PEAFMLA Form

FMLA Year Indicator

This defaults by policy to the value "Qualifying Event" and should not be changed.

    Valid values:
  • Calendar
  • Fiscal
  • Qualifying Event
  • Rolling Backward
FMLA Year

Four-digit year in which the leave starts: e.g., if leave starts on 9/25/08, this value would be 2008.

Year Begin

When "FMLA Year" is entered, this field defaults to today's date, but can be modified to any appropriate value.

Year End

When "FMLA Year" is entered, this field defaults to one year from today's date, but can be modified to any appropriate value.


FMLA Base Record

FMLA Units Indicator

This field defaults to Hours, which follows UI policy and should not be changed.

    Valid values:
  • Weeks
  • Days
  • Hours
Maximum FMLA Units Allowed

This is the number of hours in the employee's work week multiplied by the total number of FMLA weeks possible (12). For those on a 40-hour work week, this value would be 480; for those on a 37.5-hour week, it would be 450; these are the two standard values.


FMLA Usage

Leave Effective Begin Date

This is the first day of the Leave being requested, and cannot be before the FMLA Year Begin date.

Leave Effective End Date

This is the last day of the Leave being requested, and the employee is expected to return to work the next workday.

Leave Requested Date

This can be the current date or the date the Leave was requested by the employee.

Eligibility Notification Date

This date indicates when the employee is notified the requested Leave has been granted.

Status

This two-character value indicates the current status of the leave; table-validated (PTVFMST).

    Valid values:
  • AP = Approved
  • DN = Denied
  • PA = Pending approval
  • RE = Requested
Reason

The reason for the FMLA leave is indicated by this two-character value; table validated (FTVFREA).

    Valid values:
  • CH = Birth / Adoption / Foster care of child
  • FM = Serious health condition of child, parent, spouse
  • PE = Personal serious health condition
Approval Date

Officially, this is the date the Leave is approved; it is normally the current date.

Percent of Leave

This is the percent of Leave from the position, typically 100%; it does not determine percent of pay. If percent of Leave must be adjusted, percent of salary must be maintained during the Leave; it is manually entered on NBAJOBS.

Comments

This is a general text field for comments.

Eligible for Benefit Continuation

This indicates whether the employee is entitled to a continuation of benefits during Leave. This Checkbox is checked by default - by UI policy, benefits normally continue.

Medical Certification Received

This Checkbox shoudl be checked when medical certification of the reason for the Leave is received.

Received Date

The date the medical certification is received.

Scheduled Back to Work

Status (Full Time/Part Time)

The selection here indicates whether the employee plans to return from Leave to Full Time work, or to Part Time work.

Scheduled Date

This is the expected date for the employee to return to work following the Leave. For example, if Leave ends on 07/11/08 (Friday), this date would be 07/14/08 (Monday).

Actual Back to Work

Status (Fully Time/Part Time)

The selection here indicates whether the employee actually returns from Leave to Full Time work, or to Part Time work.

Actual Date

Date the employee actually returns to work following Leave; this can initially be the same as the scheduled date, then updated later if needed.


FMLA Leave Tracking

Earnings Code

Earnings code for this portion of the Leave (line repeats).

Unit Indicator

Defaults to 'Hours' and should not be changed (line repeats).

Begin Date

Beginning date of the part of the leave associated with the indicated Earn Code; must be within overall leave dates (line repeats).

End Date

Ending date of the part of the leave associated with the indicated Earn Code; must be within overall leave dates (line repeats).

FMLA Units Claimed

Units (Hours) claimed against the indicated Earn Code (line repeats).

Maximum Units Allowed

The value defaults from the previous sub-form; it is not editable.

Total Units Claimed

This is computed as the sum of the Units (Hours) claimed for all Earn Codes on this sub-form; it is not editable.

FMLA YTD Claimed

The computed Year-to-Date total of all 'FMLA Units Claimed'; it is not editable.

FMLA Units Available

This is computed as the Units (Hours) remaining after subtracting 'YTD Claimed' from 'Maximum Units Allowed'; it is not editable.


FMLA Comments Sub-Form

Leave Begin Date

Not editable; display defaults from previous sub-form.

Leave End Date

Not editable; display defaults from previous sub-form.

FMLA Unit Indicator

Not editable; display defaults from previous sub-form.

Made By

Do not use; enter name and contact information in the comment itself; entering data here has caused issues with the records if trying to delete them later.

Comments

This area allows the entry of free form textual comments relating to the leave.


Fields on PEAFMLA which are Not Used

      FMLA Base Record
    • Spouse Employed
    • Spouse ID
      FMLA Usage
    • Approval ID - Should not be used due to problems with deletion later
      Scheduled Back to Work
    • User ID - Not editable on this form.
  • Fields on FMLA Comments Sub-Form
    • Made By - Do not use; entering data here has caused problems.