DOL Proposed Changes to FMLA Forms

Posted September 23rd, 2019

On August 5, 2019, the United States Department of Labor (“DOL”) published a notice seeking public comment on proposed revisions to several model FMLA forms.

While use of the DOL forms in FMLA administration is optional for employers, employers who have previously relied on the forms published by the DOL should review the new proposed forms now and plan to update their FMLA materials accordingly when final forms are issued.

The DOL’s proposed revisions to the forms are designed to make it easier for employers and employees to accurately complete the forms and therefore ensure compliance with the FMLA, replace “fill in the blank” sections with check boxes to reduce confusion, and expand on the instructions included with each form.  Additional access and formatting changes include larger text and color-coded sections to more clearly indicate which sections are to be completed by employees and the employer.

The affected forms include:

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 of Rights & Responsibilities

WH-382 Designation Notice

WH-384 Certification of Qualifying Exigency for Military Family Leave

WH-385 Certification of Serious Injury of Illness or Covered Servicemember – for Military Family Leave

WH-385-V Certification for Serious Injury of Illness of a Veteran for Military Caregiver Leave

You can review the DOL’s statement and links to the proposed forms here and submit comments on the proposed revisions by emailing  Expect to see final versions of these forms later in 2019 or early 2020 and plan to incorporate these final forms into your FMLA administration materials.

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