LETTER TO EMPLOYEE TO INITIATE FMLA AND PDL LEAVE 2025

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How to use or fill out LETTER TO EMPLOYEE TO INITIATE FMLA AND PDL LEAVE

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the date at the top of the letter. This sets the context for your communication.
  3. In the greeting section, fill in the employee's name to personalize the letter.
  4. For 'Re:', specify the subject as 'Notice of FMLA/PDL Eligibility, Rights and Responsibilities, and Designation of Leave' to clarify the purpose.
  5. Complete Section A by filling in dates related to the employee's leave request and eligibility criteria. Ensure accuracy for compliance.
  6. In Section B, indicate any previously used FMLA weeks and calculate remaining leave available for clarity.
  7. Fill in contact details for health insurance arrangements in Section B, ensuring that all necessary information is provided.
  8. In Section C, confirm approval dates and expected return date. This helps set clear expectations for both parties.
  9. Finally, sign off with your name and title at the bottom of the letter to formalize it.

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Under the regulations, an employer must notify an employee whether leave will be designated as FMLA leave within five business days of learning that the leave is being taken for a FMLA-qualifying reason, absent extenuating circumstances.
The FMLA applies only to covered employers. A covered employer may be a private-sector employer, a public agency, or a school. Covered employers must provide FMLA benefits and protections to eligible employees and comply with other responsibilities required under the FMLA and its regulations at 29 CFR Part 825.
As soon as an employer has enough information that indicates an employees need for leave may be for an FMLA-qualifying reason, the employer should begin the FMLA leave process. An employers management team and leave administrators play a vital role in ensuring FMLA compliance.
Please be advised that I hereby request an FMLA leave for a period of (number of weeks) in connection with my serious health condition. The leave is to start on (date). Attached is my medical note reflecting the need for FMLA leave. Please let me know whether you approve this leave at your earliest convenience.
If you approve an employee for FMLA leave, you must: Protect your employees job while on FMLA leave. Maintain their access to group health benefits. Not retaliate or discriminate against an employee for taking FMLA leave.

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If an employee is eligible under PDL and FMLA, both leaves will run concurrently.

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