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U.S. Department of Labor Wage and Hour Division Certification of Health Care Provider for Employee s Serious Health Condition under the Family and Medical Leave Act DO NOT SEND COMPLETED FORM TO.
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Form wh 380 e revised june 2020 pdf FAQ
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Employee's serious health condition, form WH-380-E – use when a leave request is due to the medical condition of the employee. Family member's serious health condition, form WH-380-F – use when a leave request is due to the medical condition of the employee's family member.
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Serious health condition means an illness, injury, impairment, or physical or mental condition which requires: Overnight hospitalization (including prenatal care), including the period of incapacity or subsequent treatment in connection with the overnight care.
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Forms. WH-380-E (Certification of Health Care Provider for Employee's Serious Health Condition)
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Can You Be Fired If Your FMLA Is Denied? Your employer can not retaliate against you for exercising your rights under the FMLA. That means whether you make an FMLA request or appeal their FMLA denial to the DOL or in a private lawsuit, they cannot take adverse employment action against you.
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