Domestic or Sexual Violence Leave Policy
Eligible employees may be entitled to time off under the Philadelphia ordinance called "Entitlement to Leave Due to Domestic or Sexual Violence." Although such leave (hereinafter "DSV leave") is unpaid, employees requiring DSV leave for their own serious health condition may elect to use available sick leave, paid time off, and short-term disability under University policy. Employees using DSV leave to care for a family or household member may use up to five (5) days of sick leave, if eligible, and any amount of available paid time off, if eligible. The following is the University's DSV leave policy.
All University employees working within a 50-mile radius of Penn's main campus in Philadelphia (including but not limited to New Bolton Center and Glenolden) are eligible for DSV leave under this policy.
Employee means any University faculty or staff member employed within a 50-mile radius of Penn's main campus in Philadelphia on a full-time, part-time, or temporary basis.
Domestic or Sexual Violence includes spousal or child abuse, sexual assault, rape, incest, sexual abuse, stalking, and related crimes. (For purposes of clarity, the ordinance's definition of sexual assault is merely summarized here; however, it is the University's intent to comply fully with the ordinance.)
Family or household members means:
Spouse or persons who have been spouses
Persons living as spouses or who lived as spouses
Parents and children
Other persons related by consanguinity or affinity, including persons who share biological parenthood
Current or former sexual or intimate partners and life partners, as that term is defined in the Philadelphia Code
634.4 QUALIFIED LEAVE REASONS
The University will grant DSV leave to an eligible employee who is a victim of domestic or sexual violence, or who has a family or household member who has been a victim, in order that the employee might obtain or that the employee might assist the victim in obtaining:
Medical attention needed to recover from physical or psychological injury or disability caused by domestic or sexual violence or stalking;
Services from a victim services organization;
Psychological or other counseling;
Relocation or safety planning to increase the safety of the victim or ensure economic security due to domestic or sexual violence or stalking; or
Legal services or remedies, including preparing for or participating in any civil or criminal legal proceeding related to or resulting from domestic or sexual violence or stalking.
634.5 NOTICE REQUIREMENTS
The employee shall provide the employer with at least 48 hours advance notice of DSV leave, unless providing such notice is impracticable. Any employee with an unscheduled absence due to one of the qualified leave reasons listed above must provide certification, as defined below, to the Benefits Office in the Division of Human Resources within forty-five (45) calendar days. Failure to provide the required certification within forty-five (45) calendar days may result in the delay or denial of DSV leave.
An employee requiring DSV leave must provide certification within forty-five (45) calendar days that the employee or a family or household member is a victim of domestic or sexual violence and that the leave is required for one of the purposes listed in section 634.4 above.
Certification must consist of a sworn statement by the employee, plus at least one of the following documents: (1) documentation from an employee, agent, or volunteer of a victim services organization, an attorney, a clergy member, or medical or other professional from whom the victim has sought assistance; (2) a police or court record; or (3) other corroborating evidence.
634.7 LEAVE ENTITLEMENT
Eligible employees may be entitled to up to eight (8) weeks of DSV leave during any 12-month period (measured backward from the date an employee uses the leave). However, this leave is not in addition to the twelve (12) weeks of available Family and Medical Leave Act (FMLA) leave in any 12-month period. Thus, any employee who already has used more than four (4) weeks of FMLA leave in the preceding twelve (12) months shall have his or her available DSV leave reduced by the amount of time used for FMLA leave in excess of four (4) weeks.
Employees may take DSV leave consecutively, intermittently, or on a reduced leave schedule.
634.8 SUBSTITUTING PAID LEAVE
Employees taking DSV leave to seek medical attention for or recover from their own serious health condition may elect to use available sick leave, paid time off, or short-term disability benefits, if eligible.
Employees taking DSV leave for any other purpose may, but are not required to, use up to five (5) days of available sick leave, if eligible in accordance with the University's Sick Leave policies, and any available paid time off.
DSV leave otherwise is unpaid.
634.9 BENEFITS DURING LEAVE
During DSV leave, the University will maintain an eligible employee's medical, dental, life and disability insurance coverage on the same conditions that coverage would have been provided if the employee had been continuously employed during the entire leave period. The University and the employee will each continue to pay their portion of the benefit costs. In some instances, the University may recover—on a prorated basis—premiums it paid to maintain health coverage for an employee who fails to return to work from DSV leave.
During DSV leave, sick leave and paid time off will continue to accrue only during that portion of the leave which is paid by using sick or paid time off. During any unpaid leave, sick leave and paid time off will not accrue. For those persons returning from any unpaid leave, accrual of paid time off and sick leave will resume the first of the month which follows or coincides with the date the individual returns to active work. Where the leave is taken on an intermittent basis or as a reduced-schedule, sick leave and paid time off will continue to accrue during the leave on a pro rata basis.
634.10 RETURN FROM LEAVE
Employees returning from DSV leave will be reinstated to the same or equivalent position, with equivalent pay, benefits, and other terms and conditions of employment. Failure to return to work may result in discipline or termination of employment.
634.11 OTHER LEAVE ARRANGEMENTS
Employees who have used their full allotment of DSV leave in any 12-month period may be eligible for (though are not necessarily entitled to) FMLA leave or an unpaid leave of absence under other University policies.
634.12 FOR MORE INFORMATION
Information can be obtained by contacting the Benefits Office in the Division of Human Resources. In addition, a poster will be placed in the Division of Human Resources which includes further details regarding eligibility and other requirements of the ordinance. Employees of temporary staffing agencies should contact their agency directly for information regarding their rights under the ordinance (see Policy No. 112, Using Temporary Agencies). Questions of interpretation of this policy will be resolved by reference to the ordinance and any guidance promulgated in connection therewith. Employee rights under this policy shall in no case be less than those afforded by the ordinance or any other applicable law affording greater rights.
Note: Dealing with issues covered by this policy can be challenging. For these and other matters, the University offers the Employee Assistance Program (EAP) for free, confidential, one-on-one support at any time. The EAP can be reached 24 hours a day, 7 days a week to help you manage the issues at hand and prepare for a successful return to the workplace. For more information, visit the EAP website or call 1-888-321-4433 to speak with a counselor.
DSV Leave Forms and Letters
Domestic or Sexual Violence Leave Provisional Letter
Use this letter if an employee has notified you that s/he will be out for a possible DSV Leave qualifying event.
Letter #1 - FML Provisional Letter
Use this letter if staff member has been out sick for more than 3 consecutive days and has not notified you that s/he will be out for a possible FML qualifying event.
Letter #2 – FML Provisional Letter
Use this letter if staff member has notified you that s/he will be out for a possible FML qualifying event for his/her own serious medical condition or pregnancy.
Letter #3 – FML Provisional Letter
Use this letter if staff member has notified you that s/he will be out for a possible FML qualifying event to care for a family member with a serious medical condition.
Letter #4 – FML Provisional Letter
Use this letter if staff member has notified you that s/he will be out for a possible FML qualifying event for care of newborn, adoption, or foster care.
Family Medical Leave Forms
Including the Physician's Certification Form and the Short-Term Disability & Family Medical Leave Request Form
The benefits and policies for University of Pennsylvania employees who work in locations outside of the Commonwealth of Pennsylvania may be different from the benefits and policies set forth in this website. Employees working outside the Commonwealth of Pennsylvania should contact their Human Resources representatives for more information.
Policy Number: 634
Effective Date: 05/13/2015
Supersedes Policy Number(s): 634 (1/5/2009)
Applicability: All Faculty & Staff
Cross-reference: Policy 001 (Adherence to University Policy), Policy 112 (Using Temporary Agencies), Policy 404 (Short-term Disability), Policy 412 (New Child Policy), Policy 607 (Paid Time Off), Policy 612 (Sick Leave), Policy 613 (Sick Leave and STD for Employees At or Above Position Grade 9 or in Grades E, F, G and H), Policy 616 (Leave of Absence Without Pay), Policy 631 (FMLA), Policy 714 (Occupational Injury or Illness)