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wh 381 fillable form

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Notice of Eligibility and Rights Responsibilities Family and Medical Leave Act U.S. Department of Labor Employment Standards Administration Wage and Hour Division OMB Control Number 1215-0181 Expires 12/31/2011 In general to be eligible an employee must have worked for an employer for at least 12 months have worked at least 1 250 hours in the 12 months preceding the leave and work at a site with at least 50 employees within 75 miles. While use of...
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welcome to module 2 in this module we're reviewing the forms provided by the Department of Labor for family medical leave situations this form entitled notice of eligibility and rights and responsibilities is the form that a supervisor completes when an employee indicates that he or she needs to take Family Medical Leave let's go ahead and walk through the form when an employee says that he or she is taking a leave you want to first off complete Part A to indicate whether or not the employee is eligible for leave you're going to of course list the employee's name and your name as the supervisor and the date that the form is being completed you're going to indicate here the date that you were informed that the employee needed to take leave and the date that the leave is to begin and then the various reasons for the leave are listed here so you're going to check off whichever one applies if it's due to the employees in serious health condition the birth of a child etc the notice is to inform you that and it says are eligible for Family Medical Leave are not eligible for Family Medical Leave this section is vital for the supervisor to complete correctly so please contact human resources for any guidance if you're not sure if an employee is eligible or not for family medical leave the employer is required by law to inform the employee whether or not he or she is eligible for Family Medical Leave so it is very important that we get this form to the employee in a timely fashion it indicates down here that if you have any questions contact feel free to list Molly fern or Regina mccurdy whichever employee relations manager handles your vicariate we're happy to handle any questions an employee has about Family Medical Leave it also says or view the Family Medical Leave poster located in your labor law posters have a section about Family Medical Leave so if you have that poster in your lounge you certainly can indicate that also Part B of the form is the rights and responsibilities section it states here in order for us to determine whether your absence qualifies as Family Medical Leave you must return the following information to us by so we're asking the employee to return the health care provider form back to us within the 15 calendar days so that's why it indicates here that a dates needed so the employee has a deadline so normally you're going to give this form to the employee along with giving them the form 380 II or a 380 F depending on the reason for the leave then it states here sufficient certification to support your request for Family Medical Leave a certification form that sets forth the information necessary to support your request is or is not enclosed so we normally are going to enclose that form WH 380 or F for the employee to take to his or her doctor or family members doctor to get that sufficient certification for Family Medical Leave there's also invocation here other information is...
Please select a version for Fillable DoL WH-381 form
  • 2020 DoL WH-381 Fillable
  • 2013 DoL WH-381 Fillable
  • 2009 DoL WH-381 Fillable
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Please select a version for Fillable DoL WH-381 form
  • 2020 DoL WH-381 Fillable
  • 2013 DoL WH-381 Fillable
  • 2009 DoL WH-381 Fillable
  • More...