FMLA Forms 2021 Printable

FMLA Forms 2021 Printable

Family and Medical Leave Act (FMLA) Forms printable and online fillable is available for the 2021 calendar year. Employees who are going to take FMLA leave must fill out the corresponding form to provide information to their employers and request the leave. Some of the FMLA forms require to be filled out by a healthcare provider.

There are two categories of FMLA forms. The employees can fill out the FMLA form for requesting medical leave for themselves or a family member. Fill out the right FMLA Forms 2021 Printable and furnish your employer so that it can be kept in the records.

To request leave for yourself or a family member due to a medical condition, fill out the following forms.

  • Form WH-380-E — Employee’s Serious Health Condition
  • Form WH-380-F — Family Member’s Serious Health Condition

To request leave for military family leave, fill out the following forms.

  • Form WH-384 — Qualifying Exigency
  • Form WH-385 — Military Caregiver Leave of a Current Servicemember
  • Form WH-385-V — Military Caregiver Leave of a Veteran

A health care provider must fill out the FMLA form except if the leave is for qualifying exigency, Form WH-384. Other than that, the health care provider of the employee or the family member of the employee must fill out the required parts on Section 3 of Forms WH-380-E, WH-380-F, WH 385, WH-385-V.

The current revisions of FMLA forms are available through June 30, 2023. Once the form expires, the FMLA is likely to place an extension on them and will be used by the end of the year it expires and will be renewed for 2024 and beyond.

For the 2021 calendar year, the FMLA forms that were used in 2020 are still available. Whether you’re an employee or an employer, you can fill out the existing FMLA forms and get them where it’s provided above.

FMLA Leave 2021

The Family and Medical Leave Act allows employees to take job-protected leave. Before an employee goes out to leave, an FMLA Form that suits the employee’s situation must be completed.

This provides the employer with enough information about why the leave must take place. It also makes sure that the employee won’t go on leave for unnecessary reasons. Regardless of which FMLA form is being used, the healthcare provider needs to complete their part on the FMLA form 2021. So the required leave days the employee needs is going to be known.

However, the number of days entered on the FMLA form doesn’t represent how long the employee is going to be on leave. Overall, an employee can take up to 12 weeks of leave during the course of their employment for 12 months. Keep in mind that to go on an FMLA leave, you must be working for at least 12 months and both you and the workplace is qualified for FMLA leaves.

The employee must have worked for 1,250 hours in total during the course of their 12-month employment for leaves in 2021. This equals about 24 hours per week. Also, you and your employer must meet the following conditions.

  • The employee’s work location must be within a 75-mile radius of at least 50 other employees.
  • There must be at least 50 employees working in the workplace (excluding the employee going on leave)

As for getting more than the 12 weeks of allowed FMLA leave, it is all up to your employer. If your employer doesn’t want you to go on leave for more than the 12 weeks of FMLA leave, then your job may be at risk. But as long as you use your 12 weeks, your employer cannot terminate your employment because of your absence.

Denied Family Medical Leave

FMLA leaves provide job-protected but unpaid leave to employees for their own health condition or a family member. During the calendar year, employees can take up to 12 weeks of unpaid leave that secures their employment. However, there are a few requirements for both the employee and the employer’s end.

The employee must be working for at least 12 months and worked more than 1,250 hours in total. For the employer, on the other hand, the requirements are quite flexible but most small business employees won’t be able to take FMLA leave. The legislation requires employers to have at least 50 employees. Not only limited to that but the employees must live within a 75-mile radius of the worksite.

The 12 weeks should be enough in most cases and but you can request additional leave from your employer. Learn more about that here.

Why would FMLA be denied?

An FMLA leave can be denied for a number of reasons. Often times, when the qualifications aren’t met on either the employer or the employee’s part, the leave can be denied. Other than this, since a healthcare provider must complete their section of the FMLA form that requests the leave, the doctors aren’t always keen to require homestays.

If everything fits perfectly and the qualifications are met, if there isn’t a solid reason for an FMLA leave to be denied, it is simply a matter of your employer not letting you use your rights. What you can do in this kind of situation is contacting the Department of Labor and simply notifying them about the wrongdoing in your workplace.

The Department of Labor is likely to then contact your employer and ask for the eligibility requirements first, then ask the reasoning for the denial. If the agency decides that you can take the leave, the DOL may impose a penalty on the establishment. So it is always going to be in your best interest to contact the Department of Labor in these cases.

Getting Additional FMLA Leave

The Family and Medical Leave Act allows eligible employees to take leave up to 12 weeks of leave for family and medical reasons. If you as an employee or your family member have a serious health condition that requires you to take care after them, you can request an FMLA leave from your employer.

To be eligible for an FMLA leave, you must be working for your employer for more than a year. If the hours worked is under 1,250 hours in the last 12 months, you cannot request an FMLA leave. Also, your employer must have at least 50 employees within 75 miles radius of the workplace. As long as these requirements are met, you are eligible for an FMLA leave.

More Leave Under FMLA

Although 12 weeks is enough in most cases, sometimes it isn’t enough for paternity and maternity leave. Under no circumstances, you cannot get more than 12 weeks of job-protected leave. Not showing up at work after your FMLA leave has ended, your employer will have the legal right to terminate your employment.

However, in many cases employers still let employees take the necessary leave time in these situations even if it exceeds the 12 weeks. So to get any additional leave other than the 12 weeks of FMLA leave, your employer must let you, otherwise, you may end up losing your job.

Since FMLA can grant you 12 weeks of unpaid but job-protected leave, requesting any additional leave than that can put your employment at risk. With that being said, it is always best to let your employer know beforehand that you may need additional leave on top of your FMLA leave. If you can’t reach your employer, you can tell this to the human resources department of the company.

FMLA Paternity Leave

The Family and Medical Leave Act allows employees to take up to 12 weeks of job-protected leave every year. The FMLA leave covers both maternity and paternity leave. As long as both the employee and the employer qualifies for the FMLA, the employee can leave for 12 weeks or less for paternity leave.

The qualifications the employee must meet for not just paternity leave through but for any other FMLA leave are listed below.

  • The employee must have worked for at least 1,250 hours in the last 12 months, meaning they must work for the same employer for at least 12 months as well.
  • The employee’s work location must be within a 75-mile radius of at least 50 other employees.

The only qualification for the workplace as long as your boss is a private-sector employer is that they must have 50 or more employees in 20 or more workweeks for the calendar year you’re requesting FMLA leave.

For paternity leave, you must use the Certification of Health Care Provider for Family Member’s Serious Health Condition. The form goes by WH-380-F which you can fill out from our site.

Same as any other FMLA leaves, you’ll be able to take your job-protected, unpaid leave for up to 12 weeks. Keep in mind that you can be entitled to more leave than just 12 weeks. That’s of course as long as your employer lets you. Going for leave more than 12 weeks will give your employer the right to terminate your employment.

Although it is a rare case, some companies also give paid paternity leave. It is best to consult with your employer or the payroll department of the company you’re working at before filling out an FMLA form for paternity leave.

Paid FMLA Leave

FMLA, short for the Family and Medical Leave Act is a United States labour law launched by Clint Administration in 1993. It involves the protection of employee jobs with unpaid leave rights.

Employees who can present a reasonable and eligible reason to leave their jobs can benefit FMLA every year. Employees who can benefit this act can leave their job for 12 weeks each year with no payment during this time.

There are so many FAQs on FMLA, most of these questions are related to the possibility of losing a job or proving the medical status of a family member. Let’s take a look at the most common problems that people encounter when qualifying for this act:


Would my employer fire me if I take FMLA leave?

This is the main reason for FMLA to exist in the first place. Your rights are under the protection of this law. If you were able to benefit this law, you can go back to your work when the 12 -weeks of leave time is finished. Employers can’t make negative decisions on promotions etc because of an FMLA leave taken in the past.

Can my employer refuse my FMLA leave request?

If the employer is a member of FMLA act, there is no way for him/her to refuse your request unless you have exhausted your 12 weeks of leave right for the year before that time.

Will my employer pay me during FMLA Leave?

You won’t be paid any kind of money or service ( except for the medical insurance ) during your FMLA leave.

My employer does not believe that I’m sick, What do I do?

You need to prove your medical status with proper certification from your doctor. You don’t have to present your medical history to your employer.

Can my FMLA leave time be interrupted by my employer?

This may happen because of one condition. If you fail to prove your health condition which is the main reason for your FMLA leave, your employer can end your 12 weeks of resting time in an early time.

FMLA Leave Time

Family and Medical Leave Act allows employees to take unpaid leave for up to 12 weeks. Unpaid leave that exceeds 12 weeks will not be covered by the FMLA. What FMLA does is that it secures the employee’s job rather than granting the employee a paid leave. Every employee can go on FMLA leave for up to 12 weeks every year.

If the leave is for medical reasons, the healthcare provider will have to write down the estimated days that the employee needs. There are a number of FMLA forms that employees need to use accordingly to go on FMLA leave.

The following list explains each FMLA Form and its purpose.

  • WH-380-E for Medical Leave
  • WH-380-F for Medical Leave for a Family Member
  • WH-384 for Military Family Leave
  • WH-385 for Medical Leave Covered by a Military Service Member

All of these forms can be found on our website. You can view, fill out, download, and print off the forms without the need for any third-party software. Just click on the form in the list above and you’ll open the form in a new tab on your browser.

The leave times for each FMLA form is the same. So you can go on a job-protected FMLA leave for a medical reason for yourself or your family for 12 weeks. However, your employer can allow you to provide additional time off if he chooses. In conclusion, after the initial 12 weeks of leave ends, it is all about your employer but during that time, you don’t need to worry about your job at all.

FMLA Form WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition

The Family and Medical Leave Act of 1993 allows employees to go on job-protected leaves. Depending on the situation you’re in, you can fill out the FMLA form for your condition and go on unpaid leave for a specific amount of days.

One of the most common FMLA forms is the WH-380-E (Certification of Health Care Provider for Employee’s Serious Health Condition) which allows the employee to take leave for his or her medical condition. Just like all the other FMLA forms, the WH-380-E has three sections one of which will be completed by the employee. The rest will be completed by the employer and the health care provider.

You as an employee who needs leave for medical will fill out the form and detail your medical condition. The information found on FMLA Form WH-380-E includes

  • How many days of leave you need and whether it will be sporadic or continuous.
  • Whether the condition requires a follow-up treatment or not.
  • Your symptoms, treatment, and diagnosis.
  • How long the medical condition might last.
  • Which of the job responsibilities your condition prevents you from performing.
  • When the condition began
  • Whether your medical condition requires an overnight stay in a medical facility. If so, when.

After you and your employer complete the WH-380-E, you can then take it to your healthcare provider. There is no reason for your doctor not to complete the FMLA Form. Unfortunately, if you don’t hear from your doctor or simply your doctor doesn’t complete the form, there isn’t anything you can do, legally.

If a situation like this occurs, we suggest taking it to another medical professional that can explain your diagnosis and how it will affect your work. Need a blank Form WH-380-E? Visit our front page to see the full list of forms download in PDF.

FMLA Form for Maternity Leave

Family Medical Leave Act requires 12 weeks of unpaid leave after you give birth. However, there are some requirements of FMLA for both your employer and you. Although some states extend the flexibility of FMLA, only a handful of states lower the firm-size threshold which is 50 employees federally.

As of 2020, the District of Columbia passed a law that makes the FMLA eligibility requirements easier by lowering the firm-size threshold to 10. However, federal requirements remain the same for most other states. Before you go on leave, it’s better to consult someone in your state’s Department of Labor to have additional information.

In general, the biggest requirement for FMLA is that the company you’re working at must have more than 50 employees within 75 miles of your workplace. Otherwise, your company is exempt from the FMLA and therefore, you can’t get the benefits. Other requirements include:

  • You must have worked for your employer for more than 25 hours a week for 50 weeks.
  • If you and your partner are working in the same company, you both are entitled to 12 weeks of maternity leave, not 12 weeks each.
  • If you’re in the top 10% of wage earners in the company, your employer can give a notice that your absence would cause financial harm to the company. So your employer isn’t required to allow you for 12 weeks of leave or keep your job open for you.
  • Your employer may require that the time of paid maternity leave count toward the 12 weeks allotted under the Family Medical Leave Act if your employer is offering paid maternity leave.
  • You can use your 12-week maternity leave whenever during the first year after the child’s birth. So you don’t have to use all of the 12-weeks all at once as long as your employer agrees.

For more information on FMLA for Maternity Leave in 2020, visit the Department of Labor from the link below. You can also get the necessary forms for your leave below.

Maternity Leave Printable Form FMLA

FMLA Form for Employees 2020

Family Medical Leave Act Form for Employees or WH-380-E for short is the FMLA form for employees seeking leave for their serious health condition. When going on an FMLA leave, you must use the WH-380-E for yourself, using any other form will instantly get you denial and you may miss the 15 days window which you need to file the form after you leave.

Let’s say you went on leave for 10 days on February 10th, 2020. You must submit your complete FMLA Form by February 25th. Not doing might endanger your employment to your current employer. You can complete the WH-380-E FMLA Form for employees online from the U.S. Department of Labor website.

You’ll be getting the form from the Department of Labor but you don’t have to send the form to the agency. If you do so, it will be immediately returned to the sender as the FMLA is between the employer and the employee. The whole purpose of FMLA is to secure the job of the employee when leaving work for a period of time because of their or family member’s health condition.

Family Medical Leave Act Form 2020

You can complete the form online but you will need to take the form to your healthcare provider as their signature is needed and Section 3 of the WH-380-E must be completed by medical professionals. We recommend filling out the parts you need to complete online then print out and take it to your employer and the healthcare provider.

The FMLA Form for Employees can be found below from DOL.

WH-380-E PDF