Utah Certification of Health Care Provider under the FMLA of 1993

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US-289EM
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This form is used by a health care provider to give an assessment of an employee's health.
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FAQ

Healthcare Professional means any member of the medical, dental, pharmacy or nursing professions or any other person who in the course of his or her professional activities may prescribe, recommend, purchase, supply, or administer a pharmaceutical product.

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.

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.

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.

Under federal regulations, a "health care provider" is defined as: a doctor of medicine or osteopathy, podiatrist, dentist, chiropractor, clinical psychologist, optometrist, nurse practitioner, nurse-midwife, or a clinical social worker who is authorized to practice by the State and performing within the scope of their

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.

In short, a medical certification is a relatively short form that is filled out by a health care provider and provided to the employer to establish a patient or family member's medical condition that requires FMLA-protected leave.

The Act defines health care provider as: A doctor of medicine or osteopathy who is authorized to practice medicine or surgery (as appropriate) by the State in which the doctor practices; or. Any other person determined by the Secretary to be capable of providing health care services.

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave.

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Utah Certification of Health Care Provider under the FMLA of 1993