FMLA (Family and Medical Leave Act) protects the rights of employees to take up to 12 weeks of leave to take care of a family member’s serious health condition. This is unpaid leave and covers a wide range of conditions, from childbirth to heart attack.
This allows new dads to take care of their spouses and newborn children without worrying about losing their jobs. However, the employee needs to provide a written certification to use these rights and fill out different FMLA forms to verify that the condition of their relative is covered by the Act.
In this regard, one of the forms that the employee must fill out is the Certification of Health Care Provider for Family Member’s Serious Health Condition, i.e., Form WH-380-F. You can easily access this form by visiting the official Department of Labor website or by asking for it from the human resources department.
Form Wh-380-F Consist of Three Sections
The form consists of three sections. The first section must be completed by the employer. It is not a detailed section, and information such as the employer’s contact name or information is requested.
The second section must be completed by the employee, who is requesting unpaid leave that can take up to 12 weeks. This section also starts with requesting basic information about the employee, such as the employee’s name and the family member with a serious health condition.
In the following part, the employees must provide information about the relationship between them and the relative. They also need to provide the relative’s date of birth as well.
Later on, the employee needs to explain why they are requesting the leave and what is the estimated amount of the leave.
The third section must be filled in by the healthcare provider. It is worth noting that words such as indeterminate, unknown, or life should be avoided while describing the patient’s condition. Using these words may result in the denial of your leave request.
In addition, the healthcare provider must limit the description of the medical condition in question.
The third section consists of two parts, Part A and Part B. After providing the basic information, such as the healthcare organization’s name, address, and contact information, the provider can continue filling out the remaining parts.
In Part A, the healthcare provider must provide information about when the health condition began and how long it may last. In addition to this, any medications or overnight stays at the hospital must be included too.
In Part B, if any, the healthcare provider must have any incapacitated date for the patient. The care that will be provided for the patient must also be included in the description.
As you can see, the Form WH-380-F instructions are quite straightforward, and anyone can fill out the form. The most challenging part of the form is that it must be completed by three different individuals or entities.