Leave of Absence Benefits and Resources

As a quick reference, please utilize our Leave of Absence Checklist. Also, a printable version of the below information can be found on this Leave of Absence Guide.


  • Complete and sign the Request for Leave Form. This form should be faxed to Leave Administration at (704) 446-6624 no more than 30 days in advance and no later than 22 days from the start of your leave. 
  • Take the Certification of Health Care Provider to your healthcare provider to complete. This form should be turned in to Leave Administration no later than 22 days from the start date of your leave. This entire form must be completed and faxed to Leave Administration at (704) 446 – 6624 for a decision to be made.
  • While a decision is being made on your leave request, continue to follow the call-out policy of your department daily.
  • All updates to your status should be completed by your healthcare provider and sent to Leave Administration utilizing your Certification of Health Care Provider For Teammate form.
  • If your leave extends beyond your job protection end date, please contact Leave Administration prior to that date to discuss your employment status.
  • All teammates returning from work after a Medical leave will need to provide medical clearance from their provider. This can be completed using the Fitness for Duty Certification to Return from Medical Leave form. This document is required prior to being allowed to return to work.
  • If you are returning from a Family Care Leave, complete and send in the Return from Family Care Leave form. This document is required prior to being allowed to return to work.
  • On occasion, a teammate can return to work, but has a medical restriction or needs an accommodation. This situation will be reviewed with our Return to Work Program prior to the teammates return date.
  • Upon leave approval, teammates are responsible for communicating the amount of PTO requested per pay period with their leadership.
  • Teammates receiving Short-Term Disability Payments from MetLife should not be receiving PTO, or have any worked hours coded while receiving Short-Term payments. Teammates and leaders are responsible for discussing if-and-when a teammate will begin receiving Short-Term Disability payments.
  • If you have a disability and want to request an accommodation, please contact Leave Administration.
  • Your HRLink portal will remain available during your leave of absence. Access to Your HRLink is not intended for work-related reasons. Teammates are prohibited from performing any work-related duties during a leave of absence.
  • Leaders are responsible for completing the Request for Leave Form on behalf of a teammate on the fourth day of an unexpected absence.
  • Enter the teammate’s PTO and/or Absent Hours as requested by the teammate and the appropriate pay code into the time keeping system.
  • Use of PTO is optional (PTO code 041). If you choose not to use PTO, Absent Hours should be used. (Absence code 391).
  • Leaders are responsible for coding FMLA Hours (Code 395) or Non FMLA hours (Code 295), PTO and Absent Hours in the time keeping system during your approved leave of absence.
  • All used FMLA (code 395) or Non-FMLA (code 295) hours should be coded in the time and labor system in addition to PTO or absent hours. FMLA and Non-FMLA must be used and recorded in one- hour increments.
  • Teammates receiving Short-Term Disability Payments from The Hartford should not be receiving PTO, or have any worked hours coded while receiving Short-Term payments. Teammates and leaders are responsible for discussing if-and-when a teammate will begin receiving Short-Term Disability payments.
  • Catastrophic Bank hours may not be used for Intermittent leaves.
  • A team member cannot work additional hours to replenish or avoid use of their bank of available FMLA hours.
  • Please reference the time-off flow chart to determine your potential pay schedule.
  • Please use the FMLA Tracking Chart to track FMLA hours used while a teammate is on leave.
  • All teammates returning to work must submit the Fitness for Duty Certification to Return from Medical Leave and/or Return from Family Care Leave forms prior to returning to work. All teammates must be properly returned in the system by Leave Administration prior to working.

Benefits and Pay While on Leave

If you need to make changes to your benefits, please contact Benefits Administration at (704) 631-0263, or email HRBenefitsOnline@atriumhealth.org. If you have questions regarding benefits billing, please contact the Benefits Service Center at 704-631-0263.

  • To View your benefits while on a Leave of Absence please review this Benefit Guide.
  • To view your benefits while on a Maternity Leave of Absence, please review this Maternity Benefit Guide.
  • For more information about Maternity Leave Benefits, please review our Maternity webpage.
  • While on a leave of absence you will continue to be paid by the same method you were paid prior to your leave (i.e. direct deposit). Short-Term Disability payments are not automatically direct deposited; you will need to contact MetLife to apply for this benefit.
  • Teammates on an approved medical leave may apply for Short-Term Disability payments through MetLife. To file for a claim, please call (800) 421-7014.

 

Leave of Absence Forms and Policies