Picture of Graff Main Hall

UW-La Crosse

Human Resources
 

Medical Certification PowerPoint presentation

UW-L Sick Leave Certification of Medical Necessity Form

Printable version of UW-L Unclassified Sick Leave Procedure

Return to UW-La Crosse Homepage

Return to Human Resource Homepage

 

 

 

UW-La Crosse Procedure

For Unclassified Employee

Certification of Medical Necessity (CMN)

 

Coverage:  Applies to all unclassified positions - faculty, academic staff, and limited appointees. 

  • Where use of sick leave is authorized in advance pursuant to WFMLA or FMLA (with documentation that HR has approved the leave) a CMN is not required.

  • In cases of emergency which prevent communicating with or obtaining information about the condition of the employee, written CMN shall not be required until such time as communication is possible and appropriate.  Within 15 days of returning to work the employee will secure a CMN from their health care provider and deliver it to their direct supervisor.

  • If a staff member fails to submit a CMN as prescribed in these guidelines and in Unclassified Personnel Guideline 10.04 (c ) the period of the sick leave should be charged to leave without pay as an unexcused absence.

  • In cases of suspected abuse of sick leave privilege a CMN may be required if consultation by the supervisor with their Dean/Division Officer and HR results in concurrence with supervisor’s request for CMN.  The consultation must occur prior to a request for the CMN due to suspected sick leave abuse.

 

Requirements:  All unclassified staff who are absent and use sick leave for more than 5 full consecutive working days must provide a written Certification of Medical Necessity (CMN) from their health care provider.

  • CMN must be provided by the employee within 15 days of the employee’s return to work.

  • CMN must be provided to supervisor, who signs and dates form and delivers to Dean or Division Officer immediately.

  • Division Officer signs, dates CMN and delivers immediately to HR.

  • HR reviews and audits the CMN with leave report records

  • HR maintains the CMNs in separate files.

 

Responsible Parties

     Employee is responsible for:

·    Knowing and complying with the guidelines;

·    Timely and accurate reporting of their leave usage on the Leave Report form;

·    Obtaining the CMN from their health care provider;

·    Providing the CMN to their supervisor within the allotted time frame.

     Direct supervisor is responsible for:

·      Establishing and maintaining record of employees’ schedules (for leave reporting purposes) if they vary from 7:45 a.m. to 4:30 p.m. Monday through Friday for 100% appointments, in consultation with their dean/division officer.  Less than 100% appointments should have a schedule agreed upon with supervisor and dean/division officer on file.

·      Consulting with their dean/division officer and HR as appropriate;

·      Reviewing and verifying accuracy of leave reports prior to signing them;

·      Tracking the sick leave usage for the more than 5 day rule;

·      Requesting the CMN and ensuring that it is obtained and routed;

·      Contacting their dean/division officer and HR for assistance if the CMN is not provided by the employee within in the timeline.

 

     Dean/Division Officer is responsible for:

  • Approving schedules with the direct supervisor;

  • Reviewing, verifying the accuracy, signing and delivering the completed CMN immediately to HR;

  • Consulting with HR as appropriate;

  • Consulting and providing assistance with HR to the supervisor as necessary

 

     HR Staff are responsible for:

  • Providing information on the guideline and UW-L procedures to the campus as appropriate—at least each semester;

  • Maintaining current knowledge of the policy and any changes;

  • Auditing campus compliance each month by checking the CMNs received against the leave reports on file in HR;

  • Following up as needed;

  • Retaining separate files of CMNs received, with a disposition schedule to be established at a later date in consultation with UWSA;

  • Assisting employees, supervisors, and dean/division officers in understanding and complying with this Board of Regents Policy and the guidelines.

  

References:

  • Human Resource Staff

  • UPG 10.4 (C ); revised by BOR action October 7, 2005

  • PowerPoint slides provided by UWSA (From Jack Wilson on December 13, 2006; modified by UW-L HR 2/8/2006)

  • UW-La Crosse Certification of Medical Necessity form 

 

HR 2/22/2006 jbw