29 C.F.R. Part 825, The Family and Medical Leave Act of 1993

ICR 201003-1235-003

OMB: 1235-0003

Federal Form Document

IC Document Collections
IC ID
Document
Title
Status
187163
New
187079
New
187078 New
187073
New
186957
New
186955 New
186913 New
186900
New
186899 New
186898
New
186891
New
186890
New
182234
Modified
182233
Modified
182083
Modified
182081 Modified
178656
Modified
178655
Modified
178654
Removed
178653
Modified
178608
Removed
178607
Modified
178568 Modified
13897 Modified
ICR Details
1235-0003 201003-1235-003
Historical Active 200709-1215-004
DOL/WHD
29 C.F.R. Part 825, The Family and Medical Leave Act of 1993
Revision of a currently approved collection   No
Regular
Approved with change 03/12/2010
Retrieve Notice of Action (NOA) 03/12/2010
  Inventory as of this Action Requested Previously Approved
12/31/2011 36 Months From Approved
88,385,575 0 15,058,850
18,969,645 0 1,370,288
162,821,810 0 11,915,480

The DOL created the subject information collections (i.e., notifications) to implement statutory notice and certification provisions and to assist employees and employers in meeting their FMLA third-party notification obligations as required by The Family and Medical Leave Act of 1993 (FMLA) and by the amemdments to FMLA contained in National Defense Authorization Act for FY 2008 (NDAA), Pub. L. No. 110-181. The subject recordkeeping requirements are necessary in order for the DOL to carry out its statutory obligation under FMLA section 106 to investigate and ensure employer compliance. 29 U.S.C. § 2616.

US Code: 29 USC 2601, et seq. Name of Law: Family and Medical Leave Act
  
PL: Pub.L. 101 - 181 585(a)(s)-(3)(D) Name of Law: National Defense Authorization Act for Fiscal Year 2008

1215-AB35 Final or interim final rulemaking 73 FR 67933 11/17/2008

No

22
IC Title Form No. Form Name
Fitness-For-Duty Medical Certifications
Notice to Employee of Change of 12-Month Period for Determining Entitlement (Federal)
Notice to Employee of FMLA Eligibility and Rights & Responsibilities (State, local, tribal) WH-381 Notice of Eligibility and Rights & Responsibilities
Notice to Employee of FMLA Eligibilty and Rights & Responsibilities (Federal) WH-381 Notice of Eligibility and Rights & Responsibilities
Periodic Employee Status Report
Notice to Employee of FMLA Designation (Private Sector) WH-382 Designation Notice (Family and Medical Leave Act)
Documenting Family Relationship
Employee's Notice of Need for FMLA Leave
Notice to Employee of Change of 12-Month Period for Determining Entitlement (Private Sector)
Key Employee Notification (Private Sector)
General FMLA Recordkeeping (Private Sector)
Employee Certifications (Serious Health Condition, Recertification, Fitness-for-Duty; Call to Military Active Duty; Qualifying Exigency Due o Call to Military Active Duty; Servicemember Illness/Injuy WH-380-F, WH-384, WH-385, WH-380-E Certification of Health Care Provider for Employee�s Serious Health Condition ,   Certification of Health Care Provider for Family Member�s Serious Health Condition ,   Certification of Qualifying Exigency For Military Family Leave ,   Certification for Serious Injury or Illness of Covered Servicemember--for Military Family Leave (Family and Medical Leave Act)
Notice to Employee of FMLA Eligibility and Rights & Responsibilities (Private Sector) WH-381 Notice of Eligibility and Rights & Responsibilities
Written Guidance to Employees of FMLA Rights (Handbooks/Manuals)
Notice to Employee of Pending Cancellation of Health Benefits (Private Sector)
General FMLA Recordkeeping (State, local, tribal)
General FMLA Recordkeeping (Federal)
Notice to Employee of Change of 12-Month Period for Determining Entitlement (State, local, tribal)
Notice to Employee of Pending Cancellation of Health Benefits (Federal)
Key Employee Notification (State, local, tribal)
Key Employee Notification (Federal)
Notice to Employee of FMLA Designation (State, local, tribal) WH-382 Designation Notice (Family and Medical Leave Act)
Notice to Employee of Pending Cancellation of Health Benefits (State, local, tribal)
Notice to Employee of FMLA Designation (Federal) WH-382 Designation Notice (Family and Medical Leave Act)

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 88,385,575 15,058,850 14,827,012 4,669 58,495,044 0
Annual Time Burden (Hours) 18,969,645 1,370,288 3,482,473 7,020,126 7,096,758 0
Annual Cost Burden (Dollars) 162,821,810 11,915,480 455,927 0 150,450,403 0
Yes
Changing Regulations
Yes
Changing Regulations
In addition to the 3,482,473 burden hour increase that occured as a result of new statutory requirements, discretionary changes were made to the regulations -- adding and deleting specific notification requirements -- that resulted in an increase of 7,020,126 hours. The burden estimates were also adjusted upward by 7,096,758 because of improved information on the number of respondents subject to the FMLA paperwork requirements, recalculation of burden based on a more disaggregated approach, and a reconsideration of whether certain regulations impose a burden beyond what employees and employers customarily would do in the absence of the regulations. The estimated annual cost burden has increased due to an increase in maintenance and operations costs of $150,906,330, of which $455,927 are based on statutory changes and the remainder is due to the reasons mentioned above, as well as, increased wage rates and other costs for persons completing the information collections.

$651,550
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Michel Smyth 202 693-0638 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/17/2008


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