An employer may require an employee requesting FMLA leave to care for a covered veteran to obtain certification from an authorized health care provider of that veteran that provides:

• The name, address, telephone number, fax number and/or e-mail address of the health care provider;
• The type of medical practice;
• The medical specialty;
• The type of authorized health care provider (See previous screen, Military Caregiver Leave Certification – Authorized Health Care Provider);
• Whether the veteran’s injury or illness was incurred in the line of duty on active duty or, if not, whether the veteran’s injury or illness existed before the beginning of the veteran’s active duty and was aggravated by service in the line of duty on active duty;
• The approximate date on which the injury or illness commenced or was aggravated, and its probable duration;
• A statement or description of appropriate medical facts regarding the veteran’s injury or illness for which FMLA leave is requested, which may include:
  • information on whether the veteran is receiving medical treatment, recuperation or therapy for an injury or illness that is the continuation of an injury or illness that was incurred or aggravated when the veteran was a member of the Armed Forces and rendered the servicemember medically unfit to perform the duties of the servicemember’s office, grade, rank or rating;
  • information on whether the veteran is receiving medical treatment, recuperation or therapy for an injury or illness that is a physical or mental condition for which the covered veteran has received a U.S. Department of Veterans Affairs Service-Related Disability Rating (VASRD) of 50 percent or greater, and that such a VASRD rating is based, in whole or in part, on the condition causing the need for military caregiver leave;
  • information on whether the veteran is receiving medical treatment, recuperation or therapy for an injury or illness that is a physical or mental condition that substantially impairs the veteran’s ability to secure or follow a substantially gainful occupation by reason of a disability or disabilities related to military service, or would do so absent treatment; or
  • documentation of enrollment in the Department of Veterans Affairs Program of Comprehensive Assistance for Family Caregivers;
• Information sufficient to establish that the veteran is in need of care and whether he or she will need care for a single continuous period of time (including any time for treatment and recovery) and an estimate as to the beginning and ending dates for this period of time;
• If an employee requests leave on an intermittent or reduced schedule basis for planned medical treatment appointments, whether there is a medical necessity for the veteran to have such periodic care and an estimate of the treatment schedule of such appointments; and,
• If an employee requests leave on an intermittent or reduced schedule basis for unscheduled care (for example, episodic flare-ups of the injury or illness), whether there is a medical necessity for the veteran to have such periodic care (which can include assisting in recovery) and an estimate of the frequency and duration of the period of care.

The authorized health care provider may, as needed, rely on certain military-related determinations made by an authorized DOD representative (such as a DOD Recovery Care Coordinator) or an authorized VA representative.

The employer must accept as sufficient certification of the servicemember’s serious injury or illness documentation indicating the servicemember’s enrollment in the Department of Veterans Affairs Program of Comprehensive Assistance for Family Caregivers. Such documentation is sufficient certification regardless of whether the employee is the named caregiver in the enrollment documentation.

In all instances when a certification is requested, it is the employee’s responsibility to provide the employer with a complete and sufficient certification. Failure to do so may result in the denial of FMLA leave.

Continue to Military Caregiver Leave Certification – Required Information from the Employee or Veteran or Return to Military Family Leave Certifications.