Need a Florida Family and Medical Leave Act Attorney to help file a claim? Our employment lawyers take cases involving FMLA violations. Employers can intimidate workers into giving up their rights to family and medical leave.
The Family and Medical Leave Act of 1993
Family and Medical Leave Act (FMLA) Forms and Explanations
The various federal FMLA forms are posted below to download and print. FMLA allows the majority of employees (who meet certain eligibility requirements) to take a leave of absence from work for a variety of health and family related reasons.
This includes childbirth and the initial care of a newborn. If the employee is on the company’s health insurance plan, the coverage continues throughout the period of absence. Note that the leave of absence is without pay.
Health Care Provider Certification Form – Employee
WH-380-E – This form is essentially a doctor’s note to take advantage of the rights provided by FMLA. The top section is filled out by you. The bulk of the form is filled out by your doctor or other medical practitioner.
Health Care Provider Certification Form – Family Member
WH-380-F – This is the same as the above – except it is for a leave of absence to care for a family member as opposed to you. As before, the majority of the document is directed toward the medical practitioner.
Notice of Eligibility and Rights & Responsibility Form
WH-381 – This is the form given by an employer to an employee instructing the employee of FMLA eligibility if and when an employee requests a leave of absence. It is filled out by the employer and notifies the employee if she is eligible for benefits and whether any further documentation is required.
Designation Notice Form
WH-382 – This is another form given by the employer to the employee. As opposed to eligibility, this form notifies of approval or disapproval of FMLA application. If FMLA rights are denied, it provides the employee with the reason. If additional documents are needed for determination, that is noted as well.
Certification of Qualifying Exigency for Military Leave Form
WH-384 – This form is generally filled out by the employee, but the top portion is filled out by the employer. This form is used to demonstrate the need for a leave of absence due to a family member’s military requirements.
Certification for Serious Injury or Illness of Covered Service Member Form
WH-385 – This form is used if the family member who is in the Armed Services has become seriously ill or injured during active duty. Again, it is filled out primarily by the employee but contains a small section at top for the employer.
Contact A Tampa Family and Medical Leave Act Attorney
We fight for employee rights and win. If you think that you have been wrongfully terminated or discriminated against in accordance with the FMLA, then schedule your free initial consultation with us today.