Welcome to module 2 in this module we'll review the forms provided by the Department of Labor for family medical leave situations the website address for the Department of Labor is located in the top left-hand corner of the screen WW DOL gov this form entitled “Certification of Health Care Provider for Employees Serious Health Condition” is the form that a supervisor should give to an employee when he or she is taking a leave for his or her own serious health condition this form is also referred to as form WH 380 II Section 1 of the form is for the supervisor to complete and as you can see it's very brief it asks with the employer name and contact information the employee's job title and regular work schedule and the essential job functions if you don't wish to list the essential job functions you can simply attach a job description one thing to note is the paragraph above that states that employers must keep all the medical records related to Family Medical Leave and that these records should be kept outside the personnel file because they contain confidential medical information the next section of the form is for the employee to complete and as you can see it's very brief it only asks for the employee's name right above the employees name is a sentence that we should note it states here your employer must give you at least 15 calendar days to return this form so when the employee takes the form to his or her doctor they are entitled to 15 calendar days to get it back to the employer if you don't receive the form back within the 15 days please call Human Resources and will contact the employee and assist you with getting the...
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How to prepare Form WH-380-E
About Form WH-380-E
Form WH-380-E is a Certification of Health Care Provider for Employee's Serious Health Condition. It is a document used by employers to obtain certification from an employee's health care provider regarding the serious health condition of the employee or the employee's family member. It is required under the Family and Medical Leave Act (FMLA) when an employee is requesting time off from work to care for themselves or a family member due to a serious health condition. The form must be completed and signed by the employee's health care provider and returned to the employer within the designated time frame.
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