FMLA - Medical
Eligible employees can take up to 12 weeks of Family and Medical Leave due to a serious health condition for themselves, spouse, child or parent during a school year.
Employees are eligible if they have worked for a covered employer for at least one year, for 1,250 hours over the previous 12 months, and if at least 50 employees are employed by the employer within 75 miles.
While you are on Family and Medical Leave, you will use your accrued sick leave and vacation or personal leave.
Any time beyond your accrued leave will be leave without pay.
While employees are under the FMLA leave, the District does continue to pay the insurance premiums (if the employee is using unpaid leave, they must continue to pay their portion of the insurance coverage.)
Employees who will be absent 4 or more days, due to a medical condition for themselves, spouse, child or parent, are required to complete the request for Family and Medical Leave and provide a doctor’s note (see specifics below).
FMLA - Medical Leave Request to Human Resources
Employees who will be absent 4 or more days, due to a medical condition for themselves, spouse, child or parent, are required to complete the request for Family and Medical Leave in Talent Ed Records and provide a doctor’s note (see specifics below).
Instructions to request FMLA Leave for Medical in Talent Ed Records are below along with the doctor note requirements:
• Login Talent Ed Records (same as your BPS email)
• Click on “Blank Docs” (top tool bar)
• FMLA Medical HR Request is the name of the document
• When you click on it – hit the button that says “add as an
e-form” - it may ask if you want to archive as you may have a previous document in the system - click on "yes"
• Complete the form and hit “Save Final” at the bottom of the
• Signature line will then come up highlighted in yellow - please electronically sign and hit "Save Final"
HIPAA Authorization for Release of Information
Employee Serious Health Condition Form (Doctor)
- Please complete the Employee Serious Medical Condition form if absence will be more than 1 week; a general doctor note will be sufficient if less.
- Please fax to HR at (701) 323-4115
- Please complete the Family Member Serious Health Condition form if absence will be more than 1 week; a general doctor note will be sufficient if less.
- Please fax to HR at (701) 323-4115.
If you have any questions or need any assistance, please contact Paulette Kerzmann or 323-4072.
Sick Leave Bank
Staff members new to the Bismarck Public School District have a one-time opportunity to join the Sick Leave Bank by donating one day of sick leave within the first thirty days of employment with the District. Employees would have to donate an additional day of sick leave if the balance of the Sick Leave Bank was below 500 days. The Sick Leave Bank was created in 1998 and each member has only donated one day to the bank.
The Sick Leave Bank was created to provide a resource to employees who are impacted by a catastrophic illness or injury and do not have any accrued leave available to use during their time off. An employee, who is a member of the sick leave bank, can apply for days from the sick leave bank if they, their spouse or child has a catastrophic illness or injury and the employee has use all of their available leave. The application for days from the sick leave bank is reviewed by a committee of three district employees who are members of the sick leave bank.
The following are parameter of receiving days from the sick leave bank:
- All accumulated sick, personal and vacation leave days have been used and the employee would need to take more than five days of leave without pay.
- The application must outline the reason for needing days from the bank along with a medical doctors’ certificate verifying the severity, nature, and projected duration of the illness or injury. All medical information will be kept confidential and the members of the sick leave bank will not be given the name of the individual applying for days from the bank.
- If the employee’s illness or injury qualifies for disability coverage, the employee must apply for long-term disability coverage, the HR Manager will verify to the Committee if an application for disability has been filed.
- Participants can be granted up to 20 days of sick leave per application and a maximum of 80 days per school year.
The following forms can be accessed through the iVisions site:
Sick Leave Bank Request Form
HIPAA Authorization for Release of Information
Employee Serious Medical Condition Form
Family Member Serious Medical Condition Form
For more information on the sick leave bank request form, please contact Paulette Kerzmann or (701) 323-4072.