resources and Forms If you’re uncertain which one fits, email the FMLA team at fmla@lausd.net before you start.9Los Angeles Unified School District. Integrated Disability Management

Complete the Employee Section

The employee section is yours to fill in. Have the following ready:

  • Your eight-digit LAUSD employee number, which usually begins with two zeroes (for example, 00723671).10Los Angeles Unified School District. Activating Your LAUSD Account – IT Helpdesk
  • Your current work location.
  • Your supervisor’s name.
  • The start and end dates of the leave you’re requesting.

If you’re asking for intermittent leave instead of one continuous block, include an estimated schedule showing how often you expect to be out and how long each absence will last. The district must track intermittent leave in increments no larger than the shortest increment it uses for other kinds of leave, and that increment can’t exceed one hour. If LAUSD tracks sick leave in 15-minute blocks, your intermittent FMLA leave gets tracked in 15-minute blocks too. The district also cannot force you to take more time off than your condition actually requires during any single absence.11eCFR. 29 CFR 825.205 – Increments of FMLA Leave for Intermittent or Reduced Schedule Leave

Get the Medical Certification Done Right

The medical certification is where most LAUSD FMLA requests stall. You cannot complete this part yourself. A licensed healthcare provider has to fill it out, sign it, and include their license number and contact information so the IDM office can authenticate the document if needed. Digital signatures are generally accepted.

The certification must describe the medical facts supporting the need for leave. That can include symptoms, diagnosis, hospitalization, doctor visits, prescribed medication, and referrals for continuing treatment. The provider also has to estimate how long the condition will last and state whether the leave will be continuous or intermittent.12eCFR. 29 CFR 825.306 – Content of Medical Certification for Leave Taken Because of a Serious Health Condition

About detail: the provider needs to include enough information for the district to decide whether the condition qualifies under FMLA, but the completed certification goes to the IDM office, not to your principal or site supervisor. Talk to your provider ahead of the appointment about what level of detail is appropriate so you aren’t scrambling to collect a corrected form later.

If any required fields come back blank or unclear, the IDM office will send you a deficiency notice and you’ll have seven calendar days to cure the problem.13U.S. Department of Labor. Family and Medical Leave Act Advisor: Medical Certification – General If the district has reason to doubt the certification, it can require a second opinion from a provider of its choosing, at district expense, and you remain provisionally protected while that opinion is pending.14eCFR. 29 CFR 825.307 – Authentication and Clarification of Medical Certification

Watch Three Deadlines

Three clocks run at the same time once you know you need leave. Missing any of them can delay or jeopardize your protections.

  • 30 days of advance notice for foreseeable leave: for a scheduled surgery, an expected due date, or planned treatment, give the district at least 30 days of notice. When the need arises suddenly, notify the district the same day you learn about it or the next business day.1eCFR. 29 CFR 825.302 – Employee Notice Requirements for Foreseeable FMLA Leave
  • 15 calendar days to return the medical certification: once the district formally requests it, the certification is due within 15 calendar days. The deadline can extend if circumstances genuinely prevent compliance despite a good-faith effort, but routine excuses rarely qualify.15eCFR. 29 CFR 825.305 – Certification, General Rule
  • 7 calendar days to cure a deficiency: if the IDM office returns the certification as incomplete or insufficient, the fix is due within seven calendar days of the notice. Check your district email daily while a request is pending.13U.S. Department of Labor. Family and Medical Leave Act Advisor: Medical Certification – General

Submit the Completed Packet

Send the finished packet, including the employee section and the signed medical certification, to the Integrated Disability Management branch. IDM accepts submissions three ways:

  • Upload through the IDM online portal at disability.lausd.org.
  • Email to fmla@lausd.net.
  • Secure fax to the IDM office.9Los Angeles Unified School District. Integrated Disability Management

Mailing a physical copy to district headquarters is possible but adds transit time to an already tight 15-day certification window. Whichever route you pick, keep a copy of everything you send and save any delivery confirmation. If the fax came back with a transmission report, keep it. If you emailed, keep the sent message.

After the packet arrives, IDM staff verify your eligibility against your employment history and prior leave usage. If anything is missing, you’ll get a deficiency notice through your district email. Stay in regular contact with your site administrator during this window so the school can arrange coverage for your absence.

What Happens After You Submit

Once the IDM office has enough information to decide, federal regulations give the district five business days to issue a written Designation Notice telling you whether the leave has been approved as FMLA-qualifying.16eCFR. 29 CFR 825.300 – Employer Notice Requirements The notice lists the specific dates approved, states whether you’ll be required to use paid leave concurrently, and, if the leave is for your own health condition, says whether you’ll need a fitness-for-duty certification before you return. If the district determines the leave doesn’t qualify, that denial also comes in writing.

Keep the Designation Notice with your personal records. It’s the document that proves your leave carried legal protection if any question comes up later.