FMLA Form Letters
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2 Posts
Does anyone have any FML form letters that they can share? I am specifically looking for letters sent from the er to ee's when they go out on FML and when they have exhausted their 12 week allowance and are supposed to return to work. Thanks to all for your asssistance.
Comments
They have a lot of forms and letters on this web site including a link to the Department of Labor's form called Employer's Response to Employee's Request for Family & Medical Leave. You can find the government form at:
http://www.dol.gov/esa/forms/whd/WH-381.pdf
Thanks, but these dol documents are not what I am looking for. Does anyone sent a letter to the employee (prior to the end of the fml) informing them of the date their FML expires and that they are to return the day after? I want to send a "reminder" let employees know that they need to get back to work. I wanted to see what other employers send to get an idea.
Dear
Regrettably, I must inform you that as of _____________ your 12 weeks of leave under the federal Family and Medical Leave Act was exhausted. The state in which you are employed does not mandate any additional leave rights beyond this time period [confirm this is true for the state in which the employee works] and all your accrued sick and vacation leave has been exhausted [confirm this is true for this employee]. Because our company does not offer any short- or long-term disability, nor the ability to request an unpaid leave of absence [confirm this is true for your company] your leave options have now been exhausted.
In accordance with our FMLA policy and as is permitted by FMLA regulations, we require all employees on leave to provide notice of their intent to return to work [be sure your policy actually addresses this before you make this statement]. Because we did not hear from you regarding a specific return to work date nor did you report to work after the 12 weeks was exhausted, we are assuming you will not be returning to work in the foreseeable future. As a result, and in accordance with our policy [if policy states this] we must consider you to have abandoned your job. Information regarding your rights under COBRA will be sent to you separately [include this sentence only if the person is eligible for COBRA]. Please contact our office to arrange a time to drop off (or for us to pick up, if needed) any tools, keys, etc. still in your possession and to meet with us regarding your retirement fund and to complete other paperwork.
Should you be interested in future employment with the organization please contact us for a list of current openings. We appreciate your service to the company and certainly wish you well in the future. You can reach me at _________________ with any questions or to set up an appointment.
This letter is in follow up to our telephone conversation on <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />3/1/01. As we discussed, your last day worked at ABC Co. was 10/22/00. You applied for and were granted Family Medical Leave (FML) from 10/22/00 through 1/9/01. This exhausted your 12 weeks of FML available under the Family Medical Leave Act. Since you were medically unable to return to your assigned duties, ABC granted you a 90-day Leave of Absence (LOA). This 90-day LOA is from 1/10/01 to 4/11/01.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
It is important for you to understand these periods of leave so that you are aware of the 4/11/01 expiration date of your LOA. As you know, upon expiration of your LOA, you will have exhausted all available Leave Programs under ABC'sPolicies. Per our Policy, if you are unable to return to your assigned position of Shipping Material Handler and perform all the essential duties of that job by 4/11/01, ABC will no longer be able to keep you in our employment.
Prior to returning to work, ABC will require you to furnish the appropriate medical documentation in accordance with our Fitness for Duty Policy.
Please know that we are concerned about your health and look forward to your return to work. However, ABC must be consistent with administering our policies and fair to all employees at ABC.
Should you have any questions, please call me at 555-1003.
Doesn't that letter need to take into consideration that their continued leave/disability might then fall under the protections of the Americans with Disabilities Act?
This is the letter we send to individuals when their 12 weeks of FMLA entitlement ends:
<< Dear Mr. Smith,<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
The purpose of this letter is to inform you that your entitlement of twelve weeks, per the Family Medical Leave Act, has expired.
Please advise within fifteen (15) days if you are requesting an <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />ADA accommodation or personal leave so that we may consider your request.
Please contact me at (123) 456-7890 x123 should you have any questions. >>
If the 15 days passes, we send another letter giving them another 15 days. If we still don't hear from them at that point, then we send them a final letter letting them know that we made a good faith effort to extend their leave longer than their entitlement in order to give them an opportunity to respond. Due to their non-response, we assumed they did not require any additional accommodation and we would terminate their leave at that point. That way, if a lawsuit arises, we will at least be able to show that we gave them the opportunity to formally request an accommodation (such as an extension of their leave), and they didn't act by our deadline rather than just cutting them off without giving them a chance to let us know why they need additional time.
But if that template letter you attached has been effective, and no one has challenged it, I'd say go with that!