Pennsylvania FMLA Certification of Physician

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Multi-State
Control #:
US-AHI-202
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Word; 
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Description

This AHI form is used by employers who have an employee that has requested medical leave. This form is filled out by the physician of the person that is being treated.
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FAQ

Doctors aren't the only health care providers who may certify FMLA leave. Podiatrists, dentists, clinical psychologists, optometrists and chiropractors can all certify leave, as can nurse practitioners, nurse-midwives, clinical social workers and physician assistants.

You can call the United States Department of Labor's Wage-Hour toll-free information and help line at 1-866-4USWAGE (1-866-487-9243) or visit its website at for more information about the FMLA or filing a complaint with the Department of Labor.

How Does the FMLA Work in PA? Pennsylvania companies must comply with the Family and Medical Leave Act if they have at least 50 employees for at least 20 weeks in the present or previous year. Employees may take leave if they worked at least 1,250 hours in 12 month period of time. This is the same as federal law.

According to the Equal Employment Opportunity Commission which enforces the ADA employers can have a policy requiring all employees provide doctor's notes to substantiate a disability, request reasonable accommodations or prove the need for leave.

You do not have to tell your employer your diagnosis, but you do need to provide information indicating that your leave is due to an FMLA-protected condition (for example, stating that you have been to the doctor and have been given antibiotics and told to stay home for four days).

You are protected by the FMLA if you meet the following requirements: (1) you work at a location where at least 50 employees are employed by your employer within 75 miles of that location; (2) you have worked for your employer for at least one year; and (3) you have worked at least 1,250 hours over the last twelve

How Does the FMLA Work in PA? Pennsylvania companies must comply with the Family and Medical Leave Act if they have at least 50 employees for at least 20 weeks in the present or previous year. Employees may take leave if they worked at least 1,250 hours in 12 month period of time. This is the same as federal law.

Employers in every state, including Pennsylvania, are subject to the federal Family and Medical Leave Act (FMLA), which allows eligible employees to take unpaid leave, with the right to reinstatement, for certain reasons.

Fill out Section 2 of the form. If you are completing form WH-380-F, you will be required to provide information about the family member you are caring for during FMLA leave; such as their full name, your relationship to one another, and a description of your methods for providing care for that person.

No. An employer cannot require a physician's note every time an employee misses work while taking FMLA intermittent leave. The term physician's note is not referenced in the FMLA; recertification, however, is.

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Pennsylvania FMLA Certification of Physician