The Brigham and Women's Hospital (BWH) manages employee leave through its Leave of Absence Policy, HR-403. This policy has been active since January 1, 2008, with revisions made on May 22, 2012. Employees can request paid or unpaid leave for medical, personal, or other authorized reasons. Understanding BWH leave policies before submitting your request helps avoid processing delays.
The Brigham Women's leave of absence form supports multiple leave categories. Each type has specific eligibility criteria and required documentation from BWH Human Resources.
Eligibility depends on your service duration and hours worked at Brigham and Women's Hospital. For FMLA leave, federal law requires at least 12 months of employment and 1,250 hours worked in the past year. Employees who do not meet federal FMLA requirements may still qualify for non-FMLA medical leave or personal leave under BWH policies. The eligibility criteria ensure that leave benefits are extended to employees who have demonstrated a commitment to their role. Contact BWH Human Resources for specific eligibility information relevant to your situation.
Any leave or combination of leaves cannot exceed six months within any rolling 12-month period. This cap applies to all leave types covered under the HR-403 policy. Extensions beyond six months are available only when required by law, such as under the Americans with Disabilities Act (ADA). BWH management and Human Resources have discretion in applying these policies to individual employee leave requests.
The form is 10 pages and takes approximately 2 minutes and 30 seconds to complete. Follow these steps to submit your leave request correctly:
BWH HR-403 policy requires advance planning whenever possible. Submit your leave request well before your planned start date. This allows the BWH Human Resources team time to review your application and provide information about your leave status.
Benefits continuation during a leave of absence depends on the type of leave and your employment status at BWH. The following points summarize key information:
Before submitting your BWH leave of absence form, review the following points:
Can I request FMLA leave at Brigham and Women's Hospital?
Yes. If you have worked at BWH for at least 12 months and logged 1,250 or more hours, you may qualify for federally protected FMLA leave of up to 12 weeks per year. The BWH leave of absence form covers FMLA as one of its supported leave types.
Is the BWH leave of absence form available in digital format?
Yes. You can download and complete the form digitally using FormsPal's online PDF editor. The form contains 10 pages and takes about 2 minutes and 30 seconds to complete.
What documentation is required for a medical leave request at BWH?
A medical certification from your health provider is required for medical leave requests. Your doctor must confirm your need for leave and provide relevant health information. Additional documentation may be required depending on the type of leave you are requesting.
What other names is this form known by?
This form is also referred to as the BWH leave of absence form, partners health care Brigham and Women's leave of absence form, HR-403, and BWH LOA form.
You may also need these related forms when managing your leave of absence:
| Question | Answer |
|---|---|
| Form Name | Brigham Womens Leave Of Absence Form |
| Form Length | 10 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 2 min 30 sec |
| Other names | partners health care brigham and womens leave of absence form, hr, brigham leave absence, bwh leave of absence |
