FMLA - how serious does the medical condition have to be?

How serious does a medical condition have to be to qualify for FMLA (Family and Medical Leave Act), and is it a state-by-state thing or an overall rule that applies pretty much to all 50 states?

Basically, you need a note from your doctor that says you are too ill to do your job, or a qualified member of your family requires your care or assistance.

I got a note from my Moms Dr when she broke her hip. Well, actually, it was a bit of paperwork saying she required assistance. She has now had surgery twice.

Where I work, we are quite lenient on leave for this kind of stuff. I for instance will take the day off take her to the Dentist (she lives a hundred miles away, so it’s a full day for me.) I can use some of my massive amount of sick leave for that, and get full pay.

In thinking about it… Iv’e been using sick leave only. I have the FMLA turned in, but am told that I should use that if I need to spend weeks with Mom. Kinda weird.

In my area, it’s less severity and more duration. Our workplace policy is that any sick leave (so personal sickness, appointments or procedures, or any of that for immediate family that you care for) that lasts more than three working days in a row has to be registered as FMLA, as well as anything that would require more than a week total of sick leave over the course of 6 months.

It’s a pain in the ass policy, and results in a lot of shenanigans like people coming in to work for an hour or two on the third day to re-set the clock, or “forgetting” to tell HR that they’re pregnant so that their pregnancy appointments don’t eat into the FMLA leave they want to take entirely after the baby is born.

It’s also frustrating, because it’s not entirely clear which things are related - so I missed much more than a week of work over the last three months because I was sick, but I was sick from a documented series of different things. However, they were all related, and probably all caused by the first thing. Finally, I didn’t know in November that the infection I had was going to be such a pain in the ass that I needed to take FMLA for it - so I didn’t. shrug

On the other hand, after my car accident, they assumed I would need, and did all the paperwork, but I only needed two days after all. All that effort for nothing.

The FMLA is federal law, though some states may offer greater protections. The Department of Labor explains what conditions qualify here (assuming the employer and employee are covered by the Act). TriPolar basically explained it.

It also depends on whether your company is required to offer FMLA. They must employ at least 50 people within a 75 mile radius in order to be subject to FMLA compliance. Some companies offer it even if they don’t meet the threshold, but just mentioning this in case it doesn’t apply to your employer.

If FMLA applies to you, a “serious health condition” is generally defined as a condition that:

  • requires hospital admittance; or
  • disables you from performing your job for more than 3 days; or
  • requires ongoing treatment from a healthcare provider.

So, a severe cold that takes you out of work for only 3 days would probably not qualify, but if you were out for four days it might. If you were hospitalized, it definitely would. On the other hand, migraine headache would probably not quality but if you were being actively treated by a doctor for migraines then even occasional short-term absences for them (or for your doctor visits) would probably qualify.

To expand on my previous post, here is the definition of a SHC found on the SHRM website:

I work in disability insurance and work a lot with our FMLA Department. Tripolar and Skammer pretty much nailed it. File for an FMLA leave and get a doctor’s certification for out to be out of work. Our FMLA Department sends out paperwork for the doctor to complete. It’s about 3-4 pages but it’s not necessary. If your doctor just submits an off-work notice – it can be as short as a sentence, really – that’s sufficient to approve an FMLA leave.

Keep in mind that you must be employed for at least one year before FMLA protection kicks in and that FMLA protection expires after 12 weeks.

Let me know if you have any other questions.

I’d say that the information you doctor needs to submit probably depends on your employer. I used to be the FMLA manager for a very large retailer and we absolutely required the doctor to fill out a Certification of Healthcare Provider form to approve the FMLA. A doctor’s note was not sufficient, unless it contained all the information requested on the form. We also required a doctor’s certification clearing you to return to work, verifying that you were able to perform the duties of your job (with accommodation if necessary).

Interesting. Good to know. I work on the disability side but a lot of our disability claims are linked to FMLA. So if we get anything from a doctor – even if it’s an estimated return-to-work date in their chart notes – we notify FMLA of that date and they use that as certification.

So, to the OP, I guess I’d recommend you connect with your FMLA carrier to find out how they handle certification.

Yep, we do this too. Some employers refuse to let their employees retun to work until they receive a copy of the doctor’s clearance. OP should connect with his HR Department for that.

“FMLA carrier”? FMLA is unpaid.

Poor phrasing on my part. I meant that it’s likely the company has contracted a third-party to handle FMLA for them. The OP would need to contact his HR Department to find out who that third party is.

I needed a doctor’s clearance to return to work just one day early after being out on short term disability, I’m sure the same kind of requirements would be applied to FMLA, and for the same reason, to protect the company from lawsuits should anything make your condition worse while you are on the job.

Really? I guess that makes sense. In disability, we don’t require that. If we call a claimant and they say, “Oh, I returned to work on April 11th,” then we just take their word for it and close the claim. We can always re-open it later and adjust the dates if we need to.

Like I said above, our company links disability and FMLA claims together and disability drives the claim. So if disability gets approved, FMLA does too. Disability can close a claim without a doctor’s certification. I don’t know if that means FMLA closes their claim at the same time but I assumed it did. However, based on what you’re saying, maybe FMLA waits for a doctor’s release before they close the leave on their end.

It’s not a problem with FMLA per se. It’s a “letting employee with limitations return to work is just asking for a workers’ compensation claim” thing.

Generally, we would take that kind of information as an “FMLA request.” So let’s say an employee brought in a doctor’s note to their manager or submitted a disability claim - that would get forwarded to FMLA and we would treat it as a request for FMLA leave. So we would send the required notification to the employee that we had received their request. Then, we’d have to evaluate if the employee was eligible or not. If they were, we had to send them notice of eligibility along with the certification forms. Then, once the doctor filled out the certification forms, their absence would be classified as FMLA leave. If they failed to certify, their leave would be treated as an unapproved absence and they would be subject to discipline and/or termination. We had over 100,000 employees in thousands of locations so we had to be very methodical with the whole process.