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FMLA Designation Notice: Designation Notice under the Family and Medical Leave Act
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Form WH-382 in short
Form WH-382 is the Department of Labor's optional notice an employer uses to tell an employee whether their leave request is approved as FMLA leave. It also says how much leave will be counted against the employee's FMLA entitlement, or what is missing from an incomplete or insufficient certification. The employer completes it and gives it to the employee.
| Issued by | U.S. Department of Labor, Wage and Hour Division (WHD) |
|---|---|
| Current version | Revised June 2020 (checked 2026-10-25) |
| Who fills it in | A covered employer, once it has enough information to decide whether the leave is for an FMLA-qualifying reason. |
| Who receives it | The employee who asked for the leave. The form says not to send it to the Department of Labor. |
| Where to send it | The employer gives it to the employee and keeps a copy. Do not send it to the Department of Labor. |
| Deadline | The form says the information must be provided within five business days of the employer having enough information to decide whether the leave is FMLA-qualifying. If a certification is incomplete, the employee gets at least 7 calendar days to fix it. Employers must keep a copy for three years. |
| Official links | Official page · Official PDF |
How to fill out Form WH-382, line by line
| Section I, header | Date, employer, employee and date information received Enter the date of the notice, the employer and employee names, and the date the employer received the most recent information supporting the leave. |
| Section I, reason | Reason for leave Select the reason: birth or placement of a child, the employee's own serious health condition, a spouse, child or parent's serious health condition, a military qualifying exigency, or military caregiver leave. |
| Section I, decision | Approved, not approved or more information needed Check approved, not approved with the reason, or additional information needed. If not approved, reasons include that the FMLA does not apply or no FMLA leave is available. |
| Section II | Incomplete or insufficient certification Say whether the certification is incomplete or insufficient, list exactly what is needed, and give a deadline of at least 7 calendar days. You can also request a second or third opinion at the employer's expense. |
| Section III | Amount of leave counted If approved, state the hours, days or weeks that will be counted, or say that the leave is unscheduled and cannot be counted yet. |
| Section III, paid leave | Paid and unpaid leave Check whether leave will be unpaid, whether paid leave will be used at the employee's request, or whether the employer requires paid leave to run at the same time. |
| Section III, return to work | Fitness-for-duty certification Say whether the employee must provide a fitness-for-duty certification to return to work and whether a list of essential job functions is attached. |
Common mistakes to avoid
- Giving less than 7 calendar days to fix an incomplete or insufficient certification.
- Saying the certification is incomplete without stating exactly what information is needed.
- Not stating how much leave will be counted against the FMLA entitlement when the leave is approved.
- Asking for a fitness-for-duty certification about conditions other than the one that caused the leave.
- Delaying the designation. The form says an employer may not delay designating leave once an eligible employee gives an FMLA-qualifying reason.
- Sending the notice to the Department of Labor instead of giving it to the employee.
Questions about Form WH-382
What is the difference between WH-381 and WH-382?
WH-381 tells the employee whether they are eligible and explains their rights and responsibilities. WH-382 tells them whether the specific leave is approved as FMLA leave and how much leave will be counted.
How long does an employee have to fix an incomplete certification?
At least 7 calendar days, unless that is not practicable despite the employee's diligent good faith efforts. If the information is not provided, the leave may be denied.
Can an employer ask for a second opinion?
Yes. The form has a box to request a second or third opinion medical certification at the employer's expense.
What if my leave is unscheduled?
The employer can check that it cannot yet say how much leave will be counted. The form says you can ask for this information once in a 30-day period, if you took leave in that period.
Does the employer have to use this exact form?
No. The Department of Labor's forms are optional. An employer may use its own form if it gives the same basic information.
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Checked against the official sources on 2026-10-25. PDF Editor Hub is not affiliated with the U.S. Department of Labor, Wage and Hour Division or any government agency. This page is general information, not legal or tax advice.