Leaves & Medical Administration

Requesting an Unpaid Medical Leave

You can take a medical leave of absence without pay when you have a serious health condition.

Note: A serious health condition is a FMLA-qualifying event. Eligible employees must first apply for a FMLA  leave of absence. Employees who have exhausted their FMLA entitlement or who are otherwise ineligible for FMLA should apply for a medical leave of absence without pay.

If you have exhausted your FMLA entitlement, and have been placed on a medical leave of absence without pay, you may be eligible for Special Leave of Absence (SLOAC) health coverage. This is up to an additional 16 weeks of coverage that allows the employee to remain on benefits. For more information about SLOAC and the rules regarding its usage, please click here.

Employees on a leave of absence without pay for health reasons or for maternity must exhaust their Cumulative Absence Reserve or sick days prior to coming off of payroll. You must work with your payroll secretary or timekeeper to determine your paid leave entitlement.

  • Instructional/school-based staff are entitled to borrow up to 20 days and they may also request a grace period of maximum 30 calendar days.
  • UFT paraprofessionals are entitled to borrow up to 10 days. Click here for the form.
  • Administrative employees are entitled to borrow up to 10 days.

You are required to exhaust your CAR days/sick days prior to going out on a leave of absence without pay.

For more information about the use of sick days, annual days, CAR days, borrowed days, and grace periods, refer to "Can I borrow sick/CAR days?" in the Leaves of Absence FAQs.

Important Tip: You should submit your leave of absence without pay application prior to the first day of absence or as soon as possible thereafter.

The most common delays in processing a leave of absence without pay are caused by incomplete and late applications.

  • Application process

    To apply for a medical leave of absence without pay, complete the appropriate application form (see chart below). When applying, please ensure the following:

    • Complete the application form in its entirety.

    • Sign and date the application form.

    • Ensure that your principal or supervisor signs the application form.

    • Include a certification from a health care provider of your serious health condition.

    Below is a chart showing the required application forms based on employee type:

    Employee population

    Application forms

    Instructional / Non-supervisory Pedagogical Staff 

    OP 160 (Application for a leave of absence without pay)

    OP 407 - Page 2 - Instructions (Confidential Medical Report and Medical Evaluation)

    Educational Leadership Staff 

    OP 160 (Application for a leave of absence without pay)

    OP 407 - Page 2 - Instructions (Confidential Medical Report and Medical Evaluation)

    UFT Educational Paraprofessionals

    Educational Paraprofessional Leave Application

    Family Paraprofessionals & Hourly Non-Competitive Employees

    Family Paraprofessionals & Hourly Non-Competitive Employees Leave Application

    Administrative Staff

    PD 6 (Application for Leave of Absence for Health Reasons)


    Fax completed applications to HR Connect: (718) 935-4350. 

    SOLAS supporting documents can be faxed to SOLAS-only Fax number: (718) 935-5175.

    When the leave is processed, you will receive a determination. If you have more questions, please call HR Connect at 718-935-4000.