2.3.5 Disability and Family Leaves

Formerly Known As Policy Number: 27.7

This Guide Memo describes medical and other disability-type leaves, and the coordination of these types of leave with University benefit plans.

Applicability:

Applies to regular Stanford University employees not covered by collective bargaining agreements, regular Academic Staff - Research, and regular Academic Staff - Libraries. (The term "regular employee" is defined in Guide Memo 2.2.1: Definitions.) For policies that apply to employees covered by a collective bargaining agreement, refer to the agreements at Labor Relations & Collective Bargaining.  

Notes:

• Procedures for SLAC employees may vary.
• Faculty may consult the Faculty Handbook, chapter 3.
• See information on each disability plan for specific details about plan eligibility.

1. Overview

Eligible University employees can participate in a variety of family and medical leaves and disability benefit plans. Policies are described in this document. Before you go out on leave, consult with your local Human Resources office. Important information regarding the scope and use of the disability benefit plans is included in the relevant plan brochures available on the Cardinal at Work website.

a. Specific Process for filing a disability claim:

1. The employee reports the absence (or planned absence) to their immediate supervisor.
2. The employee calls Stanford's disability administrator to initiate a claim. The disability administrator will inform the employee if there are any forms or certification documents to submit.
3. If the employee does not call the disability administrator, it is the department's responsibility to notify the disability administrator.
4. Continue steps per general process for all disabilities in section 1.b.

b. General Process:

(1) Timeliness

Employees must give notice of anticipated family or medical leaves and file claims for disability plan benefits as soon as feasible. Notice should be given to the immediate supervisor, the local Human Resources office and the disability administrator. For work-related leaves, refer to section 4, Workers' Compensation. For example, an employee who will be hospitalized on a pre-determined date should contact the disability administrator before entering the hospital. In addition, the employee must submit the signed Authorization to Release Information form to their physician's office as soon as possible. No disability benefits can be paid until the disability administrator has received the completed physician's form with appropriate verification of the disability. If not hospitalized, the employee still needs to report the absence to the disability administrator and their supervisor.

(2) Workers' Compensation

When the employee's disability is, or may be, work-related, the department should report the circumstances to the Risk Management Office within 24 hours of the employee's injury. See section 4, Workers' Compensation. SLAC employees should refer to SLAC Human Resources for the relevant reporting requirements.

(3) The local Human Resources office

The local Human Resources office notifies and coordinates with the disability administrator. The local Human Resources office works with the employee, their supervisor and the disability administrator to ensure that information is communicated in a timely manner.

(4) DLS

Disability and Leave Services (DLS) in University Human Resources updates employee's record in the Human Resources Management System (HRMS) and works with the disability administrator to ensure accurate time card reporting and pay.

(5) Supervisor's Ongoing Communication

The supervisor (or local Human Resources office on the supervisor's behalf) should routinely check the determination made on the employee's claim for short-term (VDI/SDI) disability benefit or Workers' Compensation benefit payments. The supervisor should arrange with the employee to be kept informed about the estimated return to work date for an employee who is absent for an extended period. If the employee is unable to advise the supervisor personally about their inability to return to work, the supervisor should make other arrangements to be kept advised of the status of the employee's return to work.

(6) Medical Certification

The employee must contact the disability administrator to initiate a leave request and open a disability or Paid Family Leave (PFL) claim, who will then work with the employee to obtain the necessary certification from a health care provider. The employee must provide certification within 15 days to the disability administrator. Certification is also required to request a leave extension.

(7) Length of Leave

• Maximum Duration - Except as otherwise required by law, the maximum duration that a regular employee is eligible to be on an approved medical leave of absence due to a non-work-related injury or illness is no more than 12 consecutive months, inclusive of any periods of full- or part-time leave, Family Medical leave, pregnancy disability leave, or leave for personal reasons. If, through the interactive process, it is determined that an employee is unable to return to work at the end of an approved medical leave with or without reasonable accommodations, the employee will be terminated. Twelve months of leave is not guaranteed. The maximum duration of leave will be determined based on the particular circumstances of the situation, including the operational needs of the department, the number of times extensions of leave have been previously granted, and any disability accommodation leave that may have been granted.
• Exceptions - If a proposed leave will result in a total period of absence exceeding 12 months, prior approval is required from the local Human Resources office and in concurrence with the Vice President for Human Resources (or their designee). Requests for exceptions must be submitted in writing to the local Human Resources office. Such exceptions are likely to be approved only in limited circumstances.

2. Family and Medical Leaves

a. Introduction

Family Medical Leave is leave authorized by the federal Family and Medical Leave Act (FMLA) and/or the California Family Rights Act (CFRA). Certain leaves for members of the armed forces and their families are outlined in Guide Memo 2.1.18. In most cases, FMLA and CFRA run concurrently with each other and with Short-Term Disability Leave, including leave due to work-related illness or injury, and with Paid Family Leave (PFL). Eligible employees are assured up to 12 weeks unpaid leave during a rolling 12-month period that begins on the verified FMLA/CFRA start date. "Assured" means the department cannot refuse the leave when any one of the following situations is appropriately verified:

• The birth of a child or the placement of a child with the employee for adoption or foster care. Under CFRA, if both parents are employed by Stanford, each parent is eligible for up to 12 weeks of baby bonding leave.Limitations: Leave for birth or placement of a child for adoption or foster care should generally be taken in blocks of time (two weeks minimum) and must be concluded within the first 12 months after the birth or placement. A request for baby bonding leave in less than two weeks' duration may be granted on any two occasions.
• A serious health condition that makes the employee unable to perform their job.
• Under FMLA, the serious health condition of a spouse, same-sex domestic partner, parent or child that requires the employee's absence from work to care for the ill family member.
• Under CFRA, the serious health condition of a child, parent, parent-in-law (parent of a spouse or domestic partner), grandparent, grandchild, sibling, spouse, domestic partner, or designated person that requires the employee’s absence from work to care for the ill family member. “Designated person” means any individual related by blood or whose association with the employee is the equivalent of a family relationship. The “designated person” may be identified by the employee at the time leave is requested. An employee is limited to one “designated person” per 12-month period.

Definition of "Serious Health Condition"

Serious health condition (as defined by the Dept. of Labor) means an illness, injury, impairment, or physical or mental condition that involves either:

• Inpatient care (i.e., an overnight stay) in a hospital, hospice, or residential medical-care facility, including any period of incapacity (i.e., inability to work, attend school, or perform other regular daily activities) or subsequent treatment in connection with such inpatient care; or
• Continuing treatment by a health care provider, which includes: 
  1. A period of incapacity lasting more than three consecutive, full calendar days, and any subsequent treatment or period of incapacity relating to the same condition that also includes:
     1. treatment two or more times by or under the supervision of a health care provider (i.e., in-person visits, the first within 7 days and both within 30 days of the first day of incapacity); or
     2. one treatment by a health care provider (i.e., an in-person visit within 7 days of the first day of incapacity) with a continuing regimen of treatment (e.g., prescription medication, physical therapy); or
  2. Any period of incapacity related to pregnancy or for prenatal care. A visit to the health care provider is not necessary for each absence; or
  3. Any period of incapacity or treatment for a chronic serious health condition that continues over an extended period, requires periodic visits (at least twice a year) to a health care provider, and may involve occasional episodes of incapacity. A visit to a health care provider is not necessary for each absence; or
  4. A period of incapacity that is permanent or long-term due to a condition for which treatment may not be effective. Only supervision by a health care provider is required, rather than active treatment; or
  5. Any absences to receive multiple treatments for restorative surgery or for a condition that would likely result in a period of incapacity of more than three days if not treated.

b. Eligibility

Employees working in the U.S. are eligible if employed by Stanford at least one year and have worked at least 1,250 hours (paid time off, paid leave and unpaid leave not included) during the 12 months before the start of the requested leave.

c. Notification

Employees are expected to provide 30 days advance notice to their manager when the need for leave is foreseeable (i.e., anticipated date of birth, adoption or planned medical treatment). When advance notice is not possible, employees should give as much advance notice as feasible. If advance notice is not provided when the employee had sufficient prior knowledge of the need for leave, the department may deny leave until 30 days have elapsed. Such denial should be made only when operationally necessary, and always in consultation with the local Human Resources office. Employees are required to give a minimum of two days' notice if the return to work will be later or earlier than the expected return date.

d. Medical Certification

The employee must call the disability administrator to request FMLA/CFRA leave. The disability administrator will work with the employee to obtain certification from a health care provider that the employee, their child, parent, parent-in-law, grandparent, grandchild, sibling, spouse, or domestic partner has a serious health condition, the condition's expected duration, and the need for the employee to attend to the family member. The employee must provide certification within 15 days to the disability administrator. Certification is also required to request a leave extension.

e. Intermittent Leave

Under some circumstances, employees may take FMLA/CFRA leave intermittently (taking leave in separate blocks of time for a single qualifying reason) or on a reduced schedule (reducing the employee's usual weekly or daily work schedule). When leave is needed for planned medical treatment, the employee must make a reasonable effort to schedule treatment to avoid unduly disrupting department operations.

For birth and care of a child or "baby bonding" under California (CFRA) law, an employee may use intermittent leave in segments of two weeks. A request for baby bonding leave of less than two weeks duration may be granted on any two occasions.

3. Pregnancy and Disability Leave

California law currently provides eligible employees up to four months off for pregnancy disability leave (PDL). The first three months of PDL run concurrently with the employee's federal FMLA entitlement. Following PDL, the employee may be eligible to use up to 12 weeks of California Family Rights Act (CFRA) leave. Verified pregnancy disability leave does not count against an employee's California Family Rights Act (CFRA) leave entitlement unless the employee has exhausted the maximum pregnancy disability leave permitted by law.

4. Paid Organ Donor Leave

a. Introduction

Under California law, eligible employees are entitled to a paid leave of absence up to 30 days for the purpose of organ donation and up to five days for bone marrow donation. For organ donation, eligible employees are entitled to an additional unpaid leave of absence up to 30 days.

The leave may be taken in increments during any one-year period. The one-year period starts on the first day of leave. Use of accrued time for a portion of the leave will be required (see section 4.d). Periods of authorized Paid Organ Donor leave do not run concurrently with either FMLA or CFRA leave and are not counted against an employee's annual FMLA/CFRA entitlement.

b. Eligibility

The employee must complete at least 90 days of service with the University before requesting Paid Organ Donor leave.

c. Medical Certification

The employee must call the disability administrator to request a Paid Organ Donor leave and provide written medical verification that the employee is an organ or bone marrow donor and the medical necessity for the donation. The disability administrator must receive the certification within 15 days of the Paid Organ Donor leave request.

d. Pay During Leave

During the period of Paid Organ Donor leave, employees will be required to use five days of accrued time for bone marrow donation and 10 days for organ donation. Once the amount of required accrued time is used, the employee will be on a paid leave of absence for up to 30 days for organ donation and five days for bone marrow donation.

5. Workers' Compensation

a. Introduction

The purpose of this coverage is to provide partial income continuation during absences resulting from work-related injuries or illnesses, and payment of necessary medical, surgical, and hospital services for such injuries and illnesses. The university pays the full cost of Workers' Compensation coverage. Workers' Compensation payments are a non-taxable benefit paid directly to the employee by a third party administrator.

b. Eligibility

All employees of the university, including student employees, staff, and faculty, are covered by Workers' Compensation. Work-related disability provisions are applicable to temporary, student and casual employees; however, the charging (or not charging) of vacation and/or sick time is not applicable.

c. Reporting and Recording Work Injuries and Related Absences From Work

Departments have additional requirements for reporting all work-related injuries and illnesses. See Guide Memo 7.6.1: Accident and Incident Reporting.

d. Payments

The Workers' Compensation administrator normally pays benefits from the fourth day of the disability period or the first day of hospitalization, whichever occurs first. If the employee is out of work more than 14 days (need not be consecutive) with a doctor's authorization, the three-day waiting period is waived and retroactive payments will be made so that payments start with the first day of disability. For Workers' Compensation, Stanford charges up to the initial five full work days of absence (days need not be consecutive) of an accepted claim to work-related disability paid leave. The university will augment the Workers' Compensation benefit with salary during this period. An employee's sick time or vacation is not charged for these days of absence. By state law, an employee may not receive both Workers' Compensation benefits and full pay. Therefore, employees are required to reimburse the university for any Workers' Compensation benefits paid for the first five days including any associated holidays, because the university has already paid the employee for the time. For part-time employees, the full day is prorated based on the employee's normal work schedule.

e. Delayed Claims

If acceptance of a claim is delayed, the initial five full days of absence (need not be consecutive) are charged to accumulated sick time and the claim is handled as a short-term non-work-related disability. If accumulated sick time is exhausted, the time is charged to accrued PTO, floating holiday and vacation, in that order. If the employee does not have enough accrued time, the remaining hours are unpaid. If the claim is then accepted under Workers' Compensation, any sick, PTO, floating holiday, and /or vacation time taken during the first five days will be restored.

f. Supplementing Workers' Compensation Payments

Employees may receive both paid leave and disability plan benefits concurrently, not to exceed the employee's base pay. After the initial five work days of disability, accumulated sick, PTO, floating holiday and vacation time will be used, in that order, to supplement Workers' Compensation benefits. Thus, the employee continues to receive income equivalent to full pay.

g. Role of Disability and Leave Services

Disability and Leave Services (DLS) within University Human Resources updates the Human Resources Management System (HRMS) records each pay period for all employees on absences due to work-related disability. DLS makes certain that combined income from disability payments and Stanford does not exceed pre-disability pay and keeps accurate records of leave time used.

h. More Information

Details regarding claims procedures, accident reports, and related matters may be obtained from the Risk Management Office, (650) 723-7400, Workers' Compensation Benefits. Also, Guide Memo 7.6.1: Accident and Incident Reporting, has additional information about Workers' Compensation. SLAC employees should refer to SLAC Human Resources. 

6. Income during Family and Medical Leaves

a. Use of Accrued Time

Accrued time consists of sick time, PTO for the calendar year, floating holiday for the calendar year and vacation, to be used in that order. During medical leaves (including Workers' Compensation, FMLA, CFRA and PDL), the university will use an employee's accrued time to maintain the employee's base pay. For Paid Family Leaves (PFL), please see section 6.d. When the employee is also receiving disability benefits, DLS ensures that combined income from both the disability vendor and the University does not exceed pre-disability pay. Accrued time is used until the employee goes off disability, including Worker's Compensation, or until all balances are exhausted. The use of some forms of accrued time is at the employee's option during certain FMLA/CFRA leaves. If an employee chooses not to use accrued time during a medical leave, the employee must notify DLS by email within 24-48 hours of their claim being approved. An employee's request to opt out of the payment practice can only be for future pay cycles and not retroactively. Disability and Leave Services (DLS) administers the employee's records in the Human Resources Management System (HRMS). Procedures at SLAC will differ.

Thus, if the employee has accrued time and is also receiving disability benefits, the employee will receive disability checks from the disability administrator and/or the Worker's Compensation administrator and reduced paychecks from the university until their accrued time has been exhausted. Once the accrued time is exhausted, the employee will only receive disability checks from the disability vendor for the duration of the approved leave.

b. Overpayment

If an employee has been overpaid, the employee must reimburse the university for the overpayment either by direct payment or through payroll deduction.

c. Voluntary Disability Insurance / Short-Term Disability

(1) Introduction

The university's VDI plan is state-approved to take the place of SDI by providing benefits that are better than those of the state's plan. The VDI plan provides partial income continuation for periods of disability of up to 52 weeks or a maximum dollar amount. This plan is described in the Statement of Coverage available on the Cardinal at Work website. For information on SDI, go to the Employment Development Department's website at www.edd.ca.gov.

(2) Eligibility

Faculty and staff based in California are covered for short-term disabilities by either the university's Voluntary Disability Insurance plan (VDI) or State Disability Insurance (SDI) if the employee opted out of VDI. Non-California employees are covered under a separate 13-week short-term disability plan (STD).

(3) Benefit Waiting Period

Refer to the Voluntary Disability Insurance Statement of Coverage on the Cardinal at Work website.

(4) Taxability

Short-term disability (VDI/SDI) payments are non-taxable benefits. These non-taxable benefits are paid directly to the employee by the disability administrator.

d. Paid Family Leave (PFL)

(1) Introduction

This California state program provides partial income replacement during absences from work to care for seriously ill family members (parent, child, spouse, registered domestic partner, grandparent, grandchild, sibling, or parent-in-law) or to bond with a new child. It is not a separate type of leave.

(2) Eligibility

Faculty and staff based in California contribute to a Paid Family Leave (PFL) insurance benefit according to state law as part of the VDI deduction.

(3) Supplementing PFL Payments

During PFL, eligible employees will receive a portion of their base pay, up to a weekly maximum, from the disability administrator or state disability program, for up to eight weeks in a rolling 12-month period. The university will supplement the approved state paid family leave benefit to maintain the eligible employee’s base pay for the first six weeks that the employee is receiving PFL benefits. For the additional two weeks that the employee is eligible for PFL benefits, they may elect to use sick, vacation, floating holiday or PTO time, combined with the approved state leave, to maintain their base pay. Together, the state PFL and the university’s supplement will not exceed 100% of an employee’s base pay as of their last day worked before starting their leave. 

Disability and Leave Services (DLS) within University Human Resources administers the employee's records in the Human Resources Management System (HRMS). DLS ensures that combined income from both the disability vendor and the university does not exceed pre-disability pay. Procedures at SLAC will differ.

(4) Overpayment

If an employee has been overpaid, the employee must reimburse the university for the overpayment either by direct payment or through payroll deduction. Failure to repay an overpayment could result in disciplinary action.

(5) Taxability

PFL is a non-taxable benefit for state and FICA, but is a taxable benefit for Federal tax purposes.

(6) More Information

The benefit is described on the Cardinal at Work website. Forms are available on this website in the Resource Library.

e. Long-Term Disability (LTD)

(1) Introduction

This plan provides partial income continuation during longer periods of disability. LTD benefits could start after a disability period of 90 consecutive days. After a disability period of 15 months, the plan's benefits are more restricted because a more stringent definition of "disability" is used.

(2) Eligibility

Employees whose approved disability continues past 90 consecutive days may be eligible for Long-Term Disability. The disability vendor provides the employee with the appropriate information when the employee's disability period approaches 90 days.

Eligible employees based outside of California in a state that offers paid family leave must apply for paid family benefits through their state.

Eligible employees based outside of California in a state that does not offer paid family leave benefits can file a paid family claim through Stanford's disability vendor.

(3) Taxability

Long-term disability benefits are taxable for federal and state, non-taxable for FICA.

(4) More Information

The Summary Plan Description for the Long-Term Disability Plan provides information about coverage, definition of disability, and benefits. It is available on the Cardinal at Work website.

7. Benefits During Disability Periods

a. Health and Life Benefits

(1) Paid Leave

Employees on paid FMLA/CFRA, PFL, VDI or Workers' Compensation will have their applicable benefit contributions deducted from their reduced paychecks. See (3) for LTD.

(2) Unpaid Leave

Employees on unpaid PFL, VDI, Workers' Compensation, and all LTD participants (paid or unpaid) will have the same university benefit contributions as when actively employed. The employee will be billed for the employee portion of the costs on an after-tax basis.

(3) LTD and Part-Time Work

If an employee continues to receive LTD benefits, but is able to work part-time, there will be no change in benefit contributions. Employees will have applicable benefit contributions deducted from their reduced paychecks.

b. Retirement Savings Plan (SCRP)

(1) Paid Leave

When an employee continues to receive pay from the university, retirement savings plan benefit accruals and/or contributions continue, subject to plan provisions.

(2) LTD Plus Paid Leave

Employees who supplement LTD benefits with accrued time (e.g., sick, vacation, PTO, floating holiday) will have that paid time counted as earnings for university retirement savings plans, subject to plan provisions.

c. Retiree Medical Eligibility

During the first 90 days on Short-Term Disability or Workers' Compensation, time is counted toward official retiree medical eligibility. After 90 days on LTD, the time does not count toward official retiree medical eligibility.

d. Benefits in Cases of Termination

(1) Medical and Dental Coverage

A regular employee whose university employment is terminated while the employee is receiving benefit payments from a Short-Term Disability plan or Workers' Compensation plan may continue medical and dental coverages at their own expense through COBRA for 18 months, or until LTD is approved. If LTD is approved, they may contact Stanford Benefits, for information on their eligibility for medical and life insurance plans.

(2) Life Insurance

Life insurance portability or conversion to an individual plan is available. The employee should contact Stanford Benefits at the time of termination for the appropriate forms.

8. For More Information

Consult with your local Human Resources Office or review the Cardinal at Work website. General questions about State Disability Insurance (SDI) and Workers' Compensation should be referred to the appropriate government office.