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All in a Day's Work® - Insights on Labor & Employment Law

DOL publishes new FMLA forms

On May 27, 2015, the Department of Labor (DOL) published the new model FMLA notices and medical certification forms, which expire on May 31, 2018:

  • WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition
  • WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition
  • WH-381 Notice of Eligibility and Rights & Responsibilities
  • WH-382 Designation Notice
  • WH-384 Certification of Qualifying Exigency for Military Family Leave
  • WH-385 Certification for Serious Injury or Illness of Current Servicemember – for Military Family Leave
  • WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave

These forms are accessible from the DOL web page here.

DOL updated these forms to include a reference to the Genetic Information Nondiscrimination Act of 2008 (GINA).  GINA obligates employers to comply with confidentiality requirements regarding information about an individual’s genetic tests and the genetic tests of the employee’s family members, as well as information used to determine whether someone has an increased risk of getting a disease, disorder or condition in the future, such as cancer.  Employers must keep any medical information confidential under both GINA and the Americans with Disabilities Act (ADA).

Employers should check their FMLA notices and certification forms to ensure that they are using these updated forms.


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