- Delaware Health and Social Services

Office of the Secretary - Administration

REASONS FOR REQUESTING FMLA

SELECTION FROM ACT REASON DEFINITION

Pregnancy and Childbirth I'm pregnant or need time off to deliver my baby Only for the Pregnant Employee, includes pre-natal care, birth and recovery

Donation I'm donating bone marrow or an organ Only for the employee to actually donate bone marrow or an organ does not include visits to determine compatibility. Runs concurrent with FMLA and covers up to one work week pay for Bone Marrow and 30 calendar days for an Organ.

Employee Health Condition (not pregnancy-related) I have another health condition (not pregnancy-related) Only for the medical condition for the employee

Child Bonding I need time to bond with a new child For both the parents of the child

Child Placement I need time to complete an adoption or foster child placement For both the adoptive/foster parents.

Other Person Health Condition I need time off because of someone elseO's health condition For the employee to care for the Spouse, Child, parent of the employee; includes time off for the employee to provide Military Caregiver leave for current service member/veteran

Disaster Response I need time off because I am an American Red Cross member and will be responding to a disaster A non-FMLA event to respond to a disaster with approval of the agency for up to 15 workdays

Other I need leave for some other reason

Military Exigency I have a family member who is serving in or being deployed by the military For the employee to have time off to participate in one of the following events due their spouse, child, parent being called to active duty:

Short-notice deployment
Military vents and related activities
Child care and school activities
Financial and legal arrangements
Counseling
Rest and recuperation
Post-deployment activities
Care for a parent and related activities
Additional activities (Miscellaneous)

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REASONS FOR REQUESTING FMLA

Delaware's Government

SELECTION FROM ACT	REASON	DEFINITION
Pregnancy and Childbirth	I'm pregnant or need time off to deliver my baby	Only for the Pregnant Employee, includes pre-natal care, birth and recovery
Donation	I'm donating bone marrow or an organ	Only for the employee to actually donate bone marrow or an organ does not include visits to determine compatibility. Runs concurrent with FMLA and covers up to one work week pay for Bone Marrow and 30 calendar days for an Organ.
Employee Health Condition (not pregnancy-related)	I have another health condition (not pregnancy-related)	Only for the medical condition for the employee
Child Bonding	I need time to bond with a new child	For both the parents of the child
Child Placement	I need time to complete an adoption or foster child placement	For both the adoptive/foster parents.
Other Person Health Condition	I need time off because of someone elseO's health condition	For the employee to care for the Spouse, Child, parent of the employee; includes time off for the employee to provide Military Caregiver leave for current service member/veteran
Disaster Response	I need time off because I am an American Red Cross member and will be responding to a disaster	A non-FMLA event to respond to a disaster with approval of the agency for up to 15 workdays
Other	I need leave for some other reason
Military Exigency	I have a family member who is serving in or being deployed by the military	For the employee to have time off to participate in one of the following events due their spouse, child, parent being called to active duty: Short-notice deployment Military vents and related activities Child care and school activities Financial and legal arrangements Counseling Rest and recuperation Post-deployment activities Care for a parent and related activities Additional activities (Miscellaneous)