When FMLA military caregiver leave for a covered veteran is administered by Sun Life, the veteran's provider completes this form, which mirrors the federal WH-385-V. The provider confirms the service connection, selects which veteran-specific definition applies, such as a VA disability rating of 50 percent or more, and estimates the care needed.
The employee completes Section 1 with veteran details, including discharge type and date and the care to be given; the veteran's health care provider completes Section 2, Parts A to C, and signs Section 3.
Download the current version from the source each time; forms change without notice.
Family and Medical Leave Act (FMLA) – Serious Injury or Illness of a Veteran for Military Caregiver Leave
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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One of four definitions: continuation of a serious injury or illness incurred or aggravated in service, a VA disability rating of 50 percent or more based on the condition, a service-related condition that substantially impairs gainful employment, or enrollment in the VA family caregiver program for the injury.
Yes. Besides DoD, VA and TRICARE-authorized providers, any health care provider defined in 29 C.F.R. 825.125 can complete it. Where military-related determinations are outside their knowledge, they may rely on an authorized DoD or VA representative.
The provider checks 'None of the above'. The form notes that the employee may still be eligible for FMLA leave to care for a family member with a serious health condition, which would use the WH-380-F or an employer form asking the same information.