GENERAL
☐ Is the employer covered by the FMLA?
☐ Is the FMLA poster displayed in an area frequented by employees and applicants?
☐ Is there a written FMLA policy included in the employee handbook or otherwise distributed?
☐ Is the 12-month period used to calculate FMLA leave defined in the written policy?
☐ Is there a method for tracking employee use of FMLA leave and remaining leave entitlement?
☐ Have the FMLA forms from the U.S. Department of Labor been downloaded or have similar internal forms been created?
☐ Is training provided to managers on the FMLA, including information about how to identify a leave request that may be FMLA-qualifying and how to comply with anti-retaliation rules?
☐ Are procedures in place and communicated to employees regarding requests for FMLA leave and consequences for failing to provide proper notice?
LEAVE REQUESTS
☐ Is the employee's request for leave due to an FMLA-qualifying reason?
☐ Is the employee eligible for FMLA leave?
☐ Is the Notice of Eligibility and Rights & Responsibilities form (WH-381) provided within five days of learning of the need for leave that may be FMLA-qualifying?
☐ Is a medical certification necessary? If yes:
☐ Is the appropriate certification form provided to the employee?
☐ Is the employee given at least 15 calendar days to return the certification form?
☐ Are the consequences for not returning the certification form communicated?
☐ Is the certification form returned complete and sufficient without missing information or sections left blank or vague?
☐ Is the employee given at least seven days to submit a corrected certification form, if necessary?
☐ Is the Designation Notice (WH-382) provided within five days of receipt of the medical certification?
☐ If no medical certification is required, is the employee provided with the Designation Notice (WH-382) with the Notice of Eligibility and Rights & Responsibility form (within five days of learning of the need for FMLA leave)?
☐ Are key employees identified and notified of their status as such with an explanation of their limited reinstatement rights?
DURING LEAVE
☐ Is coverage under the group health plan maintained at the same level and under the same conditions as would be maintained had the employee not taken leave, including employer contributions?
☐ Is there a process to collect premium payments for health insurance from employees during periods of unpaid FMLA?
☐ Do internal policies indicate how other benefits are impacted by an FMLA absence, such as paid-time-off accruals, life insurance, etc.
☐ Are requirements for the employee to provide periodic updates to the employer during leave communicated?
RETURN TO WORK
☐ Is a release to work from a health care provider required before returning to work?
☐ Is the employee reinstated to the same or an equivalent position?
☐ Is there a process to collect outstanding insurance premiums owed by the employee?
☐ Are records of the employee's FMLA leave retained for a minimum of three years, separate from the employee's personnel file?
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