FMLA Notification Letter (Reduced Schedule)
This letter is intended solely as notice that your absence will be counted toward your 12
weeks of annual eligibility under the Family and Medical Leave Act of 1993 (FMLA). It
is not intended as a statement regarding the length of your absence.
You have met the conditions for eligibility under the FMLA. Your absence is due to:
o Birth of your child, and to care for your newborn child
o Placement of a child with you for adoption or foster care, and to care for your newly
adopted child or a child newly placed in your foster care
o To care for a family member with a serious health condition
o Your own serious health condition
o To address a qualifying exigency
You are eligible under the FMLA to be absent from work for the reasons listed above for
up to 12 weeks in your FMLA benefit year with the continuation of health, dental and
vision coverage. You must be enrolled in the benefit plan to be entitled to the
continuation of the benefit coverage. Your current FMLA benefit year is DATE 1 to
A reduced schedule of _____ (numeric) hours per week has been approved. Your 12
weeks of FMLA eligibility will be used at a rate of _____ (numeric) hours per week
beginning on DATE 3. Your FMLA eligibility for your current FMLA benefit year will
end on DATE 4.
The University may temporarily transfer an employee on a reduced schedule to an
alternate position with equivalent pay and benefits that better meets the operational needs
of the University of Michigan. The alternate position need not have equivalent duties.
Because of the operational needs of __________ (name of the department), you will be
transferred to the alternate position of __________ during the period of the reduced
schedule. This paragraph is included when the employee’s department decides to
transfer the employee to an alternate position to meet operational needs. An
employee may only be transferred to an alternate position when the absences are
foreseeable / planned.
At the conclusion of the reduced schedule, you will be restored to your former position or
an equivalent position. This paragraph is included when the employee’s department
decides to transfer the employee to an alternate position to meet operational needs.
An employee may only be transferred to an alternate position when the absences are
foreseeable / planned.
Information regarding the university’s FMLA policy can be accessed at
___________________________, and the U.S. Department of Labor FMLA poster can
be accessed at ____________________________ .
If you have any questions regarding this matter, please contact me at PHONE NUMBER,
or at EMAIL ADDRESS.
Example: Employee’s date of hire is June 15, 2001, and the employee had a reduction in
work hours from 40 to 20 per week starting on October 10, 2008 for a reason that
qualifies for the FMLA.
DATE 1: Month and day of the employee’s date of hire. Year is determined by the start
of the employee’s absence. DATE 1 is June 15, 2008. Please note that DATE 1 is not
necessarily in the same calendar year as the start of the reduced schedule. For example,
DATE 1 would be June 15, 2008 if the reduced schedule started on January 15, 2006.
DATE 2: One calendar year after DATE 1. DATE 2 is June 14, 2009.
DATE 3: Date when the employee’s FMLA qualifying absence begins. DATE 3 is
October 10, 2008.
DATE 4: Employee’s 12 weeks of FMLA eligibility should be converted to hours (12
weeks x employee’s effort. In this case, 12 x 40 = 480 hours). The employee will use 20
hours of FMLA eligibility each week. DATE 4 is March 26, 2009.