Virginia Employer FMLA Response - Form WH-381

State:
Multi-State
Control #:
US-426EM
Format:
Word; 
Rich Text
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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

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.

Form WH 380-E, Certification of Health Care Provider for Employee's Serious Health Condition, is a form used by employers and sent to the US Department of Labor, Wages and Hour Division. This form verifies that an employee has a serious medical condition.

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.

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.

Employee's serious health condition, form WH-380-E use when a leave request is due to the medical condition of the employee. Family member's serious health condition, form WH-380-F use when a leave request is due to the medical condition of the employee's family member.

Under certain circumstances, an employer may deny job restoration to "key employees." A "key employee" is a salaried, FMLA-eligible employee who is among the highest paid 10 percent of all the employees employed by the employer within 75 miles of the employee's worksite.

Eligibility Notice, form WH-381 informs the employee of his or her eligibility for FMLA leave or at least one reason why the employee is not eligible.

U.S. Postal Service employees wishing to exercise rights under the FMLA may do so by submitting online form PS 3971, Request for or Notification of Absence. This form is prepared the same as any other annual or sick leave request. Advance notification is preferred by the USPS, with 30 days advance notice ideal.

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Virginia Employer FMLA Response - Form WH-381