US-CA11 · jury_instructions
11th Cir. Pattern Jury Instr. (Civil) 4.16
Family and Medical Leave Act – Interference Claims –
29 U.S.C. §§ 2601-2654
In this case, [name of plaintiff] claims that [he/she] was entitled to a leave of
absence from work under a federal law called the Family and Medical Leave Act,
also known as the FMLA, and that [name of defendant] interfered with, restrained,
or denied [his/her] entitlement to a leave of absence.
Under the FMLA, an eligible employee may take up to 12 weeks of leave
during any 12- month period for [the employee’s own serious health condition/the
birth, placement 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.
The FMLA also gives the employee, after [his/her] leave, the right to be
restored by the employer to the position held when the leave began, or to be given
an equivalent position. It is unlawful for an employer to interfere with, restrain, or
deny the exercise of, or the attempt to exercise any of these rights.
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 eligible for FMLA leave;
Second: [Name of plaintiff] was entitled to FMLA leave;
Third: [Name of plaintiff] gave [name of defendant] proper notice
of [his/her] need for leave; and
Fourth: [Name of defendant] [describe interference, e.g., refused to
allow leave, refused [name of plaintiff] reinstatement,
discharged [name of plaintiff], failed to maintain benefits].
[In the verdict form that I will explain in a moment, you will be asked to
answer questions about these factual issues.]
For the first 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 second element, [name of plaintiff] was “entitled” to FMLA leave if
[he/she] had an FMLA -qualifying reason. [A serious health condition that
prevented [name of plaintiff] from performing the functions of [his/her] job/The
birth, placement 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.]
For the third element, [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 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 determine whether [name of defendant]
[describe interference].
[Including Affirmative Defense: If you find that [name of plaintiff] has
proved each element [he/she] must prove, you must decide whether [name of
defendant] has established [his/her/its] affirmative defense.
It is lawful for an employer to [describe interference] for reasons unrelated
to an employee’s [FMLA leave/attempt to take FMLA leave]. To establish this
affirmative defense, [name of defendant] must prove by a preponderance of the
evidence that [he/she/it] [describe interference] for reasons that were unrelated to
[name of plaintiff]’s [FMLA leave/attempt to take FMLA leave]. Put another way,
[name of defendant] must prove that [he/she/it] would have [describe interference]
even without the [FMLA leave/attempt to take FMLA leave].
If you find that [name of defendant] established [his/her/its] affirmative
defense, you will not decide the issue of [name of plaintiff]’s damages.]
If you find that [name of plaintiff] has proved each element [he/she] must
prove, [and against [name of defendant] on this defense,] 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 interference] 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 defendant] 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 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.
2. 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.
3. That [name of plaintiff] gave [name of defendant] proper notice of
[his/her] need for 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 defendant] [describe interference]?
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 interference] for reasons that were
unrelated to [name of plaintiff]’s [FMLA leave/attempt to take FMLA leave]?
Answer Yes or No _____________
If your answer is “Yes,” this ends your deliberations, and your foreperson
should sign and date the last page of this verdict form. If your answer is “No,” go
to the next question.]
6. 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
967a9a9395a251238c64402ddf266917ceac731b850af0d554c827af91fe3738
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