Medical Certifications and Recertifications

29 CFR Part 825, The Family and Medical Leave Act of 1993

OMB: 1215-0181

IC ID: 13897

Information Collection (IC) Details

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Medical Certifications and Recertifications
 
No Modified
 
Required to Obtain or Retain Benefits
 
29 CFR 825.305 29 CFR 825.306 29 CFR 825.100(d) 29 CFR 825.308 29 CFR 825.307 29 CFR .825.311  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction WH-380 Certification of Health Care Provider (Family and Medical Leave Act) WH-380 Med Cert(20080125).doc Yes No Fillable Printable

Workforce Management Labor Rights Management

 

5,248,600 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,035,890 0 0 4,126,890 0 1,909,000
Annual IC Time Burden (Hours) 2,011,963 0 0 1,375,630 0 636,333
Annual IC Cost Burden (Dollars) 102,791,207 0 0 91,489,927 0 11,301,280

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