A California leave of absence form is not one document but a sequence: an initial written request to your employer, a medical certification completed by your healthcare provider, and, if you want to be paid during time off, a separate application to the Employment Development Department. Each has its own deadline, and the job-protection paperwork you file with your employer is entirely separate from the wage-replacement claim you file with the state.
Your Initial Request to the Employer
California doesn’t publish a universal leave request form. Employers design their own or adapt templates, so the first document you’ll fill out is whatever your HR department hands you. What the law actually requires is proper notice, and the timing depends on whether you saw the leave coming.
When the need is foreseeable, such as a scheduled surgery or an expected due date, you owe at least 30 days’ advance notice.1eCFR. 29 CFR 825.302 – Employee Notice Requirements for Foreseeable FMLA Leave When it’s unexpected, notify your employer the same day you find out, or by the next business day at the latest.2U.S. Department of Labor. Fact Sheet 28E – Employee Notice Requirements Under the Family and Medical Leave Act You don’t have to say the words “FMLA” or “CFRA.” You do have to give enough information for the employer to recognize that the leave may be protected.
Whatever form your employer provides, include:
- The reason for the leave (your own condition, a family member’s condition, baby bonding, bereavement, military exigency)
- Expected start and end dates
- The family relationship, if you’re caring for someone else
Vague or incomplete information gives the employer grounds to delay processing. Complete details from the start are what trigger the employer’s obligation to treat the request as potentially protected leave.
Medical Certification Forms
If your leave is for a serious health condition (yours or a family member’s), your employer can require a medical certification from your healthcare provider. This is the most consequential document in the process, and it’s where most leave requests run into trouble.
Employers commonly use the U.S. Department of Labor’s optional forms:
- WH-380-E for your own serious health condition
- WH-380-F for a family member’s serious health condition
- WH-384 for a qualifying exigency related to a family member’s military deployment
Employers can create their own versions, but they cannot ask for information beyond what the regulations allow.3U.S. Department of Labor. FMLA: Forms Under CFRA, your employer cannot contact your healthcare provider for any purpose other than confirming the certification is authentic.4Legal Information Institute. California Code of Regulations 2 CCR 11091 – Requests for CFRA Leave
What the Certification Must Say
For your own condition, the form has to state when the condition started, how long the incapacity is expected to last, and that you cannot perform your job functions. For a family member’s condition, it has to cover when the condition began, its expected duration, and the care you need to provide.
If you’ll be taking leave in short blocks rather than all at once, your provider must also estimate how often the absences will occur, how long each will last, and explain why intermittent leave is medically necessary.5U.S. Department of Labor. Fact Sheet 28G – Medical Certification Under the Family and Medical Leave Act A certification that just says “as needed” invites the employer to push back.
Certification is not required for leave taken solely to bond with a new child.
The 15-Day Deadline and the 7-Day Cure
Once your employer requests the certification, you have at least 15 calendar days to return it completed. If what you turn in is incomplete or missing key information, the employer must tell you in writing exactly what’s missing and give you seven calendar days to fix it.6U.S. Department of Labor. Family and Medical Leave Act Advisor – Medical Certification Miss the 15-day window without a good reason and your employer can deny FMLA coverage for the period of delay.7eCFR. 29 CFR 825.313 – Failure to Provide Certification
Wage Replacement Forms Go to the EDD
FMLA and CFRA leave is unpaid. This catches people off guard. Job protection and a paycheck are two separate things, filed with two different places on two different tracks.
California’s State Disability Insurance (SDI) and Paid Family Leave (PFL) programs provide partial wage replacement. SDI covers your own non-work-related illness, injury, or pregnancy. PFL covers time off to care for a seriously ill family member or bond with a new child. Starting in 2025, the benefit replaces 90% of wages for lower-income workers and 70% for everyone else.8Employment Development Department. January 2026 Disability Insurance Fund Forecast
The forms:
- Form DE 2501 for SDI
- Form DE 2501F for PFL
- Form DE 2525XX, submitted by your provider, to extend a claim beyond the originally estimated period
The EDD strongly recommends filing online through SDI Online via myEDD. Paper applications must be originals ordered from the EDD; you cannot print them from the website.9Employment Development Department. Disability Insurance and Paid Family Leave – Forms and Publications
For PFL, file no earlier than your first day of leave and no later than 41 days after it begins, or you risk losing benefits.10Employment Development Department. Paid Family Leave Claim Process
These EDD claims are completely separate from your employer’s leave paperwork. Handle both: the leave request with your employer to protect your job, and the benefit application with the EDD to get paid.
Paid Leave You’ve Already Banked
Whether your employer can force you to use accrued vacation or sick time during CFRA leave depends on whether you’re receiving state wage replacement. If you’re collecting SDI for your own condition, or PFL for a family member, the employer cannot require you to use vacation, though you can choose to supplement your benefits with it. If you’re not collecting either, the employer can require you to burn vacation time.11California Civil Rights Department. Family Care and Medical Leave: Quick Reference Guide
Bereavement Leave Documentation
California employers with five or more employees must grant up to five days of bereavement leave when a family member dies. The days don’t have to be consecutive, but all five must be used within three months.12California Legislative Information. Government Code 12945.7
Documentation here is simpler and comes after the fact. If your employer asks for proof, you have 30 days from the first day of leave to provide it. Acceptable proof includes a death certificate, a published obituary, or written confirmation from a funeral home, crematorium, religious institution, or government agency.13Civil Rights Department. Bereavement Leave FAQ Your employer must keep whatever you submit confidential.
Military Exigency Documentation
For qualifying exigency leave tied to a family member’s military deployment, your employer may require you to complete Form WH-384 along with supporting documentation such as a copy of the service member’s active duty orders or official military correspondence confirming deployment.14U.S. Department of Labor. Certification for Military Family Leave for Qualifying Exigency Depending on the specific exigency, you may also need to show proof of related appointments or expenses. The same 15-calendar-day certification deadline applies.
What the Employer Has to Send Back
Once you put the employer on notice, response deadlines shift to their side. An employer that misses them is the one at risk, not you.
Eligibility Notice
Within five business days of learning you may need leave, your employer must tell you whether you’re eligible and explain your rights and responsibilities. Under FMLA this is usually done using Form WH-381 or an equivalent document.15U.S. Department of Labor. Form WH-381 – Notice of Eligibility and Rights and Responsibilities CFRA requires a response within the same five-business-day window.4Legal Information Institute. California Code of Regulations 2 CCR 11091 – Requests for CFRA Leave The notice tells you whether you meet the eligibility requirements and what documentation you still need to submit.
Designation Notice
Once the employer has enough information to decide whether your leave qualifies for protection, they must notify you in writing within five business days. The designation notice tells you whether your time off counts as FMLA- or CFRA-protected and how much of your 12-week entitlement will be used.16eCFR. 29 CFR 825.300 – Employer Notice Requirements If leave is denied, the notice must explain why.
Written Reinstatement Guarantee
When granting CFRA leave, the employer must inform you of your right to reinstatement in the same or a comparable position. If you ask for it in writing, they must provide the guarantee in writing.17Legal Information Institute. California Code of Regulations 2 CCR 11089 – Right to Reinstatement Ask for it in writing. A verbal promise is harder to enforce if things go sideways.
Fitness-for-Duty Certification Before You Return
If your leave was for your own serious health condition, the employer can require a fitness-for-duty certification from your provider before letting you back. Two conditions apply. First, the employer must have told you about the requirement in the designation notice at the start of your leave; they cannot spring it on you at the end. Second, the policy has to be applied uniformly to all employees returning from the same type of leave.18eCFR. 29 CFR 825.312 – Fitness-for-Duty Certification
Fitness-for-duty certification does not apply to leave taken for a family member’s condition or for baby bonding.
When You Need More Time Than the Forms Cover
Running out of CFRA and FMLA leave doesn’t automatically mean your employer can fire you. If you have a disability under California’s Fair Employment and Housing Act (FEHA), additional unpaid leave may qualify as a reasonable accommodation. FEHA’s protections are separate from CFRA and FMLA, and they apply to employers with five or more employees.
When your employer becomes aware you’ve exhausted leave but still need time off, they must initiate the interactive process to determine whether extended leave or another accommodation would let you eventually return.19Legal Information Institute. California Code of Regulations 2 CCR 11069 – Interactive Process No specific form is legally required; the law cares about good-faith communication.20California Civil Rights Department. Reasonable Accommodation The California Civil Rights Department offers a sample reasonable accommodation request package, though using it isn’t mandatory. Documenting everything in writing protects you.
Keep Every Piece of Paper
Keep copies of every form you submit, every notice your employer sends, and every communication about your leave. If a dispute arises months later, that paper trail is your best evidence that you followed the rules and, if the employer failed, that they didn’t.