Form WH-380-E Certification of Health Care Provider for Employee's Serious Health Condition (Family and Medical Leave Act)

What Is Form WH-380-E?

This is a legal form that was released by the U.S. Department of Labor - Wage and Hour Division on May 1, 2015 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form WH-380-E?
A: The Form WH-380-E is a certification form for health care providers under the Family and Medical Leave Act (FMLA).

Q: What is the purpose of Form WH-380-E?
A: The purpose of Form WH-380-E is to gather information from health care providers to certify an employee's serious health condition, which allows the employee to take leave under FMLA.

Q: Who needs to complete Form WH-380-E?
A: Health care providers need to complete Form WH-380-E to certify an employee's serious health condition.

Q: What information is required on Form WH-380-E?
A: Form WH-380-E requires information such as the employee's name, the type of serious health condition, the start and end dates of the condition, and the health care provider's contact information.

Q: Can an employee be required to provide Form WH-380-E?
A: Yes, an employer can require an employee to provide Form WH-380-E to certify their serious health condition and eligibility for FMLA leave.

Q: How long is Form WH-380-E valid?
A: Form WH-380-E is valid for the duration of the employee's FMLA leave period or for six months, whichever is shorter.