An FMLA certification only holds up if it answers the employer's questions in one pass. That means naming the condition and its onset, stating functional limitations in job-relevant terms, and being explicit about the treatment schedule and any intermittent leave pattern. This page is a template for organizing that information before you complete the certification, not the certification itself: the U.S. Department of Labor's WH-380-E or WH-380-F form is the document of record, and this page is not legal advice.
What Every FMLA Certification Needs
| Section | What it captures |
|---|---|
| Condition and diagnosis | The serious health condition, described in the clinician's own clinical terms |
| Onset and duration | When the condition began, and the probable duration of the need for leave |
| Functional limitations | What the employee cannot currently do because of the condition, in job-relevant terms |
| Treatment plan | Frequency and duration of treatment, and whether it is ongoing |
| Intermittent leave pattern | Frequency and duration of episodes, when leave is intermittent or on a reduced schedule rather than continuous |
| Work restrictions | Any restriction on the employee's ability to perform specific job functions |
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Example of a Completed Certification Summary
Illustrative only: this is a hypothetical summary for a fictional employee, not output from a real certification, and contains no protected health information.
- Condition. Recurring migraine with functional impairment, under active treatment since March.
- Functional limitations. Unable to work during episodes due to photophobia and cognitive impairment; between episodes, no restriction.
- Intermittent leave pattern. Estimated 2–3 episodes per month, each lasting 1–2 days.
- Treatment plan. Monthly follow-up visits and ongoing preventive medication management.
How ClinicFrame Writes This Section
ClinicFrame is an ambient AI scribe built around custom note templates: you define the sections an FMLA certification note needs, describe what belongs in each one, and generate a draft from your own summary of the visit. You review and edit every entry before it goes into the official certification.
