If you are taking a protected leave of absence from work under the Family and Medical Leave Act (FMLA), you may need to fill out some paperwork to satisfy your employer’s requirements. The types of qualified medical and family reasons why an employee might require leave may include adoption, pregnancy, foster care placement, family or personal illness, or military leave.
There are seven different FMLA forms from the U.S. Department of Labor’s Wage and Hour Division; which one(s) you will need to complete depends on the reason for your leave and how much information your employer requires in order to approve or deny your request.
Below, we describe the various forms and the information that is asked for on each.
Form 380-E: Certification of Health Care Provider for Employee’s Serious Health Condition
Your employer can use Form 380-E to obtain medical certification of your own need to take a leave of absence from work. They will give you the partially-completed form, which you will then have completed at your doctor.
It covers information about your condition, including:
- when it began
- how long it might last
- whether your condition has required an overnight stay in a medical facility, and if so, when
- which job responsibilities your condition prevents you from fulfilling
- your symptoms, diagnosis and treatment regimen
- how much time off you need, and whether it will be continuous or sporadic
- whether your condition will require follow-up treatment that will require you to miss work
Form 380-F: Certification of Health Care Provider for Family Member’s Serious Health Condition
You can use Form 380-F to tell your employer that you need to take leave to care for a seriously ill or injured family member. You’ll need to provide your family member’s name and your relationship to that family member (only certain relatives qualify). You’ll also need to describe the type of care you must provide and how much time off you will need.
Your relative’s medical provider must complete the rest of the form with information similar to that required by Form 380-E such as:
- when did the condition begin
- how long might it last
- what type of care does your relative require and so on.
The idea is to explain why your absence from work is necessary.
Form 381: Notice of Eligibility and Rights & Responsibilities
This is a form your employer may give you within five business days of receiving your notice of intent to take FMLA leave. This form confirms the information you gave your employer, including the dates and reason for your leave. You don’t need to complete any part of this form.
However, depending on how your employer completes this form, you might need to take additional steps. If your employer uses this form to confirm and approve your leave, there’s nothing more to do. But your employer might use this form to request that you submit one of the other forms described in this article to certify your need to take leave.
They also might use it to formally request proof of your relationship to the family member you’re requesting leave to care for, or to request documentation for military family leave. It may also say that you need to take steps to maintain your health insurance during your leave or to let you know that you’re required to periodically report back to your employer during your leave to let them know when and if you expect to return to work.
Form 382: Designation Notice
There are several reasons why your employer might hand you Form 382. There’s nothing for you to fill out yourself, but if your employer is using this form to ask for additional information to determine whether your leave request is valid, you’ll need to take the steps to provide that information.
Also, if your employer is using this form to tell you that they are requesting a second or third medical opinion of your ability to work, you’ll need to make arrangements for that medical appointment. Your employer is required to foot the bill for these opinions.
(Learn more about workers’ rights in Salary vs. Hourly: How Benefits and Laws Differ.)
Form 384: Certification of Qualifying Exigency For Military Family Leave
Your employer can ask you to complete Form 384 to prove your need to take leave under the FMLA’s special provisions for military service members and their families. For example, you might need time off to make financial and child-care arrangements pending your spouse’s deployment.
This form asks you for information about how long and how often you’ll need to miss work, the name of the military member this request is related to, your relationship to him/her and his/her dates of active duty. You’ll need to specifically state why you’re requesting leave and provide proof in the form of the service member’s active duty orders or other acceptable documentation.
(Learn more in Financial Preparation for Deployment.)
Form 385: Certification for Serious Injury or Illness of a Current Service Member — for Military Family Leave
If you want to take leave to care for a sick or injured service member, your employer may give you this form. You’ll use it to provide details about the individual you’ll be caring for, including your relationship to that person and the amount of time off you expect to need.
Following that, you’ll need to give the form to the service member’s qualified health provider (such as a Department of Defense doctor) to have them complete the sections of the form about the service member’s condition and treatment.
Form 385-V: Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
If you want to take leave to care for a veteran who is seriously ill or injured and requires your care, your employer might give you Form 385-V. You must provide the veteran’s name and your relationship to them — leave may only be granted if you are their spouse, child, parent or next of kin.
You’ll also need to fill out the date of the veteran’s discharge, indicate whether the veteran was dishonorably discharged, provide the veteran’s rank and branch at the time of discharge, and check the box indicating whether they are receiving medical treatment for an injury or illness. You must then describe the type of care you need to provide and the amount of time you need off to provide that care. After that, you'll give the form to the veteran’s qualified health provider (such as a Department of Defense doctor) and ask them to complete the sections of the form about the veteran’s condition and treatment.
The Bottom Line
Most FMLA forms do not require you to fill out the form yourself — they require you to take certain steps to prove your need for taking leave or provide information about how long you’ll miss work. It is usually an employer or doctor who fills out the majority of the form. Your employer’s use of these forms is optional, but they can be helpful in formalizing arrangements between employers and employees to ensure both parties fulfill their rights and responsibilities.
(To learn more about the Family and Medical Leave Act, read How FMLA Works and Protects Your Job.)