Medical Certification for FMLA Clause Samples
Medical Certification for FMLA. (when requesting leave for serious health conditions)
A. An employee shall provide written medical certification to the Employer in a timely manner.
B. The written medical certification shall include:
1. the date the serious health condition commenced;
2. the probable duration of the serious health condition;
3. the appropriate medical facts within the knowledge of the health care provider regarding the serious health condition, including a statement as to the incapacitation, examination, or treatment that may be required by a health care provider; and
4. a statement that the employee is unable to perform the essential functions of his/her position.
C. The Employer shall not require any personal or confidential information in the written medical certification other than that required above.
