Fmla Release Of Information Form

State:
Multi-State
Control #:
US-288EM
Format:
Word; 
Rich Text
Instant download

Description

This form is used to provide information to employees about extended absences under the FMLA.
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  • Preview FMLA Information Letter to Employee
  • Preview FMLA Information Letter to Employee

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FAQ

A. If an employer requests it, an employee is required to provide a complete and sufficient medical certification in order to take FMLA-protected leave due to a serious health condition. The employer cannot ask for a diagnosis.

Go to your Human Resources department and let them know you would like to take an FMLA-approved absence for stress leave. They will provide you with the necessary paperwork that you must take to your doctor.

Among the forms changed were the WH-381, the notice of eligibility and rights and responsibilities; WH-382, designation notice; WH-380-E, medical certification of an employee's serious health condition; and WH-380-F, medical certification of a family member's serious health condition.

Employers typically respond to FMLA leave requests by providing the employee with the Notice of Eligibility and Rights & Responsibilities (Form WH-381) and a medical certification form.

Mental health conditions can trigger compliance requirements under both the FMLA and the ADA. An anxiety attack, PTSD episode, major depression or other mental health event may qualify as a serious health condition under the FMLA.

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More info

Section I of the form provides boxes for how the employer will designate the requested leave. The form allows for the doctor to state how the condition prevents or impacts an employee's ability to execute a job.If you prefer to complete a paper authorization form, please download and print the Authorization for Release of Health Information Form. We also can help you fill out disability or FMLA paperwork. Please allow up to 10 business days to complete forms. You and your health care provider must fill out this form about your serious health condition.

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Fmla Release Of Information Form