FMLA


Applying for FMLA:

The US Department of Labor has developed FMLA forms which Plainfield utilises to provide required notices to employees, and for employees to provide certification of their need for leave for an FMLA qualifying reason. These forms are electronically fillable PDFs and can be saved electronically.

Information on FMLA can be found in the guide below: 


EMPLOYEE FMLA GUIDE.PDF

Plainfield employees should utilise the following forms:

FMLA FORM SELF

Employee’s serious health condition, form WH-380-E – use when a leave request is due to the medical condition of the employee.

FMLA FORM FAMILY MEMBER

Family member’s serious health condition, form WH-380-F – use when a leave request is due to the medical condition of the employee’s family member.