CFRA and FMLA Designation Notice - 50 or More Employees

Sep 15, 2026

Uploaded by Kyle

CFRA and FMLA leave rules differ for employer coverage, employee eligibility, and how qualifying reasons are matched to leave entitlements. The notice explains that most public employers and specific private-employer thresholds determine coverage, and it describes shared eligibility criteria plus an FMLA-specific 50-employee, 75-mile worksite requirement. After eligibility is established, qualifying reasons govern approved leave, including concurrent CFRA/FMLA when both apply, CFRA-only for certain designated-person situations, and FMLA-only military caregiving up to 26 weeks.

LanguageEnglish

CategoryLetters

FormatPDF

Pages8

Reading Time3 min

AccessFree to download

Notice of Rights and Responsibilities

Coverage and Eligibility Differences

Qualifying Reasons and Concurrent Leave

CFRA-Only, FMLA-Only, and Exhaustion Scenarios

Notice Requirements and Medical Certification

Designation Notice Instructions

Section I—Employer

Section II—Additional Information Needed

Section III—CFRA and/or FMLA Leave Approved

The California Family Rights Act (CFRA) and the Family and Medical Leave Act (FMLA) have different employer coverage rules. All public employers regardless of size and all private employers with five or more employees are covered by the CFRA. All public employers regardless of size and all private employers with 50 or more employees are covered by the FMLA. The CFRA and the FMLA also have different employee eligibility requirements. Both the CFRA and the FMLA require the employee to have worked for their current employer for at least 12 months (these months do not have to be consecutive) and have worked 1,250 hours in the 12 months preceding the date of leave. The FMLA has an additional employee eligibility requirement that the employee works at a worksite that has 50 or more employees within a 75-mile radius. Once the employee has established eligibility, the employee may only take CFRA and/or FMLA leave for qualifying reasons. The CFRA and FMLA share the following qualifying reasons for leave: • The employee’s own serious health condition; • A parent’s, child’s (if the child is under the age of 18 or over the age of 18 if the child is incapable of self-care due to a physical or mental disability), or spouse’s serious health condition; • To bond with a child after the birth, adoption or place in foster care of the child; or • For qualifying military exigencies. If an employee’s qualifying reason for leave is covered under both the CFRA and the FMLA, then both leave entitlements will run at the same time, otherwise known as CFRA/FMLA concurrent leave. In addition to the above qualifying reasons, an employee may take CFRA-only leave for any adult child’s serious health condition regardless of disability, as well as a parent-in-law's, grandparent's, grandchild's, sibling's, registered domestic partners's, or someone else with a blood or family-like relationship with the employee's ("designated person") serious health condition. Also, an employee may take up to 26 weeks of FMLA-only leave to care for a military servicemember. Because there are some differences in qualifying reasons between the CFRA and the FMLA, there may also be a situation where an employee exhausts CFRA leave but will remain eligible for FMLA—and vice versa—in the same 12-month period because the reason for the CFRA leave is not covered by the FMLA (e.g., the employee first takes 12 weeks of leave to care for a grandparent under the CFRA and then takes a separate 12 weeks of leave to bond with a baby under the FMLA.) Employers must provide employees with a notice of their rights under the CFRA. The Notice section of this form provides that information to the employee. Fill in the blank at the end of the notice with the name of the individual managing leaves of absence for your organization. If the employee’s leave request also qualifies under the FMLA, you must also provide the separate FMLA—Notice of Eligibility and Rights and Responsibilities form. Leave covered under the CFRA must be designated as CFRA-protected and the employer must inform the employee of the amount of leave that will be counted against the employee’s CFRA leave entitlement. If the leave qualifies for FMLA, the employer must designate the leave as FMLA-protected, and the employer must inform the employee of the amount of leave that will be counted against the employee’s FMLA leave entitlement. This form meets both of those requirements. This form is not for use if the employee is requesting pregnancy disability leave. Please use the FMLA/PDL Designation Notice form. If an employee is taking leave that is only covered by the FMLA, you may use the FMLA Designation form, which does not contain any references to the CFRA. In order to determine whether leave is covered under either the CFRA, the FMLA or both, the employer may request that the leave be supported by a medical certification (this requirement must be noted in your employer’s CFRA/FMLA leave policy) . If

FAQs

How do employer coverage rules differ between CFRA and FMLA?

CFRA covers all public employers regardless of size and private employers with five or more employees. FMLA covers all public employers regardless of size and private employers with 50 or more employees.

What employee eligibility requirements apply under both CFRA and FMLA?

Both acts require at least 12 months with the current employer (not necessarily consecutive) and 1,250 hours worked in the 12 months before leave. FMLA adds a worksite requirement: the employee must work at a site with 50 or more employees within a 75-mile radius.

When do CFRA and FMLA run concurrently and what happens if only one applies?

If the qualifying reason is covered under both CFRA and FMLA, entitlements run at the same time as concurrent leave. Otherwise, each act’s entitlement can apply separately in the same 12-month period, including situations where CFRA leave is exhausted but FMLA eligibility remains (and vice versa).

Sep 15, 2026

Uploaded by Kyle