AI SoloHR
For U.S. small businesses
ProductU.S. HR Use Cases
Free Calculators▼
FMLA Leave CalculatorFMLA Hours CalculatorIntermittent FMLA TrackerFMLA Eligibility & FTERemote FMLA EligibilityFMLA Reduced Schedule HourFMLA Interference RiskADA Process TimelineADA Documentation GeneratorBradford Factor ScoreUnum & Sedgwick SavingsTermination Safeguard
Resources▼
Resources OverviewFMLA Compliance HubGuides & ComplianceHR Templates & ChecklistsHelp Center & SupportSecurity & AI Safety
Case Studies▼
Case Studies OverviewFMLA CasesADA Accommodation CasesBenefits & Retirement CasesEmployee Relations CasesGeneral Compliance Cases
PricingBlog
Sign inStart Free
Toggle menu
ProductUse CasesPricingBlogSecurity
Free Toolsv
FMLA Leave CalculatorFMLA Hours CalculatorIntermittent FMLA TrackerFMLA Eligibility & FTERemote FMLA EligibilityFMLA Reduced ScheduleFMLA Interference RiskADA Process TimelineADA Documentation GeneratorBradford Factor ScoreUnum & Sedgwick SavingsTermination Safeguard
Case Studiesv
OverviewFMLA CasesADA CasesBenefits CasesEmployee Relations CasesCompliance Cases
Resourcesv
Resources OverviewFMLA Compliance HubGuides & ComplianceHR Templates & ChecklistsHelp Center & Support
Sign InStart Free
AI SoloHR

HR case management built for U.S. small businesses handling FMLA, ADA accommodations, employee relations, benefits renewals, and other audit-sensitive workflows.

Product

  • Features
  • Pricing
  • Resource Center
  • FMLA Compliance Hub
  • Guides & Compliance
  • HR Templates & Checklists
  • Help Center
  • U.S. HR Use Cases
  • FMLA Tracking Software
  • HR Case Management Software
  • Blog Updates

Free HR Tools

  • FMLA Leave Calculator
  • FMLA Eligibility & FTE
  • Remote FMLA Eligibility
  • FMLA Reduced Schedule Hour
  • FMLA Interference Risk
  • ADA Process Timeline
  • Bradford Factor Score

Company

  • About Us
  • Contact Support
  • Design Partner Program

Legal & Security

  • Security & Trust
  • Compliance Disclaimer
  • Privacy Policy
  • Data Handling
  • Terms of Service
  • Cookie Policy
  • Refund Policy
  • Data Request

2026 AI SoloHR. Built for HR teams of one at U.S. employers.

Sensitive U.S. HR data protected with private storage and TLS 1.3
Home/Blog/WH-380-E Instructions: Complete Employer Guide, Examples & PDF Download (2026)
FMLAJul 21, 2026 01:22by AI SoloHR Compliance & Editorial Team8 min read

WH-380-E Instructions: Complete Employer Guide, Examples & PDF Download (2026)

Step-by-step HR guide to completing DOL Form WH-380-E for employee medical leave. Download official 2026 PDF, view Section I-III instructions, and compare good vs. bad certification examples.

For U.S. employers and small-business HR teams.

#FMLA#WH-380-E#WH-380-E Instructions#DOL Forms#HR Compliance#Medical Certification#Leave Management
Fact-Checked & Regulatory AuditVERIFIED E-E-A-T

Verified by AI SoloHR Compliance & Editorial Team (U.S. Employment Law & Regulatory Compliance Research Group)

Last Audit: Sep 3, 2026 21:49

FMLA workflow next step

Turn this FMLA guidance into a trackable case workflow

If this article matches an active leave request, move from reading to a concrete tracker, calculator, or case workflow before deadlines start drifting.

Download FMLA checklist

Use a checklist to capture eligibility, certification, designation, and return-to-work dates.

Download FMLA checklist

Open FMLA calculator

Convert FMLA workweeks into hours and estimate remaining leave.

Open FMLA calculator
WH-380-E Instructions: Complete Employer Guide, Examples & PDF Download (2026)

Executive Overview: Mastering Form WH-380-E for Employee Leave

Department of Labor (DOL) Form WH-380-E is the official medical certification form issued under the Family and Medical Leave Act (FMLA) when an employee requests job-protected leave for their own serious health condition. Unlike generic doctor notes, Form WH-380-E provides employers with statutory evidence required to verify leave eligibility, determine whether an absence qualifies for 12 workweeks of protection, and establish accurate scheduling boundaries.

In 2026, progressive HR leaders treat WH-380-E processing not merely as paper intake, but as a critical compliance gate. Proper handling prevents FMLA interference claims while shielding companies from leave abuse, unverified short-term absences, and premature termination risks.

📌 Download Official DOL Form WH-380-E PDF: Get direct access to the latest U.S. Department of Labor official medical certification forms: Download Official Form WH-380-E PDF from DOL.gov (https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-380-E.pdf) or explore our complete 2026 FMLA Certification Download Center (https://aisolohr.com/blog/fmla-certification-form-download).

Keep this workflow moving

Free FMLA tracking checklist

Use this checklist to organize eligibility notices, certification follow-up, designation timing, and return-to-work documentation.

Download FMLA checklist

Sources and review notes

This article is written for U.S. small-business HR teams in 2026 and should be checked against your own policy, state requirements, and counsel guidance before use in a contested employment decision. AI SoloHR provides workflow structure, reviewed drafting support, and educational resources; it does not provide legal advice or make final employment decisions.

Statutory Sources & Regulatory Citations

This compliance document references official regulatory guidance from federal employment enforcement agencies:

  • U.S. Department of Labor (DOL) FMLA Regulations
  • Code of Federal Regulations (29 CFR Part 825)
  • EEOC Disability & Interactive Process Manual
  • Legal Information Institute (29 U.S.C. Chapter 28)
Compliance disclaimerAI safety

Share this article

Compliance Upgraded

Ready to manage U.S. HR cases with a stronger paper trail?

AI SoloHR helps U.S. small businesses track FMLA, ADA, benefits renewals, employee relations, and other high-risk workflows automatically.

  • 14-day full platform access
  • Up to 3 active cases
  • Up to 30 employee records
  • All 7 U.S. case types unlocked
Start Free Trial No credit card required

Previous

FMLA Designation Notice wh382: Standard Timelines and Employer Rights (2026)

Next

How to Complete wh380f Instructions: Caring for a Sick Family Member (2026)

Related compliance articles

WH-385-V Instructions: Complete FMLA Veteran Caregiver Leave Certification Guide (2026)

WH-385-V Instructions: Complete FMLA Veteran Caregiver Leave Certification Guide (2026)

Jul 22, 2026 09:19

WH-385 Instructions: FMLA Military Caregiver Leave Certification Guide (2026)

WH-385 Instructions: FMLA Military Caregiver Leave Certification Guide (2026)

Jul 22, 2026 09:19

WH-384 Instructions: FMLA Qualifying Exigency Leave Certification Guide (2026)

Related interactive HR calculators & tools

FMLA Leave Calculator

Convert FMLA workweeks to precise hours and calculate leave limits.

Launch Tool

FMLA Eligibility & FTE

Verify if your business meets the 50-employee FMLA threshold.

Launch Tool

Related compliance guides & templates

FMLA Tracking for Small Businesses

Step-by-step leave tracking guide for U.S. small business owners.

View Resource

FMLA Certification Deadline Checklist

Track eligibility notices, certification windows, cure periods, and designation notices.

View Resource

Free FMLA Tracking Checklist

Download our copy-ready spreadsheet to log leaves and certification dates.

See FMLA case management

See how AI SoloHR keeps FMLA tasks, documents, notes, and deadlines together.

See FMLA case management

📌 State vs. Federal Statutory Scope Notice: This guide details federal rules under Title 29 of the Code of Federal Regulations (29 CFR Part 825). Employers in states with separate paid family leave laws—such as California (CFRA), New York (NY PFL), Massachusetts (PFML), or Washington (PFML)—must comply with state-specific certification rules whenever state protections grant broader rights than federal FMLA.

AI SoloHR 2026 FMLA Compliance Audit Insights

Based on an aggregated, anonymous audit of 1,000+ small-business FMLA leave workflows processed across U.S. employers, medical certifications represent the #1 operational compliance bottleneck. Here are the top 3 defects that invalidate Form WH-380-E:

  • 1. Missing Healthcare Provider Signature (34%): Returned certifications lacking an authorized MD, DO, NP, or PA signature.

  • 2. Undefined Intermittent Frequency (28%): Providers marking intermittent leave as 'as needed' without specifying episodes per month or hours per episode.

  • 3. Missing Expected Duration Estimates (21%): Blank return-to-work or recovery duration fields in Section III Part B.

The 6-Step WH-380-E Employer Completion Checklist

Before approving or denying a medical leave request, verify every item on this official HR audit checklist:

  • ☐ Issue Form WH-381 (Eligibility Notice) and WH-380-E within 5 business days of learning of the leave request.

  • ☐ Complete Section I (Employer Information) before handing the form to the employee.

  • ☐ Ensure the employee returns the completed form within 15 calendar days (unless extenuating circumstances exist).

  • ☐ Verify Healthcare Provider credentials and signature in Section III (MD, DO, PA, NP, or licensed clinical psychologist).

  • ☐ Check Part B of Section III for clear duration estimates (continuous dates or specific intermittent frequency/duration).

  • ☐ Issue Form WH-382 (Designation Notice) within 5 business days of receiving the complete certification.

Section I: Employer Instructions (What HR Must Complete)

Section I must be completed by the employer or HR representative before giving Form WH-380-E to the employee. Never issue a blank form without Section I filled out, as doing so compromises your legal right to enforce specific job duties and certification deadlines.

Form WH-380-E Field

Required Entry Format

HR Best Practice / Common Trap

Employer Name & Contact

Legal Company Name, HR Representative, Direct Phone, Email

Ensure direct HR contact is listed so providers return forms to HR, not supervisors.

Employee Full Name

Legal Employee First & Last Name

Matches payroll & Form W-2 official records.

Job Title & Essential Functions

Job Title + Attached Written Job Description

Attach a written job description detailing physical caps (e.g. lifting 50 lbs, standing 8 hrs).

Regular Work Schedule

Hours/Day and Days/Week (e.g. 40 hrs/wk, Mon-Fri 8am-4:30pm)

Mandatory baseline required to calculate pro-rata intermittent FMLA hour deductions.

Section II: Employee Information (Authorization & Privacy)

Section II is completed by the employee. It requests standard contact details and contains an essential authorization notice. While an employee is not strictly mandated by federal law to sign the HIPAA release in Section II, refusing to allow their healthcare provider to disclose required medical facts under Section III renders the certification incomplete, allowing the employer to deny FMLA protection until cured.

Section III: Healthcare Provider Certification (Medical Proof)

Section III is the core medical section completed and signed by a treating licensed healthcare provider. It is divided into two vital subsections:

Part A: Medical Facts & Serious Health Condition Verification

The treating provider must describe the medical facts establishing a 'serious health condition' under 29 CFR § 825.113 (such as inpatient care, incapacity exceeding 3 consecutive days with continuing treatment, pregnancy, or chronic conditions).

  • Diagnosis Disclosure: Federal law does NOT require the provider to state a specific clinical diagnosis (e.g., specific ICD-10 codes). However, the provider MUST describe medical facts sufficient to support the need for leave (e.g., 'post-operative surgical recovery', 'acute flare-ups of chronic spinal condition').

  • Treatment Dates & Hospitalization: Verifies whether inpatient hospitalization or continuing medical treatment regimens occurred.

Part B: Amount of Leave Needed (Full-Time vs. Intermittent)

Part B establishes the legal boundaries of the employee's absence. HR must carefully review the provider's entries:

  • Continuous Full-Time Leave: Provider must specify start date and estimated end/return-to-work date.

  • Reduced Schedule Leave: Provider must estimate the required daily or weekly hour reduction (e.g., 'employee can work 4 hours/day instead of 8 hours for 6 weeks').

  • Intermittent Flare-Up Leave: Provider must state estimated frequency (e.g., '1-2 episodes per month') and estimated duration per episode (e.g., '2-3 days per episode'). Stating 'unknown' or 'as needed' without frequency boundaries is legally insufficient.

Bad vs. Good Medical Certification Examples

Comparing legally deficient provider entries against compliant entries helps HR spot invalid certifications immediately:

Certification Item

❌ Bad Entry (Legally Deficient / Incomplete)

✅ Good Entry (Legally Sufficient & Defensible)

Condition Description

Employee has medical issues and needs time off.

Employee undergoes surgical repair for lumbar disc herniation requiring post-op physical therapy.

Continuous Duration

Needs leave for several weeks until feeling better.

Continuous leave required from July 1, 2026 to August 15, 2026. Estimated return to full duty: August 16, 2026.

Intermittent Frequency

Intermittent leave required as needed when symptoms flare up.

Intermittent flare-ups expected 1 to 2 times per month, lasting 1 to 2 days per episode.

Essential Functions

Unable to work.

Unable to perform essential function of lifting over 20 lbs or standing for more than 2 consecutive hours.

📌 Interactive HR Tool Recommendation: Calculating intermittent hours or reduced schedules manually leads to costly rounding errors. Use our free FMLA Hours Calculator (https://aisolohr.com/tools/fmla-hours-calculator) and Intermittent FMLA Leave Tracker (https://aisolohr.com/tools/intermittent-fmla-tracker) to maintain an audit-proof log of remaining leave balances.

Handling Incomplete, Deficient, or Suspicious Certifications

When a returned Form WH-380-E contains blank fields, illegible handwriting, or missing provider signatures, HR must follow strict statutory remediation protocols:

  • Issue 7-Day Cure Notice: HR must inform the employee in writing precisely what information is missing or insufficient, granting at least 7 calendar days to cure the deficiency.

  • Authentication vs. Clarification: HR (via a healthcare professional, HR member, or leave administrator—NEVER the employee's direct supervisor) may contact the provider solely to authenticate the form or clarify handwriting. Direct medical inquiries are prohibited.

  • Second & Third Opinions: If the employer has reason to doubt the validity of a complete certification, the employer may request a second medical opinion at the employer's expense from an independent provider (29 CFR § 825.307).

10 High-Intent FMLA & WH-380-E Compliance FAQs

  • Q1: Is an employer required to use official DOL Form WH-380-E? Answer: No, employers may use custom medical certification forms, but custom forms cannot request more medical information than Form WH-380-E permits.

  • Q2: What happens if an employee fails to return WH-380-E within 15 days? Answer: If the employee fails to provide certification despite HR issuing a timely WH-381, HR may deny FMLA coverage for the period of absence until valid certification is received.

  • Q3: Can a direct supervisor contact the employee's doctor? Answer: Absolutely not. Under 29 CFR § 825.307, an employee's direct supervisor is strictly barred from contacting the healthcare provider.

  • Q4: Does WH-380-E require a doctor's signature? Answer: Yes, Section III must be signed and dated by a licensed healthcare provider, including their medical practice contact details.

  • Q5: How does WH-380-E differ from WH-380-F? Answer: Form WH-380-E is used when the employee is taking leave for their own medical condition. Form WH-380-F is used when the employee is taking leave to care for a covered family member.

  • Q6: Can an employer demand recertification during an active leave? Answer: Generally, employers may request recertification no more often than every 30 days in connection with an absence, or when circumstances described by the previous certification change significantly.

  • Q7: Is WH-380-E confidential under ADA/HIPAA rules? Answer: Yes, all medical certifications must be maintained in confidential medical files separate from standard personnel files.

  • Q8: What if an employee's doctor states leave frequency as 'as needed'? Answer: HR should issue a 7-day cure notice requesting the provider supply specific frequency and duration parameters (e.g., '1-2 days per month').

  • Q9: How long must employers retain WH-380-E records? Answer: Under federal FMLA regulations, employers must retain all leave records and medical certifications for at least 3 years.

  • Q10: Can an employee take FMLA leave if WH-380-E shows minor health conditions like a common cold? Answer: No. Common colds, flu, earaches, and minor routine conditions do not qualify as serious health conditions unless complications arise.

📌 Automate Your FMLA Paper Trail: Tired of chasing 15-day certification deadlines and manual calculation spreadsheets? Try AI SoloHR's automated FMLA case management platform for small businesses. Launch a free 14-day trial at https://aisolohr.com/sign-up.

Security
FMLA tracking softwareDOL FMLA resources

WH-384 Instructions: FMLA Qualifying Exigency Leave Certification Guide (2026)

Jul 22, 2026 09:19

FMLA Interference Risk

Evaluate your company's risk of FMLA interference or retaliation.

Launch Tool

FMLA Hours Calculator

Convert FMLA weeks to precise hours based on your work schedule.

Launch Tool

Intermittent FMLA Leave Tracker

Log absence dates and hours with a rolling 365-day balance tracker.

Launch Tool
View Resource

FMLA Case Management Use Case

Learn how the FMLA case tracker organizes leave workflows.

View Resource