Family Medical Leave Act (FMLA) Toolkit

Employees are generally eligible for medical leave under federal and Wisconsin law.  When approved, employees are permitted to use all leave types based upon the parameters established for duration of leave based on the unique medical situation. Managers and supervisors should contact their local HR office for assistance in proper completion of the FMLA process.  For convenience, the following resources may be of assistance:

FMLA Information for Employees - Rights and Responsibilities

DOA-15322 Family and Medical Leave – Employee Request

DOA-15325 Notice of Eligibility and Rights & Responsibilities (two forms combined)

DOA-15324 FMLA Designation Notice

DOA-15336 – Fitness for Duty Certification – Return to Work Release

WH-380-E Certification of Health Care Provider for Employee's Serious Health Condition (PDF) (federal DOL form)

WH-380-F Certification of Health Care Provider for Family Member's Serious Health Condition (PDF) (federal DOL form)

WH-384 Certification of Qualifying Exigency For Military Family Leave (PDF) (federal DOL form)

WH-385 Certification for Serious Injury or Illness of Current Service member -- for Military Family Leave (PDF) (federal DOL form)

WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (federal DOL form)


POSTERS / NOTICES

WFMLA Poster (for posting in the workplace – Spanish and Hmong versions are also available through the DWD Equal Rights Division)

FMLA poster (for posting in the workplace - federal DOL model – WHD Publication 1420)

DOL ADMINISTRATOR INTERPRETATIONS

Interpretation No. 2010-3 - Regarding person standing in loco parentis

Interpretation No. 2013-1 - Regarding an individual 18 years of age or older and incapable of self-care because of a mental or physical disability