Clarification from Health Care Provider Form - Digital | WWC

According to the Family and Medical Leave Act of 1993 (FMLA), if an employee submits a complete and sufficient medical certification signed by the health care provider, the employer may not request additional information from the health care provider. Furthermore, under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, the employee’s direct supervisor may not, under any circumstances, contact the employee’s health care provider. However, an employer may often need clarification of an employee’s medical certification as part of a request for FMLA leave. Clarification involves contacting the health care provider to understand the handwriting on the medical certification or to understand the meaning of a response.

To obtain clarification of an employee’s completed and sufficient medical certification, the employer may direct the employee or an otherwise appropriate representative to contact the employee’s health care provider. The employee or appropriate representative should provide our digital, attorney-reviewed Clarification from Health Care Provider Form to request clarification and authentication from the health care provider. Clarifying an employee’s medical certification when it is required is a critical step in the process of reviewing and approving an FMLA request.

Features & Benefits Include:

• A digital form to request clarification and authentication of an employee’s medical certification during an FMLA request;
• Attorney-reviewed to ensure compliance with mandatory FMLA and HIPAA Privacy Rule requirements;
• Printable, fill-in-the-blanks digital format for physical or electronic recordkeeping;
• A detailed instruction sheet explaining how & when to use the form and how long to retain it.

Our attorney-reviewed form is designed to help employers:

• Request clarification of an employee’s medical certification to understand handwriting or the meaning of a response.
• Authenticate an employee’s certification in order to approve or deny a FMLA request.

Guarantee

• If you are not completely satisfied, you can cancel your order within thirty (30) days of receipt for a full refund.