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4.080 - Pregnancy

Effective Date: 3/19/2014


This policy applies to pregnant employees.

1. Pregnant Employees May Request a Limited Duty Assignment-See 4.070-Limited Duty

The pregnant employee will notify her supervisor and the Employment Services Lieutenant when the employee or a health care provider believes her condition prevents her from safely performing all the duties of her regular position or assignment.

2. Pregnant Employees May Request Family and Medical Leave-See 4.100-Family and Medical Leave

Employees may take family and medical leave for pregnancy, prenatal care, or to care for a newborn child.

Employees may request both pregnancy disability leave and family and medical leave.

Employees may review leave options with the Family and Medical Leave Coordinator.

3. Pregnant Employees May Claim Long Term Disability Benefits

See 4.060-Long Term Disability Benefits

4. Pregnant Employees May Request Pregnancy Disability Leave as Described in City Personnel Rule 7.2 – Pregnancy Disability Leave

Pregnant employees will use all accrued sick leave and then may take an unpaid pregnancy disability leave of absence for a disability related to pregnancy or childbirth.

  • Employees may request both pregnancy disability leave and family and medical leave.

See 4.080-PRO-1 Requesting Pregnancy Disability Leave

5. Eligible Employees May Buy Back Retirement Service Credit for Unpaid Leave of Absence

Employees may buy back service credit after they return to regular paid status or separate from employment.

LEOFF II members may contact DRS (Department of Retirement Systems) at 360-464-7000 or toll free at 1-800-547-6657; pressing “0” to speak with a live representative.  Sworn employees may view the Department of Retirement Systems policy from this link:

Civilian employees may contact SCRS (Seattle City Employees’ Retirement System) at 206-386-1293.  Non-sworn employees may view the Seattle City Employees’ Retirement System policy from this link:

6. The Department Follows the City Policy on Breastfeeding

Also see: SMC 4.34.055(G) Use and Scheduling of Vacations

4.080-PRO-1 Requesting Pregnancy Disability Leave


1. Completes an Employee Request for Leave of Absence (form 2.9) and a Washington State Insurer Activity Prescription Form (APF).

  • A health care provider must state the medical necessity for pregnancy disability leave on the APF and estimate the duration of the leave.

2. Submits completed forms to the Family and Medical Leave Coordinator.

Family and Medical Leave Coordinator

3. Reviews completed forms and follows up with the employee.

4. Forwards the request to the Human Resources Director.

Human Resources Director

5. Informs the employee in writing of the Department’s decision regarding the request.


6. If the disability leave is extended, then submits a new Employee Request for Leave of Absence (Form 2.9) and a Washington State Insurer Activity Prescription Form (APF) per steps 1 and 2 of this procedure.

7. Obtains a health-care provider signed APF releasing the employee to full duty without restrictions.

8. Reports for duty per the release date on the APF, obtains sergeant/supervisor signature on APF, and forwards APF to Employment Services Lieutenant.


Adrian Diaz, Chief of Police
Address: 610 5th Avenue, Seattle, WA, 98104-1900
Mailing Address: PO Box 34986, Seattle, WA, 98124-4986
Phone: (206) 625-5011
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