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June 11, 2015

U.S. Department of Labor Releases New Family And Medical Leave Act Forms

On May 27, 2015 the U.S. Department of Labor (“DOL”) released new model Family and Medical Leave Act (“FMLA”) notices and medical certification forms which covered employers should begin using. The new model forms replace the previously expired forms and are valid through May 31, 2018.

The new FMLA forms now recognize the obligations of employers and health care providers under the Genetic Nondiscrimination Act (“GINA”). GINA, makes it illegal for an employer to discriminate against employees on the basis of genetic information. GINA prohibits requesting, requiring or purchasing genetic information and strictly limits the disclosure of genetic information. For more information in regards to GINA, please see our alert dated, November 14, 2010 at

Updated Forms

Consistent with GINA, the new forms now contain language that is designed to protect employers from inadvertent disclosure of genetic information. All rules can be found at the DOL website at under the forms section. The new forms are:

  1. WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition
  2. WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition
  3. WH-385 Certification for Serious Injury or Illness of  a Current Servicemember-for Military Family Leave
  4. WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave

Takeaway for Employers

Employers should update their FMLA forms to reflect the changes made by the DOL.

If you have any questions concerning the new FMLA forms, GINA or the FMLA generally, please do not hesitate to contact us.