Sample FMLA Policy
Page Two
Employees who are granted leave due to their own serious health condition may be required to present a return-to-work authorization from their health-care provider upon returning to work. The work authorization should indicate if the employee is able to return to full duty or if there are restrictions. Work restrictions must be detailed.
If leave granted is for less time than the twelve weeks allowable by law, employees are asked to request an extension within two weeks of the ending date of their approved leave.
Employees who do not wish to return from leave are asked to notify the company in writing as soon as a decision has been made not to return. In some circumstances, employees who do not return from approved FMLA will be liable for reimbursing the company for the company's share of health insurance benefits paid for the employee.
While on leave, employees are asked to contact their supervisor once every four weeks with their intent to return to work. Employers are entitled to this courtesy under section 825.309of FMLA regulations.
Employees who are a key employee, as described in section 825.217 of the FMLA regulations, may be denied leave. A key employee is a salaried employee who holds a position in the top 10 percent of all salaries within the company. Leave may be denied if an extended absence of the employee will cause undue hardship to the company.
Employees who request FMLA leave are notified in writing of the status of their request upon receipt of medical certification from a health-care provider.

