Updated Model FMLA Certification Forms

June 29, 2015

The Department of Labor (DOL) published four updated model medical certification forms in May. The forms are for certification of the employee’s or family member’s serious health condition or the serious injury or illness of a current servicemember or veteran.

The updated forms include a statement directing medical providers to not release any of the patient’s genetic information, as defined under the Genetic Information Nondiscrimination Act (GINA). The purpose of the new “safe harbor” language is to ensure the employer can claim that they did not request any information that would violate GINA, especially if they inadvertently receive such information. The new language, added to the “Instructions to the Health Care Provider”, is as follows:

Do not provide information about genetic tests, as defined in 29 C.F.R. § 1635.3(f), genetic services, as defined in 29 C.F.R. § 1635.3(e), or the manifestation of disease or disorder in the employee’s family members, 29 C.F.R. § 1635.3(b).

Employers are not required to use the DOL model forms, but may start using them immediately. If the employer chooses to use their own form, it is recommended that they add the new “safe harbor” GINA language to their own forms.

In addition, the DOL has eliminated the FMLA Leave Request Form. FMLA does not require employees to use any specific form or format in order to request FMLA leave. The employee may request leave through any reasonable notice that makes the employer aware of the employee’s need for FMLA-qualifying leave, including verbal notice. Once an employee requests leave that is potentially FMLA-qualifying, it is the employer’s responsibility to provide the Notice of Eligibility and Rights & Responsibilities.