New FMLA Forms

Type:  General 

 

New FMLA Forms

 

Last week, the federal Wage and Hour Division released new FMLA forms to be used going forward.  The forms were revised due to previous editions having expired in February. In addition to a new expiration date, the new forms also include specific references to the Genetic Information Nondiscrimination Act, which limits collection of data on hereditary health conditions that could be used to discriminate against employees.

 

Those employers with 50 or more employees within a 75 mile radius of its locations are required to offer FMLA to their employees.

 

Under FMLA, eligible employees are entitled to:

 

* Twelve workweeks of leave in a 12-month period for:

  • the birth of a child and to care for the newborn child within one year of birth;
  • the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;
  • to care for the employee's spouse, child, or parent who has a serious health condition;
  • a serious health condition that makes the employee unable to perform the essential functions of his or her job;
  • any qualifying exigency arising out of the fact that the employee's spouse, son, daughter, or parent is a covered military member on "covered active duty;" or

* Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the servicemember's spouse, son, daughter, parent, or next of kin (military caregiver leave).

 

These new forms may be found on the federal Wage and Hour Division website or by clicking the link below:


 

       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 Covered Servicemember -- for Military Family Leave (PDF)

       WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (PDF)