Organ Donation Leave Laws in Illinois

Federal law does not mandate paid leave for organ or bone marrow donation. The Family and Medical Leave Act (FMLA), 29 U.S.C. § 2601, provides up to 12 weeks of unpaid leave for serious health conditions, which may cover some donation-related recovery in certain circumstances, but FMLA does not specifically create a right to organ donation leave.

The FMLA applies to employers with 50 or more employees within 75 miles and requires employees to work there for 12 months with 1,250 hours worked. While an employee recovering from organ donation surgery might qualify for FMLA protection if the recovery period meets the serious health condition standard, the FMLA leave is unpaid (unless the employer offers paid leave that runs concurrent), and FMLA does not address pre-operative leave for the donation procedure itself.

At the federal level, employers are not required to provide any specific paid leave for organ donation. Therefore, state laws like Illinois's Bone Marrow and Organ Donation Leave Act fill this gap and provide stronger protections than the federal baseline.

Illinois provides significantly stronger protections than federal law through the Bone Marrow and Organ Donation Leave Act, codified at 820 ILCS 140/1 et seq. This state statute grants eligible employees up to 30 days of paid leave per calendar year specifically for the purpose of donating bone marrow or an organ (including but not limited to kidney, liver, lung, pancreas, and heart).

The law applies to employers with 50 or more employees in Illinois. This threshold is identical to federal FMLA coverage, but Illinois's organ donation law stands alone as a specific, mandatory paid leave entitlement. Employees do not need to choose between using FMLA (unpaid) and using organ donation leave; the leave runs separately and concurrently with other leave entitlements the employer may provide.

Unlike federal law, Illinois requires that organ donation leave be paid at the employee's regular rate of compensation. The law does not subtract from vacation, personal days, or sick leave balances unless the employee and employer agree in writing. An employee may use paid organ donation leave for any time needed in connection with the donation—including pre-operative testing, the surgery itself, and recovery time as medically necessary.

The employee must notify the employer as soon as practicable before taking leave. Employers may require reasonable proof that the leave is for the stated purpose, such as a physician's certification. Critically, under 820 ILCS 140/3, employers are prohibited from retaliating against an employee for using or requesting organ donation leave, from requesting or requiring an employee to donate, or from discharging, disciplining, or otherwise penalizing an employee for refusing to donate.

The Illinois Bone Marrow and Organ Donation Leave Act contains several important limitations and does not apply universally to all employees and employers.

Employer Size: The law applies only to employers with 50 or more employees. Employees working for smaller employers (49 or fewer) do not have a statutory right to paid organ donation leave under this Illinois law, though such employees may still qualify for FMLA unpaid leave if applicable.

Timing and Notice: While the law requires notice 'as soon as practicable,' employers may require reasonable notice and proof. If an employee fails to provide notice and proof, the employer may delay the leave or require it to be unpaid or charged to other leave balances. Emergency donations where advance notice is not feasible may be treated differently; employers are expected to accommodate emergency situations reasonably.

Recovery and Medical Necessity: Leave is available for time needed 'in connection with' the donation. This covers surgery and reasonable recovery, but employers may request medical certification to verify the leave is medically necessary. An employee cannot use organ donation leave for purposes unrelated to the donation process itself.

Concurrent Leave: The leave runs alongside FMLA and other employer-provided leave such as vacation or sick leave. However, if an employer's policy requires employees to use paid leave concurrently (e.g., vacation first), the organ donation leave will run concurrently, reducing the distinct organ donation leave available.

No Retaliation: While employers cannot retaliate for exercising the right, they can require proof of donation or refuse leave if the medical facts do not support a donation is occurring. Similarly, an employer does not have to pay for leave if the employee does not actually donate (absent a commitment letter or medical directive).

Step 1 — Document and Gather Evidence: Keep detailed records of your donation-related medical appointments, physician letters, and communications with your employer about the leave request. Document the dates you requested leave, the dates you actually took leave, and confirmation of the donation surgery. Save emails, texts, and written correspondence. Take notes on conversations with your supervisor or HR, including who was present and what was said. Retain your medical records and any correspondence with the transplant center or hospital. If you were denied leave or faced retaliation, document the exact actions taken against you, the date, and any witnesses.

Step 2 — Internal Complaint and Employer Process: Notify your employer in writing (email is acceptable) as soon as practicable that you need organ donation leave. Include the date of the donation procedure and, if helpful, a brief medical note confirming the donation. Request confirmation in writing that the leave will be provided paid. If your employer denies the request or delays it, follow the company's internal grievance or appeal process, if one exists. Request a written explanation for any denial. Keep copies of all communications. If your employer does not have a formal complaint process, send a written message to HR or management clearly stating your organ donation leave request and requesting written confirmation of approval. This creates a paper trail if you later need to file a complaint.

Step 3 — File a Complaint with the Illinois Department of Labor (IDOL): If your employer denies paid organ donation leave or retaliates against you, file a complaint with the Illinois Department of Labor, Wage and Hour Division. The complaint should be submitted in writing and should include your name, employer name and address, the dates leave was requested or denied, a description of what happened, names of witnesses, and copies of supporting documents. The address is: Illinois Department of Labor, 217 South High Street, Springfield, IL 62702. You may also file online at www.cyberdriveillinois.com/departments/labor or call (800) 252-2112 for assistance. There is no strict statute of limitations specified in the statute, but complaints should be filed as soon as reasonably possible after the violation occurs. Include copies of emails, denial letters, or other evidence.

Step 4 — IDOL Investigation Process and Timeline: The Illinois Department of Labor will assign your complaint to an investigator. The investigator will contact your employer to gather information and request records related to your leave request and compensation. You should expect communication from the investigator, who may request additional information or clarification from you. The investigation typically takes 30 to 90 days, though more complex cases may take longer. The investigator will determine whether the employer violated 820 ILCS 140. If a violation is found, the Department of Labor may seek to compel the employer to pay back wages (the unpaid leave compensation) and may recommend penalties. You will be notified of the outcome.

Step 5 — When to Consult an Employment Attorney: If your employer retaliates against you after taking organ donation leave (such as demotion, reduced hours, hostile treatment, or termination), consult an employment attorney immediately. If the Department of Labor investigation does not resolve the issue or if your employer fails to comply with the investigator's findings, an attorney can file a civil lawsuit on your behalf. An employment attorney can pursue damages for lost wages, damages for retaliation, and potentially attorney's fees. Contact an employment attorney who specializes in retaliation or wage and hour claims. Many offer free initial consultations. If you cannot afford an attorney, contact the Illinois Workers' Rights Center or a legal aid organization in your area.