Background
The Family and Medical Leave Act of 1993 (FMLA) gives eligible employees the right to take unpaid, job-protected leave each year in certain situations, including the birth, adoption or foster care placement of a child, their own or a family member’s serious health condition and a family member’s military service.
To administer FMLA leaves, employers must provide certain notices to employees, such as notice designating whether a requested leave will qualify as FMLA leave. Employers may also require that employees provide certifications to substantiate their eligibility for certain types of FMLA leave.
The Department of Labor (DOL) has provided model notices and certifications to help employers administer FMLA leaves. The DOL’s model FMLA forms are optional; employers may decide to customize the DOL’s model forms or create their own FMLA forms.
Model Forms and Poster
- WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition (pdf)
- WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition (pdf)
- WH-381 Notice of Eligibility and Rights & Responsibilities (pdf)
- WH-382 Designation Notice (pdf)
- WH-384 Certification of Qualifying Exigency For Military Family Leave (pdf)
- WH-385 Certification for Serious Injury or Illness of Current Servicemember — for Military Family Leave (pdf)
- WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (pdf)
The DOL recently updated its model FMLA forms. The updated forms include an expiration date of May 31, 2018. In addition, the model certification forms that request medical information have been updated to include information on the Genetic Information Nondiscrimination Act (GINA). Employers that use the model FMLA forms should start using the DOL’s updated models as soon as possible.
In addition, the DOL has provided a model FMLA poster, which is available in both English and Spanish, for employers to post in the workplace.
The following are a few basic reminders regarding the FMLA poster:
- Employers covered by the FMLA are required to display the poster in a prominent place where it can be readily seen by employees and applicants;
- The poster must be displayed even if the employer does not have any employees who are eligible for FMLA leave; and
- Covered employers with eligible employees must include the poster in any written guidance to employees, such as an employee handbook, that explains other employee benefits or leave rights (if such written guidance exists) or distribute a copy of the poster to each new employee upon hiring.
The model FMLA forms and poster are also available on the DOL’s FMLA webpage.