Clackamas Community College
Sample Designation Letter to Employee - FMLA/OFLA Leave
The following is a sample cover letter to an employee notifying the employee that the employer is treating
a request for leave as a request for FMLA and/or OFLA leave (either paid or unpaid) that will reduce the
employee’s FMLA and/or OFLA leave entitlement. This letter, along with the Designation Notice form
GCBDA/GDBDA-AR(6), FMLA/OFLA or GCBDA/GDBDA-AR(4), OFLA only eligible, should be mailed
to the employee within five working days after receiving enough information to determine whether the
leave qualifies under FMLA or OFLA.
you advised the College that you were requesting a leave under the Family and
Medical Leave Act (FMLA) and/or Oregon Family Leave Act (OFLA). Under our policy, leaves of
absence that qualify for family and medical leave under federal law (FMLA) run concurrently with other
types of leave such as sick leave, vacation leave, short-term disability leave, OFLA and leave for a
workers’ compensation injury or illness. Leaves of absence that qualify for family and medical leave under
state law (OFLA) can run concurrently with other types of leave such as sick leave, vacation leave, short-
term disability leave but cannot run concurrently with leave for workers’ compensatory injury or illness.
We understand the purpose of your requested leave qualifies as family medical leave under state and/or
federal law. Accordingly, this letter is to notify you that the leave will be counted against your annual
family and medical leave entitlement. Also attached is a form entitled Designation Notice which contains
other information for you regarding federal and state family medical leave rights.
Dean of Human Resources
Enclosure (FMLA and/or OFLA Designation Notice form)
Approved by President’s Council:
May 22, 2012
Sample Designation Letter to Employee - FMLA/OFLA Leave - GCBDA/GDBDA-AR(5)