If you are taking a protected leave of absence from work under the Family and Medical Leave Act (FMLA), you may need to fill out FMLA forms to meet your employer’s requirements. The act was signed into law by President Clinton in February 1993. It requires that some employers allow eligible employees access to unpaid time off for specific family and medical reasons. You need to review the FMLA Eligibility Checklist and fill out the FMLA Application, which includes the Family Medical Leave Act form.
How does the Family Medical Leave Act work?
The FMLA applies to public and private employees who have worked with the same employer for more than 1,250 hours in the past year. The Act limits its scope to employers with more than 50 employees and also excludes or limits specific categories of upper-level employees.
It allows qualified employees to be out of work for up to 12 weeks — without pay — when they experience a need for qualifications. Situations include caring for a sick family member, caring for a new baby – from birth or adoption – and recovering from a serious injury or illness. Types of qualifying medical and family purposes include adoption, pregnancy, foster care placement, family or personal illness, or caring for a military or veteran family member.
The US Department of Labor’s Wage and Hour Division (DOL-WHD) oversees the FMLA program. It specified seven different FMLA application forms that specify the reason for the eligible leave and how much information your employer needs to approve or deny the request. You can download the form from the DOL-WHD website. Also, your human resources officer can help you locate the right request application for your position.
Below are details of the different forms, the information sought for each type of leave, and how to apply for FMLA.
FMLA Form WH-380-E for Employee Health Status
Your employer can use Form 380-E (Health Care Provider’s Certification for a Serious Health Condition of the Employee) to obtain a medical certification of your need to leave work. This form has two sections, one that your employer will complete, and another for your doctor or health care provider to complete.
Your human resources office will usually give you a partially completed form for your healthcare provider to complete.
It contains information about your condition, including:
- when it started
- How long can it last
- Whether your condition requires an overnight stay in a medical facility, and if so, when
- What job responsibilities prevent you from fulfilling your condition
- Your symptoms, diagnosis, and treatment regimen
- How much time do you need, and will it be continuous or sporadic
- Will your condition require follow-up treatment that will require you to leave work?
FMLA Form WH-380-F for Family Health Status
You can use Form 380-F (Health Care Provider’s Certification for a Serious Health Condition of a Family Member) to tell your employer that you need to take leave to care for a seriously ill or injured family member. is required. You must provide the name of your family member and your relationship to that family member (only certain relatives are eligible).
You will also need to specify the type of care you must provide and the amount of leave you will need. Like 380-E, this form requires the employer, employee, and health care practitioner to complete specific information.
Your relative’s medical provider must complete the rest of the form for Form 380-E along with the required information, such as:
- When the condition started
- How long can this last
- the type of care your relative needs and other important medical information such as the schedule of care
The idea is to explain why your absence from work is necessary.
FMLA Form WH-381 Eligibility and Rights
Form 381 (Notification of Eligibility and Rights and Responsibilities) is a notification document that your employer may give you within five business days of receiving notice of your intention to take FMLA to leave. This form verifies the information you have provided to your employer, including the date and reason for your leave. You are not required to fill out any part of this form.
However, depending on how your employer completes this form, you may have to take additional steps. If your employer uses this form to confirm and approve your leave, there is nothing more to do. But your employer may use this form to request that you submit one of the other reports described in this article at:
- Prove your need to take leave
- Request proof of your relationship with the family member you are requesting leave for care
- Document military family leave
It may also say that you need to take the necessary steps to maintain your health insurance during your vacation. Additionally, you may need to report to your employer from time to time during your leave so that you can let them know when and if you expect to return to work.
Warning: FMLA protects your job while you’re on vacation, but because it’s unpaid time off (up to 12 weeks), many families can’t afford to take it.
FMLA Form WH-382 Designation Information
There are several reasons why your employer may hand you Form 382 (Designation Information). You don’t have anything to fill out yourself, but if your employer uses this form to ask for additional information to determine whether your leave request is valid, there are steps you can take to provide that information. Have to lift
If your employer is using this form to let you know that they are requesting a second or third medical opinion about your ability to work, you will need to arrange for that medical appointment. Your employer must bill for these considerations.
FMLA Form WH-384 for Military Family Leave
Your employer may ask you to complete Form 384 (Certification for Military Family Leave for Qualifying Qualifications) to prove the need to take leave under the special provisions of the FMLA for military service members and their families. For example, you may need time off to make financial and childcare arrangements pending your spouse’s deployment.
You must specifically state why you are requesting leave and provide proof in the form of a service member’s active duty order or another acceptable document.
Form WH-384 Section II is much longer than the other forms. First, you need to fill in your name and relationship with the service member.
Next, you provide the service member’s active duty service dates and a copy of their order or another official document.
Then, provide the event that requires you to take the FMLA in question five. Question six asks you to check a box that certifies what documents are available.
Questions seven to 10 require dates and estimates of work schedules or periods of absence.
Questions 11 and 12 ask for more estimates or whether the member is on rest and health leave.
Finally, you provide your information and sign and date the request.
FMLA Form WH-385 for Servicemember Care
Use Form 385 (Certification for Serious Injury or Illness of a Current Service Member for Military Carer Leave) to request leave to care for a sick or injured service member. You will use WH-385 to provide details about the person you will care for, including your relationship with that person.
Next, you’ll fill out the servicemember status, the care you’ll provide, an estimate of the amount of leave needed, and the reduced work schedule.
After that, you must give the form to the service member’s qualified health provider (such as a Department of Defense doctor) to complete sections of the form about the service member’s condition and treatment.
FMLA Form WH-385-V for Veteran Carer Leave
If you need to take leave to care for a veteran who is seriously ill or injured and needs your care, your employer will give you Form 385-V (A Veteran’s Serious Injury or Illness for Military Carer’s Leave). certification). You must provide the veteran’s name and your relationship to them—leave can only be granted if you are their spouse, child, parent, or relative.
You will also need to fill in the date of the veteran’s discharge, indicate whether the veteran was discharged, provide the veteran’s rank and branch at the time of discharge, and check the box indicating whether they were discharged due to injury. are receiving medical treatment or not. disease. You should then describe the type of care you need to provide and the amount of time you need to provide it.
Then, you’ll give the form to the veteran’s qualified health provider (such as a U.S. Department of Defense doctor) and ask them to complete sections of the form about the veteran’s condition and treatment.