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PDFWAC 192-610-020

What is required on the certification for medical leave or for family leave to care for a family member who has a serious health condition?

When leave is taken because of an employee's own serious health condition or the serious health condition of a family member, certification from a health care provider will be required. Certification must include the following:
(1) The name, address, telephone number, and contact information of the health care provider and type of medicine the health provider is licensed to practice;
(2) The anticipated duration of leave;
(3) Other information as requested by the department to determine eligibility for the qualifying event; and either
(a) For medical leave, information from a health care provider that the employee has a serious health condition; or
(b) For family leave, information sufficient to establish that the family member has a serious health condition requiring physical or psychological care.
[Statutory Authority: RCW 50A.04.215. WSR 19-08-016, ยง 192-610-020, filed 3/22/19, effective 4/22/19.]
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