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Posted on: January 11, 2024

Follow this Easy Leave of Absence Claim Submission Checklist

FMLASourse logo and image

As a reminder, the City is now outsourcing Family and Medical Leave Act (FMLA) processing to FMLASource. To file a claim for a leave of absence, follow these step-by-step:

1.    Contact FMLASource 

a.    Website:
b.    Phone:       844-862-0892, Monday - Friday,  
                         7:30 am - 9:30 pm 

2.    Review the Medical Certification Form (MCF) in your FMLASource Leave Notification Packet or download it from 

a.    Medical certification forms are time-sensitive. Check the due date on your initial request letter from the Packet

3.    Take the blank MCF to your or your family member’s physician to be completed

a.    If leave is not for medical reasons, follow instructions from an FMLASource specialist or info in the Packet 
b.    FMLASource must receive the completed MCF before the due date. It is your responsibility. If there are delays completing the form, contact FMLASource before the due date

4.    Return the completed form to FMLASource:

a.    Fax: 877-309-0218
b.    Email:
c.    Address: FMLASource, NBC Tower - 13th Floor 
                      455 N. Cityfront Plaza Drive, Chicago, IL  60611-5322

5.    Receive and review the decision letter from FMLASource. Decisions are based on the certification form completed by the health care provider. Notify FMLASource if your leave is denied and you need to clarify the next steps.

If approved for the leave, you will be responsible for keeping track of your available entitlement:

  • Intermittent Frequency Leave:  Report each intermittent FMLA absence to FMLASource by midnight of the date of absence and follow your department’s call-off procedures. All prescheduled appointments need to be tracked ahead of time with both FMLASource and your department. Failure to report call-offs to both parties may result in disciplinary action.
  • Continuous Frequency Leave:  Pay close attention to the date range on your decision letter. Your position is only protected during that date range. To keep your entitlement accurate and to ensure protection, notify FMLASource if your leave is different than what was provided in the decision letter.

If you have a qualifying family or medical leave situation, but are not qualified for FMLA (e.g., you haven’t worked for the City for 12 months and have not worked 1250 hours in the preceding 12-month period), you should still file a claim through FMLASource. They will deny the FMLA claim and send you paperwork to initiate an ADA claim. In instances of pregnancy (of self), you will receive paperwork to file a claim under the Pregnant Workers Fairness Act. See chart for more information.

FMLASource claims info

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