Amazon DLS forms: medical certification, RFI, and return to work

Amazon DLS forms document why you need leave, disability benefits, a workplace accommodation, or return-to-work restrictions. There is no single form for every request. Start with the paperwork attached to your own DLS case, then use this guide to understand what it is asking for.

Form titles and requirements can vary by case and role. The categories below explain the names you may encounter; your current packet identifies what to complete and where to send it.

Need healthcare provider paperwork completed?

Certicare offers help with Amazon DLS paperwork. A state-licensed provider reviews the request and completes supported forms when clinically appropriate. Amazon decides whether to approve leave, benefits, or an accommodation.

What is Amazon DLS?

DLS stands for Disability & Leave Services. Amazon employees may deal with DLS for medical leave, disability benefits, workplace accommodations, and returning to work. These requests can overlap, but approval of one does not automatically approve the others.

Where do I get the Amazon DLS forms?

1. Sign in to Amazon A to Z/MyHR. Find your leave or accommodation case and its messages or attachments. If you cannot find the packet, ask DLS to resend the current forms for your case.
2. Save the whole packet. Include the instructions, case number, deadline, and any request for additional information.
3. Check what is being reviewed. Ask whether the paperwork is for leave, disability pay, an accommodation, or return to work. One case may need more than one document.
4. Send the packet to your provider. Include your job duties, schedule, affected dates, and any existing restrictions. Complete only the sections assigned to you.

Public forms can help you understand the questions. Confirm the version with DLS before using one for a live case. If you cannot access A to Z, Amazon's login help lists the U.S. Employee Resource Center at 888-892-7180. Ask for help reaching the right team; this is the ERC number listed by Amazon, not a dedicated case manager's line.

Which Amazon DLS form fits my situation?

Use the reason for your request to identify the likely category, then compare it with the form DLS sent.

I am out of work because of my own medical condition

Look for an Own Health Condition or medical certification form. If you are also requesting disability pay, ask whether a separate disability statement is needed.

My mental health symptoms are affecting my ability to work

Your packet may include a Behavioral Health Physician Statement or another medical certification. The provider documents the condition's effect on work and the medically supported time away.

I can work, but I need restrictions or changes at work

Look for accommodation paperwork, which may include a Healthcare Provider Request for Information, or RFI.

I may be able to return, but only with limits

Ask about return-to-work or fitness-for-duty documentation and any restrictions Amazon needs to review before your return.

I need leave to care for a family member

Use the family-care certification requested for your case. The family member's healthcare provider documents their condition and need for care.

DLS wants to contact my provider directly

Review any release of information, or ROI. It concerns permission to share information; it does not replace the medical certification.

1) Physician Statement | Short-Term Disability (STD) Benefits

A short-term disability statement supports a request for disability income benefits for your own condition. The provider documents the medical basis for being unable to work and the relevant dates, using the questions in your benefits packet.

Check which provider credentials, supporting records, and signatures the plan requires. A leave approval does not by itself establish eligibility for disability pay. Ask DLS to identify any separate benefits decision or outstanding document.

2) Behavioral Health Physician Statement

If your packet includes a behavioral health statement, give it to the clinician evaluating or treating the mental health condition. The documentation should explain the supported effect on work, such as difficulty concentrating, making decisions, or safely carrying out particular duties, as well as the expected duration.

Do not fill in the provider's clinical answers yourself. A diagnosis alone may not explain why leave is needed. For more about this route, see Amazon mental health leave and DLS paperwork.

3) Health Care Provider Form - Own Health Condition

This category documents the employee's own medical need for leave. For FMLA certification, the Department of Labor identifies medical facts, when the condition began, its expected duration, and the effect on essential job duties as relevant information. A diagnosis is not required for FMLA certification.

If leave is intermittent, the provider should estimate how often episodes or treatment visits are needed and how long each absence may last. For a continuous absence, the medical evidence should support the period requested.

The DOL's optional employee-condition form is WH-380-E. Confirm which leave or benefit program DLS is reviewing before substituting a form.

4) Health Care Provider Form - Care for a Family Member

Here, the family member is the patient. Their provider explains why care is needed and estimates when and for how long you need to provide it. The employee supplies the relevant relationship and leave-request details.

The DOL's optional family-care FMLA form is WH-380-F. You can find both federal forms on the DOL FMLA forms page. Eligibility and covered relationships depend on the leave program; a family-care form does not automatically establish either.

5) Healthcare Provider Request for Information (RFI)

RFI means Request for Information. Public copies of Amazon's accommodation RFI are available for Operations roles and Corporate roles. Check with DLS that you have the version for your case.

The Operations form separates employee information and authorization from the provider's sections. It asks for relevant functional limits, schedule or task changes, and their duration. The provider should complete the applicable sections, rather than invent restrictions for every box.

For example, a lifting restriction should specify the supported weight limit and how often the task can be performed. A break request should explain frequency and length. Give your provider the actual demands of your job so the answers are useful.

Under EEOC guidance, ADA documentation should be limited to establishing the disability and need for accommodation. Employers generally cannot request unrelated complete medical records. Documentation may not be needed when both the disability and need are obvious or sufficient information has already been supplied.

A message asking for more information is not necessarily a denial. Read the specific questions and response deadline.

6) Return to Work (RTW) Planning Form

A return-to-work form documents whether you can resume work and any supported restrictions. Bring your job description and the employer's instructions to the evaluation.

Useful restrictions explain the task, limit, and expected duration. “Light duty” alone may leave questions about lifting, standing, equipment, breaks, or shift length.

For FMLA leave, an employer's fitness-for-duty requirement is subject to notice and other rules described in DOL guidance. Ask DLS what your case requires before your planned return. See also return-to-work forms and medical clearance.

7) Authorization to Obtain and Disclose Information (ROI)

An ROI concerns permission to obtain or share medical information. Read who may receive it, what it covers, how long it lasts, and any instructions about revoking it. Do not assume every release in a disability, leave, or accommodation packet has the same requirements.

For clarification of FMLA certification, you may arrange to supply the clarification yourself instead of authorizing direct provider contact. You still must provide a complete and sufficient certification; unresolved missing information can affect leave protection. Your direct supervisor may not contact your provider to clarify or authenticate FMLA certification. These rules are in 29 CFR 825.307.

Side-by-side form comparison

These categories serve different purposes. Check the title and instructions in your own packet.

STD Physician Statement

• Used for: A disability benefits claim for your own condition
• Main focus: The medical basis and dates supporting inability to work
• Check: The benefit plan's provider and documentation requirements

Behavioral Health Physician Statement

• Used for: A request involving a mental health condition
• Main focus: Supported functional effects, treatment, and leave duration
• Check: Whether the packet concerns leave, disability pay, or both

Accommodation RFI

• Used for: Medical information supporting a workplace accommodation
• Main focus: Relevant limitations and changes needed at work
• Check: The correct role-specific version and applicable sections

Return to Work Planning Form

• Used for: Returning to work, including a return with restrictions
• Main focus: Work capacity, specific limits, and duration
• Check: The required clearance and any accommodation review before returning

Need help with the right type of paperwork?

Certicare can evaluate requests for medical leave forms or workplace accommodation forms. Send the actual packet so the provider can assess what is needed.

Do providers have to use Amazon’s exact form?

For FMLA, an employer must accept a complete and sufficient certification regardless of format. The DOL explains that this can include a provider's letter containing the required information. A brief excuse note may not contain enough detail.

That FMLA rule is not a blanket rule for every disability benefit or accommodation request. Ask which program the document supports and what information is missing. Using the current packet can help your provider address the relevant questions, but it does not guarantee approval.

Common mistakes that can delay Amazon DLS paperwork

Before submitting, check the document against the request DLS sent.

Using the wrong form

Make sure the form matches your case and role. Family-care, disability benefits, and accommodation requests ask different questions.

Vague restrictions

Ask the provider to describe supported limits in terms of the job tasks affected. Do not add or change medical answers yourself.

No clear dates

Include the dates requested by the packet. If the duration is uncertain, the provider should explain that and give a supported estimate or reassessment plan where appropriate.

No functional impact

The documentation should connect the medical need to time away from work or the change being requested.

Incomplete intermittent details

For episodic leave, check that the provider has addressed frequency and duration where required. Estimates should reflect the clinical situation.

Missing provider details

Check signatures, credentials, dates, contact details, and that every applicable page is included and readable.

What happens after the form is submitted?

Keep the completed document and proof of delivery. Check the case for confirmation that it was received and whether anything remains outstanding. An upload confirmation is not a leave or benefits approval.

How do I submit the completed form?

Use the upload or delivery instructions in your current packet. The public Operations and Corporate RFI copies direct employees to MyHR or the fax number printed on those forms. For another type of form, confirm its destination instead of assuming every document uses the same route.

What does insufficient documentation mean?

Ask DLS to identify the exact missing or unclear information and the deadline to respond. Send that message to the provider with the original form. For FMLA, an incomplete or insufficient certification requires written notice of what is needed and generally at least seven calendar days to correct it, with additional time where diligent, good-faith efforts cannot meet that period. See the FMLA certification rule.

Check any approval for its dates, schedule, restrictions, and separate pay decision. Continue following applicable absence-reporting instructions while the case is reviewed; opening a case alone does not approve the absences.

Amazon DLS paperwork process timeline

Track your case's dates rather than relying on a promised number of days for approval. For FMLA certification, the employer must generally allow at least 15 calendar days from its request, with additional time when diligent, good-faith efforts cannot meet that deadline. Other requests may have different deadlines.

Case opens

Save the case number, form request, and due date. Clarify whether leave, disability benefits, or an accommodation is being reviewed.

Provider completes the form

Give the provider the packet and job information promptly. Tell DLS before the deadline if a documented delay is preventing completion, and ask what to do next.

DLS reviews the documentation

Keep proof of submission and respond to requests for missing information. Ask for confirmation of any revised deadline.

Decision or follow-up

Read the written decision and follow-up instructions. If you disagree, ask about the applicable review or appeal process and its deadline.

Final thoughts

The most useful starting point is your current DLS packet: which request it supports, what the provider must address, and when it is due. Keep the forms, messages, and decision together so follow-up questions can be answered accurately.

Need a form or letter completed and signed by a state-licensed provider?

Certicare evaluates Amazon paperwork requests. Bring your forms and supporting information. A provider determines what can be completed based on the clinical findings.

Start an Amazon paperwork request

Frequently asked questions

Is there just one Amazon DLS form?

No. Your packet depends on the type of request. Ask DLS for the current documents attached to your case.

What if I need changes at work, not time off?

Ask about the accommodation process and whether an RFI or other medical documentation is needed. Your provider should describe the limitations and the changes that may address them.

What if my provider wrote a note instead of using Amazon’s form?

For FMLA, a complete and sufficient provider letter must be accepted. A short visit note may be missing required information. For disability benefits or accommodations, ask what requirements apply to that request.

Why does Amazon ask for more information sometimes?

The form may be missing an applicable answer, a date, or an explanation of the medical need. Ask for the specific issue so the provider can respond to it.

Can you help with both medical leave and accommodation paperwork?

Certicare evaluates both types of requests. Documentation is completed only when clinically supported, and Amazon makes the final decision.

What if my doctor will not fill out the Amazon DLS form?

Ask whether the issue is the clinic's paperwork policy, missing information, or a clinical concern about the request. Another qualified provider would need enough information and an appropriate evaluation to decide what they can certify. A different provider cannot guarantee the leave you requested.