The Essential Guide to Family & Medical Leave

appendix C | forms and checklists | 381
Notice to Key Employee of Substantial and Grievous Economic Injury
To: [Employee name]
As indicated by written notice dated [date employee was given individual notice
form], you are a key employee of this company. This means that you can be denied
reinstatement following FMLA leave if such reinstatement would cause substantial
and grievous economic injury to the company.
We have determined that reinstating you would cause substantial and grievous
economic injury to the company, because [explain reasons for determination].
We cannot deny you the right to take FMLA leave, or discontinue your health
benefits, based on this determination. However, we intend to deny you
reinstatement once your leave is finished.
If you wish to avoid these consequences, you must return to work no later than [date
employee must return; also indicate why this date was chosen—for example, “this is the
latest we can afford to have you out without hiring a permanent replacement.”] If you
do not return to work by [date employee must return], we intend to replace you and
deny you reinstatement.
Please contact me immediately if you have any questions.
Sincerely,
[your name]
[your title]
Dated: