WH-380-E vs. WH-380-F: Which FMLA Medical Certification Form Do You Need?
The U.S. Department of Labor publishes two separate medical certification forms for Family and Medical Leave Act leave, and sending in the wrong one is a common reason an employer kicks a certification back. WH-380-E certifies your own serious health condition. WH-380-F certifies a serious health condition affecting your spouse, child, or parent. The WH-380-E vs. WH-380-F distinction isn't cosmetic: the two forms ask your provider different clinical questions, and mixing them up can burn through the 15-day window FMLA gives you to return a complete certification. Knowing which form applies before your appointment saves a second trip to your provider's office.
What FMLA Medical Certification Actually Does
When you request FMLA leave for a serious health condition, your employer can require medical certification before approving the leave. Certification is the mechanism the law uses to confirm that a condition genuinely qualifies, how long leave is likely to last, and whether you need continuous leave or an intermittent schedule. The Department of Labor maintains current versions of both forms, along with the rest of the required FMLA paperwork, on its FMLA forms page. Employers aren't required to use the Department of Labor's exact forms, but any substitute form they use can't demand more information than WH-380-E or WH-380-F already asks for, and it still has to be completed by a health care provider rather than filled out by the employee.
An employer also has to tell you, in writing, which form applies when it requests certification. If the request letter just says "FMLA medical certification" without specifying whether the leave is for you or a family member, that ambiguity is worth resolving with HR before your appointment rather than guessing and risking a second visit.
WH-380-E: Certifying Your Own Serious Health Condition
WH-380-E applies when the leave is for your own health condition. Your provider uses it to describe the medical facts behind the condition, give a probable duration, and state whether you can perform the essential functions of your job during that period. If your condition requires intermittent leave, such as periodic flare-ups of a chronic illness, this is also where your provider documents the expected frequency and duration of those episodes. The form doesn't require your provider to disclose your diagnosis. It asks about functional limitations and treatment, not the underlying condition itself, so your privacy stays intact while your employer still gets what the law entitles them to know.
WH-380-F: Certifying a Family Member's Serious Health Condition
WH-380-F covers leave to care for a spouse, child, or parent with a serious health condition. The relationship covered is narrow: a parent-in-law, sibling, grandparent, or a partner outside a recognized marriage doesn't qualify under federal FMLA, even if your employer's own policy is more generous. On this form, the provider describes the family member's condition and, critically, states whether the employee's presence is medically necessary for care, transportation, or psychological comfort. Because the patient on this form is someone other than the employee, the employee signs an authorization permitting the family member's relevant health information to be shared for certification purposes.
A Concrete Example: Two Employees, Two Forms
Consider two employees at the same company requesting FMLA leave in the same month. The first has a herniated disc that needs surgery and a six-week recovery; her surgeon completes WH-380-E, describing her own functional restrictions and the expected date she can return to her job duties. The second employee's father has late-stage kidney disease and needs transportation to dialysis three times a week; his father's nephrologist completes WH-380-F, describing the father's condition and confirming that the employee's presence during those appointments is medically necessary. Both employees are on FMLA leave for roughly the same number of hours each month, but the paperwork behind each leave looks different because the patient is different in each case.
WH-380-E vs. WH-380-F: The Key Differences
The two forms share a structure but diverge in what they ask and who they're about.
Whose condition is certified - WH-380-E certifies the employee's own condition; WH-380-F certifies a covered family member's condition.
Who can be the subject - WH-380-F is limited to a spouse, child, or parent. It doesn't extend to a parent-in-law, sibling, grandparent, or other relative.
What the provider documents - WH-380-E focuses on the employee's own functional limitations and job duties; WH-380-F focuses on the care the family member needs and the employee's role in providing it.
Who authorizes the release of information - On WH-380-F, the employee authorizes release of the family member's relevant medical information, since the employee isn't the patient.
Intermittent leave documentation - Both forms can support intermittent leave, but the clinical basis differs: WH-380-E describes the employee's own flare-up pattern, while WH-380-F describes episodic care needs tied to the family member's condition.
State Family and Medical Leave Programs With Their Own Forms
Federal FMLA runs through WH-380-E and WH-380-F, but a growing number of states operate their own paid family and medical leave programs with separate paperwork:
California - the Employment Development Department's Paid Family Leave program uses its own certification forms rather than the federal WH-380 series.
New York - Paid Family Leave claims go through the Workers' Compensation Board's own health care provider certification.
New Jersey - Family Leave Insurance claims require the state's own medical certification form, filed separately from any federal FMLA paperwork.
Washington - Paid Family and Medical Leave, administered by the Employment Security Department, runs its own certification process independent of WH-380-E and WH-380-F.
If you qualify for both federal job protection and a state paid-leave benefit, expect two separate certifications: the state's form for wage replacement, and WH-380-E or WH-380-F if your employer is also requiring certification for the federal leave entitlement itself. The two filings run on different clocks and go to different agencies, so completing one doesn't excuse you from the other.
Who Fills Out the Form, and What to Bring to the Appointment
The employee's job is to identify the correct form, get a copy from the employer or directly from the Department of Labor, and bring it to the appointment along with the deadline the employer provided. The provider's job is to complete the clinical sections, sign, and return it to the patient, or, under current guidance, directly to the employer if the employee authorizes that path. Bring your employer's leave request letter if you received one; it typically states which form is required and the exact due date, along with a copy of your job description if the certification asks whether you can perform your essential functions. Without a job description, your provider is left guessing at what your role actually requires, which is one of the more common reasons a WH-380-E comes back incomplete.
Providers completing a doctor's note for work or an FMLA certificate through telehealth still need an actual clinical encounter behind the form, since a provider can't certify functional limitations or care needs they haven't assessed. If the family member on a WH-380-F has their own treating physician, that physician, not your own doctor, is usually the right person to complete the clinical sections, since they have the direct knowledge of the patient's condition the form requires.
Timelines: How Long You Have to Submit Certification
Once your employer requests certification, federal regulations require they give you at least 15 calendar days to return it. If the certification comes back incomplete or unclear, your employer has to tell you specifically what's missing and give you at least seven more days to fix it. Missing these windows without a reasonable excuse can result in a delayed or denied leave designation, so scheduling your provider appointment as soon as you know certification is coming matters more than waiting to see whether your employer actually follows through on the request. If your leave has already started by the time certification is requested, a completed form can still support a retroactive FMLA designation covering the days you already missed, provided you return it within the window.
What Happens If You Submit the Wrong Form or an Incomplete One
Sending WH-380-F when your employer asked for WH-380-E, or the reverse, typically isn't an automatic denial, but it does cost you time: your employer can treat it as an incomplete certification and restart the clarification clock. An employer also can't contact your provider directly to ask clarifying questions; clarification requests have to go through you or a designated health care provider representative. FMLA separately gives employers a second, and if needed a third, opinion process when they have reason to doubt a certification's medical substance, but that process addresses disputing the clinical content of a certification, not a clerical mismatch like the wrong form number. Treat a request for the correct form as a fixable formality, not a signal that your leave is in jeopardy.
Getting the Right Documentation Without a Delay
If you're not sure whether your situation calls for WH-380-E or WH-380-F, start with who the condition belongs to: you, or a covered family member. From there, a standard sick note covers a short, non-FMLA absence, while FMLA certification is a separate, more detailed clinical document meant for leave that can run for weeks or months. When the timeline is tight, same-day notes or a same-day FMLA certification appointment can keep your 15-day clock from becoming a problem, provided the provider still completes a genuine clinical review before signing anything.
Frequently Asked Questions
Can I use WH-380-E for both my own condition and a family member's?
No. WH-380-E is limited to the employee's own serious health condition. Leave to care for a spouse, child, or parent requires WH-380-F instead, since the two forms certify different patients.
Does my employer have to accept the Department of Labor's exact form?
No, but any substitute form an employer uses can't require more information than WH-380-E or WH-380-F already asks for, and it still has to be completed by a health care provider rather than the employee.
What counts as a "serious health condition" under FMLA?
Generally, a condition requiring inpatient care or ongoing treatment by a health care provider that involves a period of incapacity. The definition covers several categories, including chronic conditions and pregnancy, and your provider determines whether your situation meets one of them.
Can a telehealth provider complete WH-380-E or WH-380-F?
Yes, provided the provider holds an appropriate license and conducts a real clinical assessment first. The delivery method doesn't change what the form requires or who's qualified to sign it.
If my state has its own paid family leave program, do I still need the federal form?
Possibly both. A state program's certification supports wage replacement under that state's law. WH-380-E or WH-380-F supports the separate federal job-protection entitlement, and your employer can require it even if you're also receiving a state benefit.
Can my employer reject a completed WH-380-E or WH-380-F?
Not outright. If an employer questions a completed certification, the law gives them a second and third opinion process and a clarification process, not a flat rejection of a properly completed form.
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