In the US, a medical leave of absence is mandatory and is administered by the U.S. Department of Labor under the Family and Medical Leave Act (FMLA). The family medical leave act applies to all: Public agencies, including local, State, and Federal employers, and local education agencies (schools); and Private sector employers who employ 50 or more employees for at least 20 workweeks in the current or preceding calendar year – including joint employers and successors of covered employers.