The U.S. Department of Labor (DOL) recently revised the Family Medical Leave Act (FMLA) forms which expired back in February 2015. The new forms are current through May 2018 and should be used going forward.

In addition to the new expiration date, the other notable change includes Genetic Information Nondiscrimination Act (GINA) disclaimer language added to the medical certification forms.  This is a great opportunity to make sure you are complying with FMLA and the applicable state laws by providing the correct forms in a timely manner.

Each form lists the expiration date in the upper right corner.  Below are links to the new FMLA forms. You can also access updated forms on the DOL website.

• 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)

Farleigh Wada Witt Employment Attorneys

Kelly Tilden - ktilden@fwwlaw.com

Kim McGair - kmcgair@fwwlaw.com

Paul Migchelbrink - pmigchelbrink@fwwlaw.com

Trish Walsh - twalsh@fwwlaw.com

Melissa Beyer - mbeyer@fwwlaw.com

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