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The Department of Labor (DOL) has re-issued their version of two important Family and Medical Leave Act forms: The Certification of Health Care Provider and the Employer Response to Employee Request for Family or Medical Leave. Other than the expiration date, there has been no change to the forms this year. The date of the most recent change in the content of the forms occurred in 1999 and 1997 respectively. These forms, however, contain an "OMB No." which has an expiration date. Both forms indicate on the back that "Note: Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number."
When contacted, the DOL has indicated that, although the OMB number has an expiration date, an employer may continue to use the "expired" form. However, such use may present a problem for an employer if a health care provider closely reads the fine print and wishes to find an excuse not to complete the information. For this reason, it is recommended that employers use the re-issued form to avoid this problem.
Download the forms here in Adobe Acrobat PDF format:
*Certification of Health Care Provider WH-380 - Adobe Acrobat PDF
*Employer Response to Employee Request for Family or Medical Leave WH-381 - Adobe Acrobat PDF
For more information regarding privacy, training programs and publications, please call (414) 423-1330 or e-mail Krukowski & Costello's educational services department.
**If you do not have Adobe Acrobat Reader, you can download it free of charge at Adobe Systems Incorporated.
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