Create and Send FMLA Eligibility Notice and Medical Certification to Employee
Create Eligibility and Rights & Responsibilities Notice
From the employee’s EFI Profile page:
• Complete the Eligibility Notice by clicking on the “Not Done – Create” button next to “Eligibility Notice."
A summary page will appear with an overview of the Eligibility Notice (EN).
Scroll down and click "Continue” to proceed to the EN form.
• Section I: Notice of Eligibility
Section I of the Eligibility Notice will be fully completed if the employee meets the FMLA eligibility criteria for FMLA leave.
If so, simply scroll to the bottom of the page and select “Continue” to proceed to Section II.
If the employee does not meet the eligibility criteria for FMLA leave, enter either the approximate number of weeks the employee has worked (or will have worked) for your organization and/or the approximate number of hours the employee has worked (or will have worked) for your organization during the 12-month period preceding the scheduled leave start date.
Note: If the employee does not meet the eligibility criteria for FMLA leave, the Rights & Responsibilities portion of the notice will not appear because it is not applicable. In those situations, indicate in the textbox in Section I what options the employee has for taking leave (if any) based on your organization's internal leave policies.
• Section II: Additional Information Needed
Certification of Health Care Provider for Employees Serious Health Condition
Section II is defaulted to require additional information from the employee in the form of a certification or other documentation.
Enter the Date that the Medical Certification is due.
If you do not need additional information, change the defaulted selection to the top option (informing the employee that you “do not need any additional information”) and click “Continue” at the bottom of the page to proceed to Section III.
Note: The type of certification an employee needs to submit will be automatically selected based on the reason for the requested FMLA leave. The selection “is enclosed” also will be preselected. There is no default selection if the reason for the leave is birth of a child or placement of a child for adoption/foster care. In the case of birth of a child, the applicable medical certification could be (a) the employee’s own serious health condition (for the birth mother), family member’s serious health condition (if the spouse has requested leave to care for the birth mother during pregnancy or recovery from childbirth), or (c) neither (if the birth mother’s spouse or non-spouse parent is requesting leave to care for/bond with a newborn child). Select the applicable certification form if (a) or (b) applies, or change the selection to the top option (informing the employee that you “do not need any additional information”) if (c) applies or if your organization does not require a medical certification form from an employee who is expecting a child. In the case of placement of a child for adoption or foster care, no certification can be required.
• Section III: Rights and Responsibilities
Certain checkboxes in Section III will be preselected based on the Eligibility Notice template selections in your Account Profile Menu. Modify as needed by checking or unchecking and checkboxes as applicable to a particular employee.
• After completing the Notice, click “Finish” at the bottom of the page. If no changes need to be made, click “Return to Profile” at the bottom of the page.
If necessary, create the medical Certification Form.
Create a Medical Certification Form
• Complete the applicable Certification Form. For example, if the FMLA leave is being requested for the employees own serious health condition, click the “Not Done – Create” button next to
“Employee’s Serious Health Condition.”
AFTER YOU CREATE THE INITIAL EMPLOYEES SERIOUS HEALTH CONDITION,
YOU WILL SEE THE UPLOAD BUTTON TO UPLOAD A PAPER OR SCANNED COPY
Note: Certain certification forms will or will not be available because they are not applicable depending on the reason FMLA leave is being requested. For example, if the reason for leave is the employee’s own serious health condition, only that medical certification will be available. If the reason for leave is to care for a covered family member with a serious health condition, only that certification will be available. If the reason for leave is birth of a child, both medical certifications will be available. If leave is for birth of a child, use the Employee’s Serious Health Condition form for the expectant mother, and Family Member’s Serious Health Condition form for the mother’s spouse only if the spouse is seeking FMLA leave to care for his or her spouse for pregnancy or recovery from childbirth. If the spouse or non-birth parent is seeking leave to care for a healthy newborn, no certification may be required. Similarly, if leave is for placement of a child for adoption or foster care, no certification may be required (but other documentation may be required).
- Select the medical certification due date, which will be the same date as you selected on the Eligibility Notice.
- If leave is for the employee’s own serious health condition, the employee’s job title and regular weekly work schedule are required fields.
Whether to attach a job description is optional.
If you wish to include the employee’s job description along with the medical certification form that is sent to the employee electronically, change the defaulted selection to indicate that the “Job Description” is attached in section number 4.
Note: If you select the option to include a job description, make sure to upload the
employee’s job description in the employee’s EFI profile and select “Job Description” to
include when emailing, make sure to select the job description as one of the documents to
send the employee.
The “Statement of the Employee’s Essential Job Functions” also is optional.
If the certification is the initial certification related to the employee’s leave request, leave “Initial
Certification” selected. If the certification is not the initial medical certification being requested,
select the type of certification that is being requested (e.g., recertification, second opinion).
After completing the employer portion of the medical certification form,
click “Finish” to view the certification form.
Scroll down to the bottom of the page and click “Return to Profile”.
Next, send the notices to the Employee by clicking on the Email Employee Forms/Files button at the bottom of the page.
