FMLA Notification Letter
FMLA Denial LetterDATEEmployee NameEmployee AddressCITY, ST, ZIPDear EMPLOYEE,This letter is intended solely as notice that your current absence is not eligible for coverage under the Family and Medical Leave Act of 1993 (FMLA). It is not intended as a statement regarding your eligibility to be absent from the workplace.At this time, your request for FMLA coverage is denied. The explanation for this determination is as follows: You have not met the 12-month length of service requirement. Our records reflect you have worked XX months as a temporary or regular employee during recent periods of employment where any break in service was less than seven years You have not met the requirement of 1,250 hours worked in the 12 months immediately preceding the start of the leave. Our records reflect you have worked X,XXX hours in the prior 12 months The FMLA does not apply to the reason for your absenceYou have not submitted medical certification to support the type of leave requestedThe medical certification you provided is not complete and sufficient to determine whether the FMLA applies to your leave request. Specific information needed to make the certification complete and sufficient, and a deadline to provide that information, will be communicated to youThe medical certification submitted does not support the type of leave requested You have exhausted your 12 or 26 week FMLA entitlementWhile you are not eligible for FMLA coverage, your absence may be supported by other benefits such as paid time off or an unpaid leave of absence. Your rights and responsibilities for taking FMLA leave can be found on the U.S. Department of Labor website: .Information regarding the university’s FMLA policy can be found on the UHR website: .If you believe this determination was reached in error, please contact me to discuss this matter at email, phone, or at the address provided on this letter.Sincerely,Cc: ................
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