DoL WH-385 2013-2026 free printable template

Limit your responses to the servicemember s condition for which the employee is seeking leave. Page 1 CONTINUED ON NEXT PAGE Form WH-385 Revised February 2013 This section must be completed first before any of the below sections can be completed by a health care provider. NONE OF THE ABOVE Note to Employee If this box is checked you may still be eligible to take leave to care for a covered family member with a serious health condition under 825. ...

How to fill out DoL WH-385

How to fill out DoL WH-385

1. Obtain the DoL WH-385 form from the Department of Labor's website or your employer.
2. Start by filling in your name, address, and contact information at the top of the form.
3. Indicate your relationship to the employee needing care in the specified section.
4. Provide information about the health condition and the duration of care needed.
5. If applicable, include details about any medical professional's recommendations or certifications.
6. Review the form for accuracy and completeness.
7. Sign and date the form before submitting it to your employer.

Who needs DoL WH-385?

1. Employees who are requesting leave under the Family and Medical Leave Act (FMLA) for family caregiving.
2. Anyone who requires medical leave to care for a family member with a serious health condition.
3. Employers who need to verify the legitimacy of a leave request for family care.

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What is DoL WH-385?

DoL WH-385 is a form used by the U.S. Department of Labor that serves as a certification for the need for leave due to a family member's serious health condition, as part of the Family and Medical Leave Act (FMLA).

Who is required to file DoL WH-385?

Employees who are seeking to take leave under the FMLA for the care of a family member with a serious health condition are required to file DoL WH-385.

How to fill out DoL WH-385?

To fill out DoL WH-385, the employee must provide their personal information, details about the family member needing care, the nature of the medical condition, and supporting medical certification from a healthcare provider.

What is the purpose of DoL WH-385?

The purpose of DoL WH-385 is to provide documentation to employers that verifies an employee's eligibility for FMLA leave to care for a relative with a serious health condition.

What information must be reported on DoL WH-385?

The information that must be reported on DoL WH-385 includes the employee's name, the family member's name, the relationship to the family member, the medical condition, and relevant medical documentation from the healthcare provider.