Employers use this form to assess the applicability of FMLA/CFRA leave and to provide the employee with the required notices.
FMLA, which stands for the Family and Medical Leave Act, is a federal law that provides eligible employees with the right to take job-protected leave for certain family and medical reasons. FMLA leave is specifically designed to help employees balance their work and family responsibilities by allowing them to take time off without fear of losing their job or health insurance coverage. In California, employees are entitled to additional protections under state law, namely the California Family Rights Act (CFA). The CFA expands on the federal FMLA provisions and provides even more extensive rights to employees. To request FMLA leaves with dependents in California, employees need to fill out specific forms that outline the details of their request and their dependent's condition. The most common FMLA California form with dependents is the CFA Certification of Health Care Provider for the Employee's Serious Health Condition and Family Member's Serious Health Condition (Form CFRA-1). This form is used when an employee's own serious health condition or the serious health condition of their dependent necessitates taking leave under CFA. The form requires medical certifications from healthcare providers to validate the need for leave. Another important FMLA California form is the Request for Family and Medical Leave (Form DE 2501F). This form is used when an employee wishes to take leave under the California Paid Family Leave (PFL) program, which provides partial wage replacement for eligible employees who take time off to care for a seriously ill child, spouse, parent, or registered domestic partner, or to bond with a new child through birth, adoption, or foster care placement. Additionally, if an employee wishes to take FMLA leaves to care for a covered service member (e.g., a member of the military), they would need to complete the Certification for Serious Injury or Illness of Covered Service member for Military Family Leave (Form WH-385). This form provides information about the service member's condition and may require input from military healthcare providers. It is important to note that FMLA California forms with dependents may vary based on the specific circumstances and applicable laws. Employers should provide their employees with the necessary forms and guidance to properly request and document FMLA leaves with dependents, ensuring compliance with both federal and state regulations.
