Form WH-380-E Instructions
Below, we have shared all the Form WH-380-E instructions for our readers to learn more about the Certification of Health Care Provider for an Employee's Serious Health Condition.
If the employee suffers from any serious health condition and is not able to show up to work, that employee must submit Form WH-380-E. Submitting this Certification of Health Care Provider for the Employee’s Serious Health Condition will let the employee protect the employee’s job during the health condition.
In addition to this, you have 15 calendar days to submit your form to your employer. Submitting this certification alone will be enough for employees to take their unpaid leave. However, if the employer has suspicions about the information written on the certification, the employer can request a second Certification of Health Care Provider for Employee’s Serious Health Condition form to be completed.
In these cases, the employer needs to cover all the costs, and the healthcare provider must be one of the providers that do not work with the employee. A third and final certification can be requested if the two certifications do not match and there is disagreement. Again, all the costs must be covered by the employer.
If you submit an incomplete form, you will be asked to repeat the process. However, if the form is incomplete a second time, your FMLA leave will be denied.
Form WH-380-E Consist of Three Sections
This form consists of three sections. The first section must be completed by the employer. They will be providing basic information such as the employer’s name or contact information, the job title, basic job duties, and the employee’s work schedule.
The second section must be completed by the employee. The employee needs to request leave on time and with sufficient medical certification.
The third section consists of two parts. After providing basic information, such as the healthcare provider’s name, address, and contact information, the provider has to fill out Part A and Part B.
In part A, information about the medical facts of the employee will be provided. For example, when the condition started, the estimated length of time the patient will have this condition, and any medications used by the employee.
If there is any, the healthcare provider also describes other medical facts about the patient. However, all this information should be related to the patient’s current condition.
In part B, the healthcare provider will provide information about the amount of leave needed by the patient. If any, the employee’s incapacitated period needs to be provided. In addition, information about the follow-up treatments and the way in which they will be performed must be described as well.
The certification must be signed by all three parties to be valid, and all the information requested on the certification must be detailed and clear. Other than that, completing the Certification of Health Care Provider for an Employee’s Serious Health Condition is highly straightforward.