Sedgwick Leave Forms vs WH-380-E and WH-380-F: Which One Does My Doctor Fill Out?

PDFLiner
Last Update: Nov 5, 2026
Sedgwick leave forms vs WH-380-E and WH-380-F (PDFLiner)

If your employer's leave administrator is Sedgwick, you may receive Sedgwick's own paperwork instead of, or alongside, the Department of Labor's FMLA certification forms. Which form your health care provider completes depends on whose condition the leave is for and on what your employer or Sedgwick asks for.

Key Takeaways

  1. WH-380-E is for your own serious health condition and WH-380-F for a family member's; DOL calls both optional-use forms.
  2. Employers must accept a complete and sufficient certification regardless of the format, so follow your Sedgwick packet for which forms apply.
  3. You generally have 15 calendar days after the request to return the certification, and completed forms never go to DOL.

WH-380-E or WH-380-F

The Department of Labor (DOL) publishes two certification forms for a serious health condition:

  • WH-380-E, Employee's serious health condition. DOL says to use it "when a leave request is due to the medical condition of the employee."
  • WH-380-F, Family member's serious health condition, for leave to care for a family member.

DOL calls these "optional-use forms." Both are on the DOL FMLA forms page.

What if Sedgwick sends a different form?

Sedgwick's claim help page tells you to check your mail and email "for an informational packet that has been sent to you," then to "Fill out any forms or paperwork needed and send back to Sedgwick." It adds: "Depending on your type of claim, some forms may need to be filled out by a medical provider as well."

The format is not what decides whether a certification counts. DOL says: "Employers must accept a complete and sufficient certification, regardless of the format." An employer cannot refuse a fax or copy of the certification, or a certification that is not on the employer's standard company form. DOL also says the information can be provided in any format, such as on the letterhead of the healthcare provider. Follow the instructions in your Sedgwick packet for where and how to send it.

How long you have

DOL says an employee must generally provide the certification "within 15 calendar days after the employer's request, unless it is not practicable under the particular circumstances to do so despite the employee's diligent, good faith efforts." DOL Fact Sheet #28G adds that the employer may allow longer than 15 calendar days.

If the certification is incomplete or insufficient, DOL says the employer must give you at least seven calendar days to cure the deficiency, unless seven days is not practicable under the particular circumstances.

Where the completed form goes

Not to DOL. The DOL forms page says: "Please do not send any completed certification forms to the U.S. Department of Labor, Wage and Hour Division." Return the completed certification as your employer or Sedgwick instructs.

PDFLiner's Sedgwick FMLA forms page describes one Sedgwick form; your claim packet tells you which forms apply to your claim.

Sources (read November 5, 2026): DOL FMLA forms, DOL eLaws FMLA advisor: certification, DOL Fact Sheet #28G, DOL FMLA FAQ, Sedgwick: help with my claim.