Oregon Family and Medical Leave Notice of Eligibility and Rights and Responsibilities Form
Author: Katherine Hinde, Littler
When to Use
This form may be used to inform employees of their eligibility for, and rights and responsibilities under, the Family and Medical Leave Act (FMLA) and/or the Oregon Family Leave Act (OFLA). Under the FMLA, the employer must notify the employee whether they are eligible for FMLA leave within five business days of the employee's request. Under the OFLA, an employer must notify the employee whether they are eligible within five business days after the employee requests OFLA leave or the employer has knowledge that the employee's leave may be eligible for OFLA leave. Each time an employer must provide the eligibility notice to an employee, it must also provide an FMLA rights and responsibilities notice.
Employer coverage under these laws is as follows:
- The FMLA covers employers that employ 50 or more employees in 20 or more workweeks in the current or preceding calendar year and that are engaged in commerce or in any industry or activity affecting commerce.
- The OFLA covers employers that employ 25 or more employees in Oregon each workday in 20 or more calendar workweeks in either the year in which OFLA leave will be taken or the preceding year.
