FMLA (Family & Medical Leave Act) Checklist

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FMLA (Family & Medical Leave Act) Checklist

Company Name:

HR Contact:

Number of Employees:

FMLA Leave Year Method:

Employer & Employee Eligibility Determination

☐Confirm the employer meets the FMLA coverage threshold of 50 employees

Verify that the company employs 50 or more employees within a 75-mile radius for at least 20 calendar workweeks in the current or preceding calendar year, making it a covered employer under FMLA.

☐Verify individual employee eligibility for FMLA leave

Confirm that each requesting employee has worked for the employer for at least 12 months (not necessarily consecutive), has completed at least 1,250 hours of service in the 12 months preceding the leave, and works at a location with 50 or more employees within 75 miles.

☐Determine the applicable FMLA leave year method

Select and consistently apply one of the four DOL-approved methods for calculating the 12-month FMLA leave year: calendar year, fixed 12-month period, 12-month period measured forward from the first date of leave, or rolling 12-month period measured backward.

☐Track hours worked for eligibility calculations

Maintain accurate records of hours worked for all employees to determine FMLA eligibility, using FLSA principles for determining compensable hours and including overtime hours in the 1,250-hour calculation.

☐Assess eligibility for airline flight crew employees under special rules

If applicable, apply the special FMLA eligibility hours-of-service requirement for airline flight crew employees (60 percent of the applicable monthly guarantee or 504 hours in the preceding 12 months).

Qualifying Reasons & Leave Entitlement

☐Identify qualifying reasons for the standard 12 weeks of FMLA leave

Confirm the leave request falls under one of the qualifying reasons: birth and bonding with a newborn, placement of a child for adoption or foster care, care for a spouse, child, or parent with a serious health condition, or the employee's own serious health condition.

☐Determine eligibility for military family leave provisions

Assess whether the employee qualifies for qualifying exigency leave (12 weeks) related to a covered military member's active duty deployment, or military caregiver leave (26 weeks in a single 12-month period) to care for a covered servicemember with a serious injury or illness.

☐Calculate remaining FMLA leave entitlement for the current leave year

Review the employee's leave history within the applicable 12-month period to determine how many weeks of the 12-week (or 26-week military caregiver) entitlement remain available.

☐Address intermittent and reduced-schedule leave requests

Evaluate requests for intermittent leave or a reduced work schedule when medically necessary for the employee's or family member's serious health condition, and consider temporary transfers to equivalent positions that better accommodate the schedule.

☐Manage concurrent leave under FMLA and state leave laws

Determine whether state family and medical leave laws provide additional or more generous leave entitlements and coordinate FMLA leave to run concurrently where permitted by law.

☐Handle leave for spouses employed by the same employer

Apply the combined leave limitation of 12 weeks (or 26 weeks for military caregiver leave) when both spouses work for the same employer and take leave for the birth or placement of a child or to care for a parent with a serious health condition.

Notice Requirements & Medical Certification

☐Provide the general FMLA rights notice to all employees

Display the DOL FMLA poster (WH Publication 1420) in a conspicuous place and include FMLA rights information in the employee handbook or distribute it to each new employee upon hire.

☐Issue the eligibility and rights & responsibilities notice within five business days

Upon learning of an employee's need for FMLA leave, provide the Eligibility Notice (Form WH-381) and the Rights and Responsibilities Notice within five business days, informing the employee of their eligibility status and obligations.

☐Provide the designation notice to the employee

Issue the Designation Notice (Form WH-382) within five business days of having sufficient information to determine whether the leave qualifies as FMLA leave, including the amount of leave counted against the entitlement.

☐Request medical certification from the employee's health care provider

If the leave is for a serious health condition, provide the employee with the appropriate certification form (WH-380-E for the employee's condition or WH-380-F for a family member's condition) and allow at least 15 calendar days for return.

☐Obtain recertification when appropriate during ongoing leave

Request recertification of a serious health condition no more frequently than every 30 days (unless circumstances have changed significantly), and require it in connection with an absence when the minimum duration of the condition has expired.

☐Seek second and third medical opinions when warranted

If there is reason to doubt the validity of the initial medical certification, request a second opinion at the employer's expense from a health care provider not regularly employed by the company, and if the opinions conflict, obtain a binding third opinion from a mutually agreed-upon provider.

☐Require a fitness-for-duty certification before return to work

If the employer's policy requires a fitness-for-duty certification and the employee was notified of this requirement in the designation notice, obtain a certification from the employee's health care provider that the employee is able to resume work before restoring the employee to the position.

Benefits Continuation & Job Restoration

☐Maintain group health insurance during FMLA leave

Continue the employee's group health plan coverage under the same terms and conditions as if the employee had not taken leave, including the employer's share of premiums, for the duration of the FMLA leave period.

☐Collect employee premium contributions during leave

Establish and communicate a method for collecting the employee's share of health insurance premiums during unpaid FMLA leave, such as pre-payment, pay-as-you-go, or catch-up payments upon return.

☐Restore the employee to the same or equivalent position upon return

Return the employee to the same position held before leave began, or to an equivalent position with equivalent pay, benefits, and other terms and conditions of employment, upon the employee's timely return from FMLA leave.

☐Assess key employee exception for job restoration

If considering denying job restoration to a salaried employee who is among the highest-paid 10 percent of employees within 75 miles, provide the required notice of key employee status and demonstrate that restoration would cause substantial and grievous economic injury to the employer's operations.

☐Protect employees from retaliation or interference

Ensure no adverse employment action is taken against an employee for requesting or taking FMLA leave, and that managers understand that discouraging FMLA use or penalizing attendance records for FMLA absences constitutes unlawful interference.

Recordkeeping & Compliance Administration

☐Maintain FMLA records for at least three years

Retain all FMLA-related records for at least three years, including leave requests, medical certifications, notices provided, benefit premium payment records, and correspondence, in compliance with 29 CFR 825.500.

☐Keep medical certifications in confidential files separate from personnel records

Store all FMLA medical certifications and related health information in files separate from the employee's general personnel file, with access limited to designated HR staff, in accordance with FMLA confidentiality requirements.

☐Track FMLA leave usage and balances for each employee

Maintain a reliable tracking system that records FMLA leave taken by each employee, including dates, hours (for intermittent leave), qualifying reason, and remaining entitlement within the applicable leave year.

☐Train HR staff and managers on FMLA obligations

Provide regular training to HR administrators and supervisors on recognizing FMLA-qualifying situations, following proper notice procedures, avoiding retaliation, and handling intermittent leave requests in compliance with the law.

☐Review and update FMLA policies annually

Conduct an annual review of the company's FMLA policy to incorporate regulatory updates, DOL guidance, and court decisions, and redistribute the updated policy to all employees through the handbook or other means.

What Is an FMLA Compliance Checklist?

An FMLA compliance checklist is a step-by-step guide that helps employers properly administer leave under the Family and Medical Leave Act, the federal law that provides eligible employees with up to 12 weeks of unpaid, job-protected leave per year for qualifying family and medical reasons. It covers eligibility determination, notice requirements, medical certification, designation procedures, and return-to-work processes. Following this checklist ensures compliance with DOL regulations and protects employers from interference and retaliation claims.

Why HR Teams Need This Checklist

FMLA administration involves strict timelines, multiple required notices, and complex eligibility rules that create significant compliance risk when handled inconsistently. The most common FMLA violations include failure to provide required notices within mandated timeframes, improper denial of leave, and retaliation against employees who exercise their FMLA rights. This checklist ensures every leave request follows a consistent, documented process that satisfies DOL requirements and withstands legal scrutiny.

Key Areas Covered in This Checklist

This checklist covers employer coverage determination, employee eligibility verification including the 50-employee-within-75-miles threshold, qualifying reason assessment, notice and certification requirements, intermittent leave tracking, concurrent leave running with paid leave policies, benefits continuation during leave, and return-to-work fitness-for-duty procedures. It also addresses military family leave provisions that extend coverage to 26 weeks for servicemember caregiver leave and the special rules for qualifying exigency leave.

How to Use This Free FMLA Compliance Checklist

Use Hyring's free checklist generator to build an FMLA administration workflow customized to your organization's leave policies and workforce structure. The Brief view provides a quick reference for experienced leave administrators, while the Detailed view offers comprehensive guidance for each step of the leave process. Download the checklist to train new HR team members and to create a standardized leave file for each FMLA request.

Frequently Asked Questions

Which employers are covered by the FMLA?

The FMLA applies to all public agencies, public and private elementary and secondary schools, and private-sector employers with 50 or more employees in 20 or more workweeks in the current or preceding calendar year. The 50-employee count includes all employees on the payroll, including part-time and temporary employees. Joint employers and successors in interest are also covered under the FMLA.

What makes an employee eligible for FMLA leave?

An employee is eligible for FMLA leave if they have worked for the covered employer for at least 12 months, have worked at least 1,250 hours during the 12 months preceding the start of leave, and work at a location where the employer has at least 50 employees within a 75-mile radius. The 12 months of employment do not need to be consecutive, but employment periods prior to a break of seven or more years generally do not count.

What are the qualifying reasons for FMLA leave?

Qualifying reasons include the birth and care of a newborn child, placement of a child for adoption or foster care, caring for a spouse, child, or parent with a serious health condition, a serious health condition that makes the employee unable to perform essential job functions, and qualifying exigency arising from a family member's military deployment. Servicemember caregiver leave of up to 26 weeks is available to care for a covered service member with a serious injury or illness.

What notices must an employer provide during the FMLA process?

Employers must provide an eligibility and rights-and-responsibilities notice within five business days of learning of the need for FMLA leave. A designation notice must be provided within five business days of having enough information to determine whether the leave qualifies as FMLA leave. Employers must also display the FMLA general notice poster in a conspicuous place and include FMLA information in employee handbooks or other written guidance.

Can an employer require medical certification for FMLA leave?

Yes, employers can require employees to provide a medical certification from a health care provider to support a request for leave due to a serious health condition. The employer must allow at least 15 calendar days for the employee to obtain the certification. If the certification is incomplete or insufficient, the employer must provide the employee a written notice specifying what additional information is needed and allow seven calendar days to cure the deficiency.

How does intermittent FMLA leave work?

Intermittent FMLA leave allows an employee to take leave in separate blocks of time or by reducing their normal work schedule for a single qualifying reason. It is available when medically necessary for the employee's own serious health condition or to care for a family member with a serious health condition. Employers may temporarily transfer employees on intermittent leave to alternative positions that better accommodate recurring absences, provided the position has equivalent pay and benefits.

Must an employer continue health insurance during FMLA leave?

Yes, employers must maintain group health insurance coverage during FMLA leave on the same terms as if the employee had continued to work. The employee remains responsible for their share of premium payments. If the employee fails to return from FMLA leave for reasons other than a serious health condition or circumstances beyond their control, the employer may recover its share of the premiums paid during the leave period.

What is FMLA retaliation and how can employers avoid it?

FMLA retaliation occurs when an employer takes adverse action against an employee for exercising or attempting to exercise their FMLA rights. This includes termination, demotion, discipline, reduction in hours, or negative performance reviews connected to FMLA leave usage. Employers can avoid retaliation claims by documenting legitimate business reasons for all employment decisions, training managers on FMLA protections, and never using FMLA leave as a negative factor in employment actions.

Written by Adithyan RK

Fact Checked by Surya N

Published on: 3 Mar 2026|Last updated:

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