Form WH-380-F: PDF Download & Caregiver Guide
The authoritative compliance manual for reviewing the U.S. Department of Labor Certification of Health Care Provider for Family Member’s Serious Health Condition. Master statutory family definitions, psychological comfort standards, 7-day cure notices, and multi-state leave coordination.
What is Form WH-380-F and When Must Employers Use It?
Form WH-380-F is the official medical certification form issued by the Wage and Hour Division of the U.S. Department of Labor for leave requested under 29 U.S.C. § 2612(a)(1)(C): "to care for the spouse, or a son, daughter, or parent, of the employee, if such spouse, son, daughter, or parent has a serious health condition."
Unlike Form WH-380-E (which certifies an employee's own condition), Form WH-380-F requires two distinct certifications: (1) a physician's medical verification that the family member has a qualifying serious health condition; and (2) an explanation of the physical or psychological care the employee will provide.
Covered Family Member Matrix: Federal FMLA vs. State Laws
One of the most dangerous HR compliance traps: Federal FMLA does NOT cover in-laws or siblings, but major state statutes do. Counting state-only family leave against federal FMLA is an automatic federal interference violation.
| Relationship | Federal FMLA | California CFRA | Washington PFML | New York PFL |
|---|---|---|---|---|
| Spouse (including same-sex) | COVERED | COVERED | COVERED | COVERED |
| Registered Domestic Partner | NOT COVERED (Federal only recognizes legal marriage) | COVERED | COVERED | COVERED |
| Child (Under 18) | COVERED | COVERED | COVERED | COVERED |
| Adult Child (18+ capable of self-care) | NOT COVERED (Must be incapable of self-care) | COVERED (Any age) | COVERED (Any age) | COVERED (Any age) |
| Parent (Biological/Adoptive/In Loco Parentis) | COVERED | COVERED | COVERED | COVERED |
| Parent-in-Law (Mother/Father-in-law) | NOT COVERED | COVERED | COVERED | COVERED |
| Sibling (Brother/Sister) | NOT COVERED | COVERED | COVERED | COVERED |
| Grandparent / Grandchild | NOT COVERED | COVERED | COVERED | COVERED |
| Designated Person (Chosen by employee) | NOT COVERED | COVERED (AB 1041) | NOT COVERED | NOT COVERED |
The Legal Definition of "Care" under 29 CFR § 825.124
Employers frequently challenge family leave by claiming the employee is "not a medical professional" or that another relative is present. Federal regulations strictly reject both employer arguments:
1. Physical Assistance
Assisting with basic personal needs such as bathing, dressing, cooking, administering medication, or providing transportation to doctor visits and chemotherapy.
2. Psychological Comfort
Providing emotional support and reassurance to a family member who is seriously ill, receiving inpatient care, or undergoing hospice palliative care.
3. Arranging Care
Making arrangements for changes in care, such as transferring to a specialized nursing facility or interviewing in-home healthcare attendants.
Line-by-Line Employer Audit Checklist: Form WH-380-F
SECTION I: Part A (Employer) & Part B (Employee Statement)
Completed by HR & WorkerHR must state the employee's name and return deadline (minimum 15 calendar days). In Part B, the employee MUST identify the patient, their relationship, and state the care they will provide and estimated schedule.
SECTION II: Medical Facts of Family Member's Condition
Completed by PhysicianThe healthcare provider certifies the start date, probable duration, inpatient hospitalization dates, or continuing treatment regimens. A diagnosis is NOT mandatory under federal law.
SECTION III: Medical Necessity of Employee Care & Intermittent Schedule
Critical VerificationThe doctor must check whether the patient requires assistance and whether the employee’s presence is medically necessary. For intermittent care, estimated frequency (e.g. 2 times/month) and duration (e.g. 8 hours/visit) MUST be stated. "As needed" is legally defective.
7-Day Cure Notice Protocol for Incomplete Form WH-380-F
If Section III is left blank or the doctor fails to verify that the patient needs care, issue this written deficiency notice under 29 CFR § 825.305(c):
"Dear [Employee Name],
We received your Form WH-380-F (Family Member Serious Health Condition) dated [Date]. The form is currently incomplete under federal regulations:
- In Section III, the healthcare provider did not confirm whether the patient requires assistance for basic personal needs, medical transportation, or psychological comfort, and omitted the estimated duration of care needed.
Pursuant to 29 CFR § 825.305(c), you are granted seven (7) calendar days—until [Date 7 days later]—to submit a completed certification. Failure to return the cured certification will result in denial of FMLA leave protection."
Frequently Asked Questions: Form WH-380-F
Who qualifies as a covered 'family member' under Form WH-380-F?
Under federal FMLA (29 CFR § 825.122), covered family members strictly include the employee’s spouse, parent, or child (under 18, or 18+ and incapable of self-care due to a mental or physical disability). Under federal law, siblings, in-laws, and grandparents are NOT covered, though state laws (like California CFRA or Washington PFML) frequently expand coverage to them.
What constitutes 'needed to care for' a family member under the FMLA?
Pursuant to 29 CFR § 825.124, 'care' encompasses both physical and psychological assistance. It includes providing basic personal hygiene, feeding, medication administration, transportation to medical appointments, arranging for third-party care, and providing psychological comfort and reassurance to a family member receiving inpatient or home care.
Can an employee take FMLA leave if another family member is already providing care?
Yes. The fact that another family member or paid caregiver is present and available does not disqualify an eligible employee from taking FMLA leave to care for the patient (29 CFR § 825.124(b)).
Can an employer demand a second medical opinion on Form WH-380-F?
Under federal FMLA (29 CFR § 825.307), an employer may request a second opinion if they have a good-faith reason to doubt the validity of the certification, at the employer's sole expense. However, beware of state differences: under California CFRA, employers are strictly forbidden from requiring second opinions for family caregiver leave.
What if Section III of WH-380-F states 'intermittent care as needed'?
Writing 'as needed' makes the certification incomplete. Under 29 CFR § 825.305(c), the employer must issue a written notice specifying the deficiency and grant the employee at least 7 calendar days to obtain an estimated frequency and duration from the physician.
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