Sample Family Medical Leave Act FMLA Guidelines

Sample_Documents

DISCLAIMER: This is a sample template provided for informational purposes only. It does not constitute legal, tax, or financial advice. Organizations should consult their own legal and tax advisors and tailor this document to reflect their specific business needs, geographies, and applicable laws.

Document Type	Family & Medical Leave Act (FMLA) Guidelines
Category	Benefits & Wellness
Company	<Company Name>
Version	1.0
Effective Date	<Date>
Last Reviewed	<Date>
Next Review Due	<Date>
Document Owner	<Job Title / Department>
Approved By	<Approver Name / Title>

Purpose and Objectives

• Provide a practical, comprehensive framework for administering Family and Medical Leave Act (FMLA) benefits at <Company Name> in compliance with applicable laws.
• Outline roles, responsibilities, and processes for employees, managers, Total Rewards, HR operations, payroll, and external partners such as <Vendor Name>.
• Promote consistent, fair, and timely leave determinations that protect employee rights and minimize operational risks.
• Define documentation, communication, and recordkeeping standards to support audit readiness and strong data privacy practices.
• Integrate FMLA with related benefits programs (PTO, sick pay, short-term disability, long-term disability, workers’ compensation, and parental leave) and applicable state and local leave laws.

Scope and Applicability

• In Scope
  • All U.S. employees of <Company Name> who meet FMLA eligibility requirements.
  • Managers, Total Rewards, HR Business Partners, HR Operations, Payroll, and Leave Administration staff.
  • External leave administration solutions and tools provided by <Vendor Name>.
  • FMLA programs aligned with federal law and coordinated with state and local leave laws where applicable.
• Out of Scope
  • Non-U.S. leave programs in <Country> or regions not covered by U.S. FMLA. These are governed by local laws and separate policies.
  • Non-FMLA leaves such as personal leaves without job protection, unless specifically coordinated in the Interaction With Other Policies section.
  • Workers’ compensation procedures beyond coordination with FMLA.
• Applicability
  • This policy applies where FMLA is applicable, generally including U.S. locations where <Company Name> employs 50 or more employees within a 75-mile radius, subject to eligibility criteria.
  • Where state or local leave laws provide greater protections, <Company Name> will apply the more generous provisions consistent with legal advice from <Legal Counsel / Firm Name>.

Legal Framework Overview

• FMLA is a U.S. federal law that generally provides eligible employees up to 12 workweeks of unpaid, job-protected leave in a 12-month period for specified family and medical reasons, and up to 26 workweeks for military caregiver leave.
• Leave may be taken continuously, intermittently, or on a reduced schedule, where medically necessary or allowed by law.
• Benefits under group health plans must be maintained under the same terms during FMLA leave as if the employee had continued to work.
• Upon return from FMLA leave, employees are generally restored to the same or an equivalent position, subject to limited exceptions (for example, certain highly compensated "key employees" under the FMLA definition).

Eligibility Criteria

• To be eligible for FMLA leave at <Company Name> an employee must:
  • Have worked for <Company Name> for at least 12 months (need not be consecutive, subject to legal rules on breaks in service).
  • Have at least 1,250 hours of service during the 12 months immediately preceding the start of leave.
  • Work at a location where <Company Name> employs at least 50 employees within a 75-mile radius.
• Eligibility is determined as of the date the FMLA leave is to start.
• HR or <Vendor Name> will issue an eligibility notice within standard timelines after the employee requests leave or <Company Name> becomes aware of a potential FMLA-qualifying reason.

Qualifying Reasons for Leave

• Birth of a child and care for the newborn within one year of birth.
• Placement of a child with the employee for adoption or foster care and care for the newly placed child within one year of placement.
• Care for a spouse, domestic partner where applicable, child, or parent with a serious health condition (subject to legal definitions and state law).
• Employee’s own serious health condition that makes the employee unable to perform the essential functions of their job.
• Qualifying exigencies arising out of the fact that the employee’s spouse, child, or parent is on covered active duty or has been notified of an impending call to covered active duty in the Armed Forces.
• Military caregiver leave to care for a covered servicemember or veteran with a serious injury or illness (up to 26 workweeks in a single 12-month period).
• Additional protections or qualifying reasons may be available under state or local laws and will be applied where they exceed federal FMLA.

Leave Entitlement and Calculation

• Standard Entitlement
  • Up to 12 workweeks of unpaid, job-protected leave in a defined 12-month period for most qualifying reasons.
  • Up to 26 workweeks in a single 12-month period for military caregiver leave; combined with other FMLA leave, the total may not exceed 26 workweeks in that single 12-month period.
• Measuring the 12-Month Period
  • <Company Name> uses the following method to measure the 12-month period: <Select one: Calendar Year / Rolling 12-Month Look-Back / Forward-Looking from First Leave / Fixed Year <Date> to <Date>>.
  • Total Rewards will document and maintain the selected measurement method and apply consistently across the organization, unless state law requires a different method.
• Intermittent or Reduced Schedule Leave
  • Permitted when medically necessary or for military exigencies, subject to certification and scheduling requirements.
  • Time is accounted for in the smallest increment used for other forms of leave, not to exceed one hour, per payroll and timekeeping configuration.
• Holiday and Shutdown Periods
  • If the employee takes a full week of FMLA leave containing a company holiday, the holiday counts toward FMLA leave if the employee is otherwise on leave the entire week.
  • If the employee works part of a week and a holiday occurs, the holiday generally does not count against FMLA unless the employee was scheduled and did not work due to FMLA.
• Substitution of Paid Leave
  • Where allowed, <Company Name> may require or employees may elect to use available paid leave (for example, PTO, sick pay, parental pay, or disability benefits) concurrently with FMLA.
  • Any paid benefits used concurrently do not extend the FMLA entitlement period.
• Overlapping Leaves
  • When an absence qualifies for FMLA and another leave (for example, state family and medical leave, paid family leave, workers’ compensation), <Company Name> will run such leaves concurrently where legally permitted.

Request and Approval Procedures

Employee Requests

1. Notify your manager and <Vendor Name> (or HR Leave Administration) at least 30 days in advance for foreseeable leave (for example, planned surgery, birth, adoption, or scheduled treatments).
2. If 30 days’ notice is not possible, provide notice as soon as practicable under the circumstances (typically the same or next business day).
3. Submit required information through <System Name / Leave Portal URL> or by contacting <Vendor Name> at <Phone Number> or <Email Address>.
4. Provide sufficient information for <Company Name> to determine whether the leave may be FMLA-qualifying (for example, stating that the leave is for a condition that renders you unable to perform job functions, hospitalization, ongoing treatment, or family care).
5. Complete and return medical certification forms by the deadline (generally within 15 calendar days) and respond promptly to any requests for clarification or missing information.

Employer and Administrator Actions

1. Acknowledge the request and provide the Eligibility Notice and Rights and Responsibilities notice within 5 business days after <Company Name> has knowledge of the potential FMLA-qualifying need.
2. Request and track required medical or other certifications, specifying deadlines, consequences of noncompliance, and confidentiality assurances.
3. Designate the leave as FMLA-protected, if applicable, and issue a Designation Notice within 5 business days after obtaining sufficient information to make the determination.
4. Coordinate with Payroll to ensure correct coding of paid time, unpaid time, and concurrent disability or paid leave benefits.
5. Communicate ongoing obligations to the employee (for example, premium payments, status updates, recertification schedules, and return-to-work or fitness-for-duty requirements).

Medical Certification and Documentation

• Certification Requirements
  • For the employee’s own serious health condition or to care for a covered family member, <Company Name> may require a completed medical certification from a health care provider, generally due within 15 calendar days.
  • For military exigency or military caregiver leave, appropriate certification or documentation may be required.
• Clarification, Authentication, and Cure
  • If a certification is incomplete or insufficient, <Company Name> will describe the deficiency in writing and allow at least 7 calendar days to cure.
  • HR or <Vendor Name> may authenticate or seek clarification of certifications consistent with legal requirements and privacy rules.
• Second and Third Opinions
  • Where permitted, <Company Name> may require a second opinion at company expense. If the first and second opinions conflict, a third opinion (final and binding) may be requested, also at company expense.
• Recertification
  • Generally may be requested no more often than every 30 days and only in connection with an absence, unless the certification states a minimum duration of the condition longer than 30 days.
  • For chronic or long-term conditions, recertification may occur every 6 months in connection with an absence, or sooner if circumstances change significantly, information is questionable, or a new leave year begins.
• Fitness-for-Duty
  • For an employee’s own serious health condition, <Company Name> may require a fitness-for-duty release (job-related and consistent with business necessity) prior to return to work, limited to the health condition causing the absence.
  • Any fitness-for-duty requirements will be included in the Designation Notice and applied uniformly to similarly situated employees.

Intermittent and Reduced Schedule Leave

• Intermittent leave or a reduced schedule may be taken when medically necessary and supported by certification, or for qualifying military exigencies.
• Employees should make reasonable efforts to schedule planned treatment so as not to unduly disrupt business operations.
• Where legally permitted, <Company Name> may temporarily transfer an employee to an alternative position with equivalent pay and benefits that better accommodates the intermittent schedule.
• Timekeeping will track FMLA usage in the smallest increment used for other leave types, not to exceed one hour, configured in <Timekeeping System Name>.
• Managers must plan coverage and staffing in coordination with HR to ensure continuity of operations while honoring employee rights.

Benefits, Pay, and Premiums During Leave

• Continuation of Health Benefits
  • Group health coverage will be maintained during FMLA leave on the same terms as if the employee had continued working.
  • <Company Name> will continue to pay the employer portion of premiums (for example, <Percentage> of medical, dental, and vision premiums) during FMLA leave.
• Employee Premium Contributions
  • Employees must continue their share of premiums. If leave is unpaid, premiums may be paid via direct billing, catch-up payroll deductions upon return, or other options as communicated by Benefits.
  • If payment is more than 30 days late, benefits may be suspended after advance written notice. Benefits will be reinstated upon return to work if required by law.
• Other Benefits
  • Retirement plan contributions depend on paid status and plan terms; contact <Plan Administrator Name> for details.
  • Disability benefits (STD/LTD) and parental pay, if offered by <Company Name>, may run concurrently with FMLA, subject to plan eligibility and waiting periods.
  • Holidays, performance bonuses, and PTO accruals during leave follow applicable plan or policy rules and may depend on paid/unpaid status.
• Tax and Payroll Considerations
  • Paid benefits received (for example, STD benefits) are subject to tax treatment per plan funding and applicable laws. Payroll will advise on withholding, if any.
  • Time coding must clearly indicate FMLA, paid or unpaid status, and any concurrent benefit program to ensure accurate payroll and reporting.

Job Protection and Return to Work

• Employees returning from FMLA leave are generally restored to the same or an equivalent position with equivalent pay, benefits, and terms and conditions of employment.
• Key Employee Exception
  • Certain highly compensated employees (top 10% within a 75-mile radius) may be subject to limited reinstatement exceptions where restoration would cause substantial and grievous economic injury to <Company Name>. Legal consultation is required before any decision is made.
• No Retaliation
  • <Company Name> prohibits interference with, restraint of, or retaliation for exercising FMLA rights or filing complaints.
• Return to Work Process
  • Employees must provide timely notice of intent to return and any required fitness-for-duty certification.
  • HR and managers will coordinate return-to-work dates, scheduling, any accommodations under applicable laws, and reactivation of systems and pay.

Interaction With Other Policies and Laws

• Paid Time Off and Sick Leave
  • Where permitted, PTO or sick leave may be substituted for unpaid FMLA time. State or local sick leave laws may require paid usage under certain circumstances.
• Parental Leave
  • Company-paid parental leave, if available, will run concurrently with FMLA where legally permitted. Refer to <Parental Leave Policy Name>.
• Short-Term and Long-Term Disability
  • Disability benefits may replace a portion of income during FMLA if the employee meets plan eligibility criteria. STD/LTD do not extend FMLA entitlement.
• Workers’ Compensation
  • FMLA may run concurrently with workers’ compensation if the workplace injury or illness meets FMLA criteria. Fitness-for-duty requirements may be coordinated with treating provider and workers’ compensation rules.
• Americans with Disabilities Act (ADA) and State Equivalents
  • After FMLA is exhausted, additional leave or schedule adjustments may be considered as reasonable accommodations where required by law. Engage <Interactive Process Lead> for case-by-case assessment.
• State and Local Leaves
  • Where state or local family and medical leave laws provide greater protections or paid benefits, <Company Name> will apply the more generous terms and coordinate concurrently as permitted.

Recordkeeping, Privacy, and Data Security

• Maintain leave records, including notices, certifications, correspondence, and time used for at least 3 years or longer if required by law or <Company Name> retention policy.
• Medical records and certifications will be stored separately from personnel files with access limited to HR/Leave Administration on a need-to-know basis.
• Electronic records in <System Name> will be access-controlled, with audit logs enabled. Data transfers to <Vendor Name> must be encrypted and governed by a current data protection agreement.
• Sharing of medical information will be limited and consistent with FMLA, HIPAA (as applicable), and other privacy laws.

Roles and Responsibilities

Role	Key Responsibilities
Employee	Provide timely notice; submit complete certifications; comply with recertification and fitness-for-duty requirements; maintain premium payments; record time accurately; communicate return-to-work plans.
Manager	Acknowledge requests; maintain confidentiality; coordinate staffing and scheduling; ensure accurate timekeeping; avoid interference or retaliation; consult HR on complex cases.
Total Rewards / Benefits	Own policy governance; coordinate plan design; oversee <Vendor Name>; ensure benefits continuation and premium billing; manage interactions with other benefit programs.
HR Leave Administration	Determine eligibility; request and review certifications; issue notices; designate leave; monitor usage; ensure compliance and documentation; manage recertifications.
Payroll	Configure pay codes; process paid/unpaid time; manage catch-up deductions; reconcile benefit premiums; produce required wage statements.
Legal Counsel	Advise on complex cases, state law interactions, key employee determinations, and disciplinary actions intersecting with FMLA.
Vendor (<Vendor Name>)	Intake requests; communicate with employees; track leaves; collect certifications; provide reporting and system integrations per service-level agreements.

Implementation Guidelines for Total Rewards

• Program Design Decisions
  • Select the 12-month measurement method and define substitution rules for paid time.
  • Determine premium payment processes during unpaid leave (direct bill, catch-up deductions, or both).
  • Align FMLA processes with <Company Name> values and DEI commitments, ensuring equitable access.
• Vendor Selection and Configuration
  • Evaluate <Vendor Name> or alternative providers against SLAs, integration capabilities with <HRIS Name> and <Timekeeping System Name>, data security, and multi-state compliance.
  • Configure case types, certifications, recertification workflows, and automated notices with standard timelines (for example, 5-day eligibility notice, 15-day certification).
• Policy Alignment
  • Harmonize FMLA with PTO, sick leave, parental leave, disability, and state paid family leave policies. Ensure clear concurrency rules.
  • Update the employee handbook and manager guides to reflect standardized processes and contacts.
• Training and Change Management
  • Provide role-based training to managers and HR on FMLA basics, non-retaliation, and documentation standards.
  • Offer employee webinars, quick-reference guides, and FAQs on requesting leave and certification expectations.
• Systems and Data
  • Implement secure data interfaces between <Vendor Name>, <HRIS Name>, payroll, and timekeeping systems using unique case IDs.
  • Establish daily or weekly usage feeds to accurately decrement FMLA balances and avoid overuse or underuse.
• Quality Controls
  • Use standardized checklists for case review, designation accuracy, and recertification timing.
  • Conduct periodic case audits focusing on timeliness, documentation completeness, and outcome consistency.
• Contingency Planning
  • Build backup processes for system downtime, including manual forms and email workflows, with clear escalation to <Support Team Name>.

Metrics, Reporting, and Quality Assurance

• Key Performance Indicators
  • Average time to eligibility notice and designation.
  • Percentage of cases with complete certification on first submission.
  • Intermittent leave frequency and average hours per month by department.
  • Average duration of continuous leaves and return-to-work rates within 30, 60, and 90 days.
  • Denial rate with root-cause categories (for example, ineligibility, insufficient certification).
  • Employee satisfaction scores from post-leave surveys.
• Management Reports
  • Monthly case inventory, open vs. closed, by location.
  • Heat maps of leave usage to inform workforce planning and cross-training needs.
  • Compliance exceptions and remediation status.
• Audit Program
  • Quarterly sample audits of cases against documentation standards.
  • Annual independent review by <Internal Audit / External Auditor>.
  • Corrective action logs tracked to closure within <Number> days.

Risk Management and Escalation

• Common Risks
  • Untimely notices resulting in compliance violations.
  • Inconsistent application of policies across locations or teams.
  • Mishandling medical information or over-collecting health data.
  • Failure to coordinate FMLA with state laws, disability, or workers’ compensation.
  • Retaliation claims due to adverse actions near leave events without clear, documented business reasons.
• Mitigation Strategies
  • Automate reminders and deadlines in <Vendor Name> system.
  • Maintain standardized scripts and letter templates vetted by Legal.
  • Train managers on do’s and don’ts, including handling performance issues during leave periods.
  • Centralize complex case review with HR Leave Administration and Legal.
• Escalation Path
  • Managers escalate complex or time-sensitive issues to HR Leave Administration within <Number> business days.
  • HR escalates legal or high-risk matters (for example, key employee exceptions, potential fraud, discipline during leave) to <Legal Counsel> promptly.
  • Document all escalations and decisions in the case management system.

Review and Approval Process

1. Total Rewards drafts policy updates based on changes in law, business strategy, or audit findings.
2. Legal reviews for compliance with federal, state, and local laws.
3. HR Operations validates feasibility across systems and processes, including vendor workflows.
4. Payroll confirms timekeeping and pay code configurations and premium billing steps.
5. Executive sponsor (for example, <CHRO / VP Total Rewards>) approves final policy.
6. Publish to <Company Name> policy repository and notify stakeholders via <Communication Channels>.

Effective Dates and Change Log

Version	Effective Date	Summary of Changes	Approved By
1.0	<Date>	Initial release aligning policy with FMLA and coordination with state leaves, disability, and parental policies.	<Approver Name / Title>
1.1	<Date>	Updated 12-month measurement method; clarified intermittent leave increments; added fitness-for-duty detail.	<Approver Name / Title>
1.2	<Date>	Vendor integration updates; added reporting KPIs; refined premium payment options during unpaid leave.	<Approver Name / Title>

Practical Administration Guidance

• Timelines and Notices
  • Eligibility and Rights and Responsibilities notices sent within 5 business days of awareness.
  • Certification due within 15 calendar days; cure period at least 7 days if incomplete.
  • Designation notice issued within 5 business days after sufficient information is obtained.
• Timekeeping
  • Use FMLA-specific codes in <Timekeeping System Name> for continuous, intermittent, and reduced schedule leave.
  • Track increments per policy and ensure concurrency with PTO, sick, disability, and state leave where applicable.
• Premium Billing
  • For unpaid leave, route to <Billing Vendor / Payroll> for monthly direct-bill statements of <Amount> due, with a 30-day grace period and clear reinstatement rules.
• Documentation Standards
  • Store eligibility, rights, designation notices, certifications, recertifications, fitness-for-duty, correspondence, and return-to-work confirmations in the case file.
  • Use standardized file naming and retention protocols consistent with <Company Name> records policy.

Frequently Encountered Scenarios

• Intermittent Leave for Chronic Condition
  • Certification indicates 1-3 flare-ups per month, 1-2 days each. Timekeeping records actual hours missed; HR monitors for pattern shifts and requests recertification if frequency materially changes.
• Concurrent STD and FMLA
  • Employee off work for surgery uses STD beginning day 8, with PTO substituted days 1-7 per policy. STD runs concurrently; FMLA entitlement is decremented during the entire medically necessary absence.
• Workers’ Compensation Injury
  • Employee on restricted duty. If unable to perform essential job functions due to injury, FMLA runs concurrently, and fitness-for-duty aligned with treating provider’s release.
• Holiday During Leave
  • Employee on full-week FMLA that includes a company holiday. The week counts toward FMLA entitlement. If working partial week, holiday does not count unless absence covers entire week.

Cost Management Considerations

• Monitor intermittent leave patterns and offer scheduling accommodations to minimize disruption while meeting legal requirements.
• Encourage early planning for foreseeable leaves to allow backfill or cross-training, reducing overtime costs.
• Analyze vendor utilization and case volumes to optimize administrative fees with <Vendor Name>.
• Use aggregated data to forecast benefit costs and staffing needs by quarter.

Training and Awareness

• Annual manager training on FMLA basics, confidentiality, and coordination with other leaves.
• New hire orientation includes a high-level overview of leave benefits and how to request assistance.
• Refresher microlearning modules targeted to HR and payroll ahead of peak leave seasons (for example, summer and year-end).

Glossary

• FMLA – U.S. federal law providing eligible employees with job-protected leave for certain family and medical reasons.
• Serious Health Condition – Illness, injury, impairment, or physical or mental condition involving inpatient care or continuing treatment by a health care provider, as defined by law.
• Equivalent Position – A job virtually identical to the employee’s former job in terms of pay, benefits, and working conditions.
• Key Employee – A salaried FMLA-eligible employee who is among the highest paid 10% of all employees within a 75-mile radius.
• Intermittent Leave – Leave taken in separate blocks of time for a single qualifying reason.
• Reduced Schedule Leave – A schedule reduction (for example, from full-time to part-time) for a period of time due to a qualifying reason.
• Rolling 12-Month Period – A method measuring the 12-month period backward from the date leave is used.
• Qualifying Exigency – Urgent need arising from a covered family member’s active duty or call to active duty in the Armed Forces.
• Military Caregiver Leave – Up to 26 workweeks to care for a covered servicemember or veteran with a serious injury or illness.
• Fitness-for-Duty – Medical provider’s confirmation that the employee can return to work and perform essential job functions safely.
• Concurrent Leave – Running multiple applicable leaves at the same time to the extent permitted by law.

Communication Section: Employee and Manager Guide

This section is intended for employees and managers and summarizes how to use FMLA at <Company Name> in a straightforward, reader-friendly way.

What FMLA Means for You

FMLA provides job-protected time away from work when you or your family need care. If you are eligible, you can take up to 12 workweeks in a 12-month period for most qualifying reasons, or up to 26 workweeks to care for a covered servicemember. Your health benefits continue on the same terms, and you return to the same or an equivalent job in most situations.

Who Is Eligible

You are generally eligible if you have worked for <Company Name> for at least 12 months, have 1,250 hours in the past 12 months, and work at a location with at least 50 employees within 75 miles. If you are unsure, contact <Vendor Name> or HR Leave Administration for guidance.

Reasons You Can Take Leave

• Your own serious health condition that makes you unable to do your job.
• Caring for a spouse, child, or parent with a serious health condition.
• Welcoming a new child by birth, adoption, or foster placement and caring for the child within the first year.
• Qualifying military exigencies related to a family member’s covered active duty.
• Caring for a covered servicemember or veteran with a serious injury or illness.

How to Request Leave

1. Tell your manager and <Vendor Name>/HR as early as possible. If you know ahead of time, give at least 30 days’ notice. If not, tell us as soon as you can.
2. Share enough information so we know leave could be FMLA-eligible. You do not have to share a diagnosis, but explain the nature of the need (for example, surgery, hospitalization, ongoing treatment, or family caregiving).
3. Submit any forms or medical certifications by the due date. Most certifications are due within 15 days.
4. Keep in touch about timing, especially if dates change or if you will return earlier or later than expected.
5. If you need intermittent time off (for example, a few hours for appointments), we will help you set this up in <Timekeeping System Name>.

What to Expect From Us

• We will let you know within a few business days if you are eligible for FMLA and what steps to take.
• We will tell you whether your leave is approved as FMLA and how it will be tracked.
• We will coordinate with Payroll so that any paid time (like PTO or disability benefits) runs at the same time where allowed, so you get any income replacement you are eligible for.
• We will keep your medical information confidential and separate from your regular HR file.

Pay and Benefits While on Leave

• FMLA itself is unpaid, but you may be able to use PTO, sick time, parental pay, or disability benefits during your leave. We run these together where the law allows.
• Your health benefits continue. You will still owe your normal share of premiums. If you are unpaid, you will receive a bill or we will catch up deductions when you return. We will explain your options clearly.
• Other benefits (like retirement contributions) depend on whether you are receiving pay and the plan rules. Ask Benefits if you have questions.

Returning to Work

• Before you return, let us know your planned date. If your leave was for your own serious health condition, we may ask for a fitness-for-duty note that confirms you can safely perform your job.
• Most employees return to the same or an equivalent role with the same pay and benefits. If any changes are needed, we will discuss them with you ahead of time.

Tips for Managers

• Thank the employee for sharing and direct them to <Vendor Name> or HR Leave Administration right away. Do not ask for a diagnosis.
• Avoid commenting on whether someone “looks sick” or “should be back.” Focus on schedule, coverage, and support.
• Keep the employee’s information confidential. Only share with HR or others who need to know for coverage planning.
• Use timekeeping codes correctly and partner with HR to manage intermittent schedules.
• Contact HR immediately if performance or conduct concerns arise around leave time so we can guide next steps fairly and legally.

Example Scenarios

• Welcoming a Child

You let us know in <Month> that your baby is due in <Month>. We confirm your eligibility and send forms. You start leave the week of the birth. Your paid parental leave and PTO run at the same time as FMLA, and your benefits continue. You return at the end of your approved leave to your same or equivalent role.

• Intermittent Leave for Treatment

Your provider certifies weekly therapy sessions for 12 weeks. We set up intermittent FMLA in <Timekeeping System Name> so you can take two hours each week for appointments. Your manager plans coverage, and you keep us updated on any schedule changes.

• Caring for a Parent

Your parent has a serious health condition and needs help after a procedure. You request one week of continuous leave and then intermittent days to attend follow-ups. We approve your leave and show you how to record intermittent time so your hours are tracked correctly.

Getting Help

• For questions, contact <Vendor Name> at <Phone Number> or <Email Address> or submit a case in <Leave Portal URL>.
• You can also talk with HR Leave Administration at <HR Email> or <HR Phone>.
• If you need an accommodation beyond FMLA, ask about the interactive process with <ADA/Accessibility Team>.

Note: This summary is for convenience. The full policy governs. Where state or local laws provide more generous rights, those will apply. Consult HR or Legal for guidance on your specific situation.

---

Document Information:

• Document Type: Family & Medical Leave Act (FMLA) Guidelines
• Category: Benefits & Wellness
• Generated: August 25, 2025
• Status: Sample Template
• Next Review: <Insert Review Date>

Usage Instructions:

1. Replace all text in angle brackets < > with your company-specific information
2. Review all sections for applicability to your organization
3. Customize content to reflect your company's policies and local regulations
4. Have legal and HR leadership review before implementation
5. Update document header with your company's version control information
6. At bottom of the document you find a short example on how the content could be communicated to end-users, for instance employees.

This sample document is provided for reference only and should be customized to meet your organization's specific needs and local legal requirements.