Designation Notice Form Mapping

Purpose

This article explains how the Designation Notice form in Leave Manager is automatically populated based on employee Leave Requests. It details how different sections of the form—Employer Information, Additional Information Needed, and FMLA Leave Approved—pull data from specific tabs in Leave Manager, including the Leave Reason, Administrative, and Status tabs. The guide maps each field in the form to the corresponding source within Leave Manager, covering federal/state leave reasons, certification status, administrative contacts, and Leave approval details. This ensures that Leave notifications are accurate, consistent, and reflect the employee’s current Leave status.

When to Use This Article

Use this article when:

• You need to understand where Designation Notice form fields pull their data from
• You are verifying that a Designation Notice form is accurately populated
• You are troubleshooting incorrect or missing data on a Designation Notice

Steps to Follow

Section I - Employer

Letter	Leave Manager Location	Letter	Leave Manager Location
A	Current Date	O	Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member who is a covered servicemember with a serious injury or illness. You are the service member’s:
B	My Profile > Company Name	P	Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member who is a covered servicemember with a serious injury or illness. You are the service member’s: Spouse
C	Employee	Q	Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member who is a covered servicemember with a serious injury or illness. You are the servicemember’s: Parent
D	Leave Request Submitted Date	R	Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member who is a covered servicemember with a serious injury or illness. You are the service member’s: Child
E	Leave Reason tab --> Select Leave Request Reason --> The birth of a child, or placement of a child with you for adoption or foster care, and to bond with the newborn or newly-placed child	S	Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member who is a covered servicemember with a serious injury or illness. You are the service member’s: Next of kin
F	Leave Reason tab --> Select Leave Request Reason --> Your own serious health condition	T	Leave Reason tab --> Select Leave Request Reason --> Other
G	Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member due to a serious health condition. Your family member is your:	U	Leave Reason tab --> Select Leave Request Reason --> Other <Drop down item>
H	Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member due to a serious health condition. Your family member is your: Spouse	V	Status Tab --> Approved/Open dropdown selection: = True
I	"Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member due to a serious health condition. Your family member is your: Child under age 18  OR  Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member due to a serious health condition. Your family member is your: Child 18 years or older and incapable  of self-care  because of a mental or physical disability	W	Status tab -->  Select the status for this request: Denied
J	Leave Reason tab --> Select Leave Request Reason --> You are needed to care for your family member due to a serious health condition. Your family member is your: Parent	X	Status tab -->  Select the status for this request: Denied  & --> The FMLA does not apply to the employee’s leave request.
K	A qualifying exigency arising out of the fact that your family member is on covered active duty or has been notified of an impending call or order to covered active duty status. Your family member on covered active duty is your:	Y	Status tab -->  Select the status for this request: Denied  &   --> As of the date the leave is to start, the employee does not have any FMLA leave available to use.
L	Leave Reason tab --> Select Leave Request Reason --> A qualifying exigency arising out of the fact that your family member is on covered active duty or has been notified of an impending call or order to covered active duty status. Your family member on covered active duty is your: Spouse	Z	Status Tab --> Select the status for this request: Denied  &  --> Other Status Tab --> Select the status for this request: Denied  &  --> Other (user text box specifying other)
M	Leave Reason tab --> Select Leave Request Reason --> A qualifying exigency arising out of the fact that your family member is on covered active duty or has been notified of an impending call or order to covered active duty status. Your family member on covered active duty is your: Child	AA	Status Tab --> Select the status for this request: Open
N	Leave Reason tab --> Select Leave Request Reason --> A qualifying exigency arising out of the fact that your family member is on covered active duty or has been notified of an impending call or order to covered active duty status. Your family member on covered active duty is your: Parent

Section II - Additional Information Needed

Letter	Leave Manager Location	Letter	Leave Manager Location
BB	Administrative tab --> Administrative Information  --> Section D. Name of contact person for employee questions:	FF	Status tab -->  Select the status for this request: Open  & -->  Please specify the information needed to make the certification complete and/or sufficient:
CC	Administrative tab --> Administrative Information  --> Section D. Please provide a phone number or email address where this person can be reached:	GG	Status tab -->  Select the status for this request: Open  & --> Provided no later than [DATE] (allow at least 7 calendar days)
DD	Status tab --> Select the status for this request: Open -- > Certification is Incomplete = true	HH	Status tab -->  Select the status for this request: Open  & --> We request that the employee obtain a. _(second or third)_ medical certification at our expense, and we will provide further details at a later time.
EE	Status tab --> Select the status for this request: Open -- > Certification is Insufficient = true	II	Status tab -->  Select the status for this request: Open  & --> We request that the employee obtain a. _second_ medical certification at our expense, and we will provide further details at a later time.  OR Status tab -->  Select the status for this request: Open  & --> We request that the employee obtain a. _third_ medical certification at our expense, and we will provide further details at a later time.

Section III - FMLA Leave Approved

Letter	Leave Manager Location	Letter	Leave Manager Location
JJ	Status tab -->  Select the status for this request:  Approved/Open Provided there is no change from the anticipated FMLA leave schedule, the number of hours, days, or weeks will be counted against the employee’s leave entitlement.	PP	Administrative Tab --> Other: (e.g., short-or long-term disability, workers’ compensation, state medical leave law, etc.) (checkbox)
KK	Calculation	QQ	Administrative Tab --> Other: (e.g., short-or long-term disability, workers’ compensation, state medical leave law, etc.) (User's text)
LL	Status tab -->  Select the status for this request: Approved/Open The leave will be unscheduled. It is not possible to provide the number of hours, days, or weeks that will be counted against the employee’s leave entitlement at this time. Thereby, the employee has the right to request this information once in a 30-day period (if leave was taken within a 30-day period).	RR	Status tab -->  Select the status for this request:  Approved/Open  & --> The employee   __ will be   __ will not be. Required to provide a certification from your health care provider (fitness-for-duty-certification) that the employee is able to resume work.
C	Employee	SS	Status tab -->  Select the status for this request:  Approved/Open  & --> The employee  __will be   __ will not be. Required to provide a certification from your health care provider (fitness-for-duty-certification) that the employee is able to resume work.
MM	Administrative Tab --> Some or all of your FMLA leave will not be paid. Any unpaid FMLA leave taken will be designated as FMLA leave and counted against the amount of FMLA leave you have available to use in the applicable 12-month period. (checkbox)	TT	Status tab -->  Select the status for this request:  Approved/Open  & --> The employee is required to present a fitness-for-duty certificate to be restored to employment.= will be & --> A list of essential functions IS attached, the fitness-for-duty certification must address your ability to perform the essential job function.
NN	Administrative Tab --> You have requested to use some or all of your available paid leave (e.g., sick, vacation, PTO) during your FMLA leave. Any paid leave taken for this reason will also be designated as FMLA leave and counted against the amount of FMLA leave you have available to use in the applicable 12-month period. (checkbox)	UU	Status tab -->  Select the status for this request:  Approved/Open  & --> The employee is required to present a fitness-for-duty certificate to be restored to employment.= will be & --> A list of essential functions IS NOT attached, the fitness-for-duty certification must address your ability to perform the essential job function.
OO	Administrative Tab --> We are requiring you to use some or all of your available paid leave (e.g., sick, vacation, PTO) during your FMLA leave. Any paid leave taken for this reason will also be designated as FMLA leave and counted against the amount of FMLA leave you have available to use in the applicable 12-month period. (checkbox)