US-CA11 · jury_instructions
11th Cir. Pattern Jury Instr. (Civil) 4.15
Family and Medical Leave Act – Retaliation Claims –
29 U.S.C. §§ 2601-2654
In this case, [name of plaintiff] claims that [name of defendant] violated a
federal law called the Family and Medical Leave Act, also known as the FMLA,
by [describe challenged employment action] because [describe protected activity].
[Name of defendant] denies [name of plaintiff]’s claims and asserts that [describe
the defendant’s defense].
Under the FMLA, an eligible employee may take up to 12 weeks of leave
during any 12-month period for [a serious health condition/the birth or adoption of
a child/the care of a spouse, child, or parent who has a serious health
condition/active-duty orders/the care of a covered service member]. This leave is
called FMLA leave. It is unlawful for an employer to take action against an
employee because the employee exercises [his/her] FMLA rights. The FMLA does
not require an employer to pay an employee while on FMLA leave.
To succeed on [his/her] claim against [name of defendant], [name of
plaintiff] must prove each of the following facts by a preponderance of the
evidence:
First: [Name of plaintiff] was employed by [name of defendant];
Second: [Name of plaintiff] was eligible for FMLA leave;
Third: [Name of plaintiff] was entitled to FMLA leave;
Fourth: [Name of plaintiff] [describe protected activity];
Fifth: [Name of defendant] [described challenged employment
action];
Sixth: [Describe challenged employment action] was an “adverse
employment action;” and
Seventh: [Name of defendant] took that action because of [name of
plaintiff]’s [described protected activity].
[In the verdict form that I will explain in a moment, you will be asked to
answer questions about these factual issues.]
[The parties have agreed that [name of plaintiff] was employed by [name of
defendant]. You should consider that a proven fact.]
For the second element, [name of plaintiff] was “eligible” for FMLA leave
if:
(a) [name of plaintiff] worked for [name of defendant] for at least 12
months before the date any FMLA leave was to begin, and
(b) [name of plaintiff] worked for [name of defendant] for at least
1,250 hours during the 12-month period before the date any FMLA
leave was to begin.
For the third element, [name of plaintiff] was “entitled” to FMLA leave if:
(a) [Name of plaintiff] had an FMLA-qualifying reason, and
(b) [Name of plaintiff] gave [name of defendant] proper notice of
[his/her] need for leave.
[A serious health condition that prevented [name of plaintiff] from
performing the functions of [his/her] job/The birth or adoption of a child/The care
of a spouse, child, or parent who has a serious health condition/Following active -
duty orders/The care of a covered service member] is an “FMLA -qualifying
reason.”
[A “serious health condition” is an illness, injury, impairment, or physical or
mental condition that involves either inpatient care in a hospital, hospice, or
residential medical facility, or continuing treatment by a healthcare provider.
Ordinarily, unless complications arise, the common cold, the flu, earaches, upset
stomach, minor ulcers, headaches other than migraine, routine dental or
orthodontia problems, periodontal disease, and other similar conditions do not
meet the definition of a “serious health condition” and do not qualify for FMLA
leave.]
[Name of plaintiff] “gave proper notice” to [name of defendant] of [his/her]
need for FMLA leave if [he/she] notified [name of defendant] of the need to take
FMLA leave in a timely manner and in a way that alerted [name of defendant] that
[his/her] absence might qualify as an FMLA leave – even if [name of plaintiff] did
not expressly mention the FMLA.
If [name of plaintiff] knew of the need for leave more than 30 days before
the leave was to begin, [he/she] was required to give [name of defendant] notice at
least 30 days before the leave was to begin. If [name of plaintiff] knew of the need
for leave less than 30 days before the leave was to begin, [he/she] was required to
give [name of defendant] notice as soon as was reasonably possible.
For the fourth element, you must decide whether [name of plaintiff]
[describe protected activity]. If you find that [name of plaintiff] [describe protected
activity], then you have found that [he/she] engaged in “FMLA-protected activity.”
For the fifth element, you must decide whether [name of defendant]
[describe challenged employment action].
For the sixth element, you must decide whether [describe challenged
employment action] is an “adverse employment action.” An “adverse employment
action” is any type of action that would have made a reasonable employee reluctant
to exercise FMLA rights. Put another way, if a reasonable employee would be less
likely to exercise [his/her] FMLA rights because [he/she] knew that [name of
defendant] would [describe adverse employment action], then that action is an
adverse employment action. If the employment action would not make it less likely
for a reasonable employee to exercise FMLA rights, it is not an adverse
employment action.
For the seventh element, you must decide whether [name of defendant]
[describe adverse employment action] because of [name of plaintiff]’s FMLA -
protected activity. To prove that [name of defendant] [describe adverse
employment action] because of [name of plaintiff]’s FMLA-protected activity ,
[name of plaintiff] does not have to prove that [his/her] FMLA -protected activity
was the only or main reason that [name of defendant] [describe adverse
employment action]. [Name of defendant] cannot avoid liability just because some
other factor played a role in its decision. To determine that [name of defendant]
[describe adverse employment action] because of [name of plaintiff]’s FMLA -
protected activity, you must decide that [name of defendant] would not have
[describe adverse employment action] if [name of plaintiff] had not engaged in
FMLA-protected activity but everything else had been the same.
[Name of defendant] denies that [he/she/it] [describe adverse employment
action] because of [name of plaintiff]’s [describe protected activity] and claims that
[he/she/it] took the action for [another reason/other reasons]. An employer may not
take an adverse action against an employee because of the employee’s FMLA -
protected activity, but an employer may [describe adverse employment action] an
employee for any other reason, good or bad, fair or unfair. If you believe [name of
defendant]’s reason[s] for the decision [to discharge/not to promote] [name of
plaintiff], and you find that the decision was not made because of [name of
plaintiff]’s FMLA-protected activity, you must not second guess that decision, and
you must not substitute your own judgment for [name of defendant]’s judgment –
even if you do not agree with it.
If you find that [name of plaintiff] has proved each element [he/she] must
prove, you must consider the issue of [name of plaintiff]’s alleged damages.
[Name of plaintiff] can recover lost wages and benefits, or [he/she] can
recover other expenses incurred because of [name of defendant]’s actions – but not
both.
If [name of plaintiff] proved that [he/she] lost wages or benefits because of
[name of defendant]’s FMLA violation, then [name of plaintiff] may recover net
lost wages and benefits from the date of [describe challenged employment action]
to the date of your verdict.
If you find that [name of plaintiff] did not directly lose pay or benefits
because of [name of defendant]’s FMLA violation, then you may award [name of
plaintiff] the actual monetary loss that directly resulted from [name of defendant]’s
FMLA violation. This amount of damages cannot exceed [12/26] weeks of [name
of plaintiff]’s wages or salary.
[Mitigation of Damages: You are instructed that any person who claims
damages as a result of an alleged wrongful act on the part of another has a duty
under the law to “mitigate” those damages. For purposes of [name of plaintiff]’s
claim for lost pay, the duty to mitigate damages requires [name of plaintiff] to be
reasonably diligent in seeking substantially equivalent employment to the position
[he/she] held with [name of defendant]. To prove that [name of plaintiff] failed to
mitigate damages, [name of de fendant] must prove by a preponderance of the
evidence that: (1) work comparable to the position [name of plaintiff] held with
[name of defendant] was available, and (2) [name of plaintiff] did not make
reasonably diligent efforts to obtain it. If, however, [name of defendant] shows that
[name of plaintiff] did not make reasonable efforts to obtain any work, then [name
of defendant] does not have to prove that comparable work was available.
If you find that [name of defendant] proved by a preponderance of the
evidence that [name of plaintiff] failed to mitigate damages, then you should
reduce the amount of [name of plaintiff]’s damages by the amount that could have
been reasonably realized if [name of plaintiff] had taken advantage of an
opportunity for substantially equivalent employment.]
SPECIAL INTERROGATORIES TO THE JURY
Do you find from a preponderance of the evidence:
1. That [name of plaintiff] was employed by [name of defendant]?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson
should sign and date the last page of this verdict form. If your answer is “Yes,” go
to the next question.
2. That [name of plaintiff] was eligible for FMLA leave?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson
should sign and date the last page of this verdict form. If your answer is “Yes,” go
to the next question.
3. That [name of plaintiff] was entitled to FMLA leave?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson
should sign and date the last page of this verdict form. If your answer is “Yes,” go
to the next question.
4. That [name of plaintiff] [describe protected activity]?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson
should sign and date the last page of this verdict form. If your answer is “Yes,” go
to the next question.
5. That [name of defendant] [describe challenged employment action]?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson
should sign and date the last page of this verdict form. If your answer is “Yes,” go
to the next question.
6. That [challenged employment action] was an “adverse employment
action”?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson
should sign and date the last page of this verdict form. If your answer is “Yes,” go
to the next question.
7. That [name of defendant] took the adverse employment action because of
[name of plaintiff]’s protected activity?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson
should sign and date the last page of this verdict form. If your answer is “Yes,” go
to the next question.
8. That [name of plaintiff] should be awarded damages?
Answer Yes or No _____________
If your answer is “Yes,”
in what amount? $_____________
SO SAY WE ALL.
___________________________
Foreperson’s Signature
DATE: ___________________
Provenance
- Source
- ca11.uscourts.gov
- Retrieved
- 2026-08-20
- Edition
- civil-2025-12
- Content hash
99769b063dd4910dbf4bba39d45d921ef2cb2c9664434f8760375f605c6c5afd
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