Use the Department of Labor's own forms for these notices. This checklist tells you which form and when; it does not replace the forms.
1. Check that you are a covered employer
- ☐ Private employer with 50 or more employees in 20 or more workweeks this year or last year, or a public agency or school.
- ☐ If covered, display the FMLA poster (WHD 1420) where employees can see it, and include FMLA information in your handbook if you have one.
2. When an employee asks for leave that may qualify
The clock starts when you learn the leave may be for an FMLA reason, even if the employee doesn't say "FMLA".
- ☐ Within 5 business days, send the Notice of Eligibility and Rights and Responsibilities (WH-381).
- ☐ Check eligibility: worked for you 12 months, worked 1,250 hours in the last 12 months, and works where you have 50 employees within 75 miles.
- ☐ If they are not eligible, give at least one reason on the notice.
3. Ask for certification, if you require it
- ☐ Employee's own serious health condition: WH-380-E.
- ☐ Family member's serious health condition: WH-380-F.
- ☐ Military family leave: WH-384 (qualifying exigency) or WH-385 / WH-385-V (caregiver).
- ☐ Give the employee at least 15 calendar days to return it. If it is incomplete, tell them in writing what is missing and allow 7 calendar days to fix it.
4. Designate the leave
- ☐ Within 5 business days of having enough information, send the Designation Notice (WH-382): approved or not, how much will count against their 12 weeks, and whether you need a fitness-for-duty certificate on return.
5. While on leave and on return
- ☐ Keep group health coverage on the same terms as if they were working.
- ☐ Restore the employee to the same or an equivalent job.
- ☐ Keep FMLA records for at least 3 years, and medical documents separate from personnel files.
Also check
- ☐ State family and medical leave laws, which may cover smaller employers and add more time or pay.