Employee Eligibility (cont.) Is the employee’s leave for a qualifying reason? Yes No Is the leave for one of the following FMLA-qualifying reasons? • The birth of a child and to bond with the newborn child within one year of birth • The placement of a child for adoption or foster care and to bond with the newly-placed child within one year of placement • A serious health condition that makes the employee unable to perform the functions of their job • To care for the employee’s spouse, child or parent who has a serious health condition • Any qualifying exigency arising out of the fact that the employee’s spouse, child or parent is a military member on covered active duty (or call to covered active duty status) • To care for a covered servicemember with a serious injury or illness if the employee is the spouse, child, parent or next of kin of the servicemember If the employee has already used FMLA leave this year, does the employee still have FMLA Yes No leave available? Eligible employees are entitled to take up to 12 weeks of FMLA leave during a 12-month period (26 weeks to care for a covered servicemember). the spouse, child, parent or next of kin of the service- member Leave Process Provide the Notice of Eligibility and Rights & Responsibilities within 昀椀ve business days of Completed the employee’s request for leave, unless there are extenuating circumstances. The DOL has a model notice (Form WH-381, Notice of Eligibility and Rights & Responsibilities) that employers may use for this notice requirement. If a medical certi昀椀cation is required for the requested leave, give the appropriate form to Completed the employee and provide the employee with 15 calendar days to return the form. An employer may require a medical certi昀椀cation when leave is requested for the employee’s own serious health condition or the serious health condition of a family member. Employers can also require certi昀椀cation for military family leave. The DOL has model forms that employers may use for obtaining certi昀椀cations. An employee requesting leave should be informed of this requirement, and the appropri- ate certi昀椀cation form should be provided with the Notice of Eligibility and Rights & Responsibilities. Grant or deny the FMLA leave by providing the Designation Notice on a timely basis. Completed This notice must be provided once the employer has enough information to determine if the employ- ee’s requested leave quali昀椀es as FMLA leave, as follows: • If a medical certi昀椀cation is not required for the requested leave, provide the Designation Notice within 昀椀ve business days of the leave request. • If a medical certi昀椀cation is required, provide the Designation Notice within 昀椀ve business days of when the employee submits a complete and su昀케cient certi昀椀cation form. The Designation Form can also inform the employee that the certi昀椀cation is incomplete or insu昀케cient and additional information is needed. The DOL has a model Designation Notice (Form WH-382) that employers may use.