Absences, Leaves, and Worker’s Compensation Forms

Absences

  • Faculty, Academic Staff, Limited Appointees Leave Report PDF
  • University Staff Accounting Correction Form PDF
  • Vacation Option Election Form LINK

Catastrophic Leave Program

  • Catastrophic Leave Applicant Eligibility PDF
  • Catastrophic Leave Donor Authorization PDF
  • Catastrophic Leave Employee Request PDF

Family and Medical Leave Act (FMLA)

  • Employee Request for Family and/or Medical Leave (UWS 80) LINK
  • Notice of Eligibility and Rights & Responsibilities (UWS 81) PDF
  • Certification of Health Care Provider for Employee’s Serious Health Condition (DOL WH-380-E) LINK
  • WFMLA-Only Certification by Health Care Provider for Employee’s Serious Health Condition (UWS 82a) LINK
  • Certification of Health Care Provider for Family Member’s Serious Health Condition (DOL WH-380-F) LINK
  • WFMLA-Only Certification by Health Care Provider for Family Member’s Serious Health Condition (UWS 83a) LINK
  • Certification of Qualifying Exigency for Military Family Leave (DOL WH-384) LINK
  • Certification for Serious Injury or Illness of a Current Servicemember for Military Family Leave (DOL WH-385) LINK
  • Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (DOL WH-385-V) LINK
  • Designation Notice (UWS 86) PDF
  • Fitness-for-Duty Medical Certification to Return to Work from Family/Medical Leave or Absence PDF

Worker’s Compensation

Employees

  • Employee’s Work Injury and Illness Report LINK
  • Labor Market Availability Restriction Statement LINK
  • Lost Time Fact Sheet PDF DOC
  • Worker’s Compensation Mileage Record DOC

Supervisors

  • Employer’s First Report of Injury or Disease PDF
  • General Incident Report UWM Employees and Student Employees DOC
  • Supervisor’s Accident Analysis and Prevention Report and Evaluation of Repetitive Motion and/or Materials Handling Activities LINK