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  • Dol Form Wh-380-f Form -- Certification Of Health Care Provider ... - Cinciapwu

Get Dol Form Wh-380-f Form -- Certification Of Health Care Provider ... - Cinciapwu

Certification of Health Care Provider for Family Member s Serious Health Condition (Family and Medical Leave Act) U.S. Department of Labor Wage and Hour Division OMB Control Number: 1235-0003 Expires:.

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The Family and Medical Leave Act (FMLA) allows an eligible state employee to take up to twelve workweeks of leave per rolling twelve-month period for the following qualifying events: Incapacity due to pregnancy, prenatal medical care or child birth; Caring for the employee's child after birth, or placement for adoption ...

Employees must make reasonable efforts to schedule leave for planned medical treatment so as not to unduly disrupt the employer's operations. Leave due to qualifying exigencies may also be taken on an intermittent basis. Employees may choose or employers may require use of accrued paid leave while taking FMLA leave.

To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.

FMLA may be unpaid leave unless the employee has accrued sick leave and/or vacation hours and/or compensatory hours which he/she is eligible to use for the purpose of the leave. Employee are required to use all their accrued and available leave during an FMLA leave.

Employee's serious health condition, form WH-380-E – use when a leave request is due to the medical condition of the employee. Family member's serious health condition, form WH-380-F – use when a leave request is due to the medical condition of the employee's family member.

Intermittent leave can be utilized when an employee needs to take leave in separate blocks of time due to a single FMLA-qualifying reason. This type of leave can be taken in periods of time ranging from one hour or more to weeks at a time. The total leave used in a 12-month period cannot exceed 12 total weeks.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232