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Certification for Serious Injury or Illness of a Current Service member for Military Caregiver Leave under the Family and Medical Leave Act. S. Department of Labor Wage Hour Division DO NOT SEND COMPLETED
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How to fill out serious-injury-illness-current-servicemember-military

01
Step 1: Obtain the serious injury/illness form from the military
02
Step 2: Fill out personal information including name, rank, and contact information
03
Step 3: Provide details of the injury or illness and how it occurred
04
Step 4: Include any medical documentation or reports related to the injury or illness
05
Step 5: Submit the completed form to the appropriate military authority

Who needs serious-injury-illness-current-servicemember-military?

01
Current servicemembers who have suffered a serious injury or illness while on duty
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Serious injury, illness, or current servicemember in the military is a form that allows eligible employees to take time off work to care for a family member who is a current servicemember with a serious injury or illness.
Employees who need time off work to care for a family member (spouse, son, daughter, parent, next of kin) who is a current servicemember with a serious injury or illness are required to file serious-injury-illness-current-servicemember-military.
To fill out the serious-injury-illness-current-servicemember-military form, the employee needs to provide their personal information, information about the family member who is a current servicemember, details of the serious injury or illness, and certification by a health care provider.
The purpose of serious-injury-illness-current-servicemember-military is to provide eligible employees with protected time off work to care for a family member who is a current servicemember with a serious injury or illness.
The serious-injury-illness-current-servicemember-military form requires information such as personal details of the employee, details of the family member who is a current servicemember, information about the serious injury or illness, and certification by a health care provider.
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