WH 381 PDF Template

[toc] The Family and Medical Leave Act, also known as FMLA, is the legislation in the United States that allows people to take unpaid time off from work due to family or medical emergencies. There are a number of different documents that must be filed if a person wishes to apply for FMLA benefits. One of these is the Notice of Eligibility. The WH 381 Form also informs people of their rights and responsibilities with regards to FMLA. You can find your WH 381 Form here with PDFSimpli.

This form is the main form that people use when they need to request FMLA leave from their employer. Under FMLA, employees have the right to take unpaid leave from their occupation when they need to take care of their own medical condition or the medical condition of a family member. FMLA also entitles employees to take time off when there are matters related to their parent’s, child’s, or spouse’s military deployment.

FMLA also gives eligible employees the right to have up to 12 weeks of unpaid leave when their child is born. This applies not just during the birth of a child, but when an employee adopts or fosters a child as well. No matter what reason a person has for taking FMLA-related leave, their right to group health benefits is protected under the law.

It is currently against the law for a person’s employer to deny, interfere with, or restrain the rights that people are guaranteed in FMLA. If a person feels that there has been a violation of their rights, they can make a complaint to the Department of Labor or bring civil action against their employer in court. If an employee’s rights are determined to have been violated, they’ll generally be awarded damages.

People who meet the FMLA eligibility requirements are able to take up to twelve weeks of unpaid leave during a particular year. The reasons outlined include:

The individual cannot work because of a surgery or illness

The individual cannot work because of a surgery or illness

The individual needs to care for a newborn child

The individual needs to care for a newborn child

The individual needs to care for a foster or adopted child who has just been placed with them

The individual needs to care for a foster or adopted child who has just been placed with them

The individual needs to care for an ill child, spouse, or parent

There might be qualifying issues related to the military deployment of an employee’s parent, child, or spouse. These include:

Issues regarding the person’s deployment

Issues regarding the person’s deployment

Military activities and events

Military activities and events

Types of childcare and other similar activities that are affected by active duty

Types of childcare and other similar activities that are affected by active duty

The need to make financial or legal arrangements in the absence of a military member

The need to make financial or legal arrangements in the absence of a military member

Counseling due to a family member’s active duty status

Counseling due to a family member’s active duty status

Up to five days spent with military members who have taken a short-term leave

Up to five days spent with military members who have taken a short-term leave

Activities post-deployment

Activities post-deployment

Any other events related to the absence of a military member as the employer and employee agree upon

If a person wants to request leave from their job, this is the main form they’ll need to use. It should be filled out when the circumstances for the leave apply to circumstances outlined by FMLA. It’s important that an employee declare the intention to take FMLA-protected leave at least thirty days prior to filing the request. There are some unforeseen circumstances, so a lack of thirty days’ notice isn’t necessarily a guarantee of a rejection.

The employer is the one responsible for filling out the WH-381 form. In Part A, there’s information about FMLA eligibility. Part B refers to the responsibilities and rights that the employee and employer have according to FMLA law.

If this form isn’t fully completed and returned, their FMLA leave request will automatically be denied. The finished form is meant to inform the employees of everything they need to know regarding their leave. This information must be provided within five business days following the notification that they need FMLA leave.

The employer must fill out this form after the employee makes their leave request.

Part A is the Notice of Eligibility. Write the name of the employee, with the representative for the employer underneath. Date the form. Then write the date that the employee requested the leave, along with the date that the proposed leave will commence. You will need to check the appropriate reason that the leave was requested, and note whether the request is regarding the child, parent, or spouse of the employee.

The employer will need to inform the person of whether they meet the eligibility requirements for FMLA leave, or if they don’t meet the eligibility requirements. If the latter is the case, they will need to check the reason or reasons explaining why. Give the contact information of the HR representative who handles FMLA leave requests, along with the position of the FMLA poster in the office.

Part B explains the rights and responsibilities that the employee has. You should note the date at which they should return the form.[pdf-embedder url=”https://cdn-prod-pdfsimpli-wpcontent.azureedge.net/pdfseoforms/pdf-20180219t134432z-001/pdf/form-wh-381.pdf?sv=2018-03-28&si=readpolicy&sr=c&sig=MXHnWmn0sXNXztiU%2Bugk2d7DV7KBCOuXF3oBMx0EeEw%3D”]