Since the U.S. Department of Labor’s (DOL) last set of Family Medical Leave Act (FMLA) forms expired at the end of 2011, savvy employers have been on the look-out for new ones. Wait no more: The DOL recently released updated model forms for employers’ use in the administration of leave under the FMLA and here’s what’s changed:
The DOL updated its certification forms for qualifying exigency for military family leave and serious injury or illness of a covered servicemember and issued a new, separate certification form for military caregiver leave for a veteran. Click here to see our alert on this topic. The new model forms also now state that they are good through February 28, 2015.
As a reminder, the FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. Eligible employees are entitled to:
Twelve workweeks of leave in a 12-month period for:
- the birth of a child and to care for the newborn child within one year of birth;
- the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;
- to care for the employee’s spouse, child, or parent who has a serious health condition;
- a serious health condition that makes the employee unable to perform the essential functions of his or her job;
- any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on “covered active duty;” or
Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the servicemember’s spouse, son, daughter, parent, or next of kin (military caregiver leave).
While use of the DOL’s model FMLA forms is optional, employers using such forms should ensure that they switch to the new forms immediately.
For copies of the new FMLA forms, use the links below:
- WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition (PDF)
- WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition (PDF)
- WH-381 Notice of Eligibility and Rights & Responsibilities (PDF)
- WH-382 Designation Notice (PDF)
- WH-384 Certification of Qualifying Exigency For Military Family Leave (PDF)
- WH-385 Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave (PDF)
- WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (PDF)