Colorado Employer FMLA Response - Form WH-381

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Multi-State
Control #:
US-426EM
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Word; 
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Description

This form is used by an employer to provide a response to a request for leave under the FMLA.
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  • Preview Employer FMLA Response - Form WH-381
  • Preview Employer FMLA Response - Form WH-381

How to fill out Employer FMLA Response - Form WH-381?

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FAQ

Designation Notice, form WH-382 informs the employee whether the FMLA leave request is approved; also informs the employee of the amount of leave that is designated and counted against the employee's FMLA entitlement.

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.

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.

PROVIDE TO EMPLOYEE. While use of this form is optional, a fully completed Form WH- 381 provides employees with the information required by 29 C.F.R. ? 825.300(b), (c) which must be provided within five business days of the employee notifying the employer of the need for FMLA leave.

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year.

EligibilityHave worked for your employer for at least 12 months; and.Have worked for your employer for at least 1,250 hours in the 12 months before you are taking leave; and.Work at a location where your employer has at least 50 employees within 75 miles of your worksite.

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.

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.

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Colorado Employer FMLA Response - Form WH-381