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USDOLRev. 06-2023

Official form guide

Form WH-385: Certification for Serious Injury or Illness of a Covered Servicemember — for Military Family Leave (FMLA)

Certifies that a covered servicemember has a serious injury or illness requiring family caregiver leave under FMLA. Provides up to 26 weeks of leave in a single 12-month period.

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Form Overview

DOL Form WH-385 - Certification for Serious Injury or Illness of a Covered Servicemember — for Military Family Leave (FMLA)

Certifies that a covered servicemember has a serious injury or illness requiring family caregiver leave under FMLA. Provides up to 26 weeks of leave in a single 12-month period.

Medical certification supporting up to 26 weeks of FMLA leave to care for an injured or ill servicemember.

Risk Radar

Scan points
  • 1Using the wrong form — this form is for current and recent servicemembers; veterans must use WH-385-V.
  • 2Healthcare provider not completing all required fields about the serious injury or illness.
  • 3Confusing this with standard FMLA forms — military caregiver leave has different rules and a separate 26-week entitlement.

Plain English

If your military family member (current or recent) has been seriously injured or is ill and needs your care, this form certifies your need for up to 26 weeks of FMLA leave.

Submission Date

  • Filing date: Submit within 15 days of employer's request for certification.
  • Preparation window: collect IDs, supporting records, and signatures in advance.
  • Final review: verify names, dates, and required fields before submission.

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Glossary Terms

medicalperiodmemberfamilyinjurymonth

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Field map

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7 fields

Employee

1 items

Employee Name

Your full name.

Requiredtext

Servicemember

3 items

Servicemember Name

Name of the covered servicemember.

Requiredtext
Relationship

Your relationship to the servicemember.

Requiredselect
Branch of Service

Branch of military service.

Requiredselect

Medical

2 items

Nature of Injury or Illness

Description of the serious injury or illness.

Requiredtext
Duration of Condition

Expected duration and need for care.

Requiredtext

Signature

1 items

Healthcare Provider Signature

Treating provider's signature.

Requiredsignature

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Quick Facts

Employees who are the spouse, child, parent, or next of kin of a covered servicemember with a serious injury or illness.
Medical certification supporting up to 26 weeks of FMLA leave to care for an injured or ill servicemember.
Submit within 15 days of employer's request for certification.
Return to your employer's HR department.
Military caregiver FMLA provides more leave (26 weeks vs. 12 weeks) than standard FMLA to support servicemembers.
A healthcare provider treating the servicemember completes the medical portions. The servicemember or employee completes personal information.

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Source transparency

Copyright & Licensing - US Government Forms

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Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
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