Health Care and FMLA

The Family
and Medical Leave Act (FMLA) was passed as a
federal law in
1993, requiring covered employers to provide employees job-protected and paid
leave for qualified medical and family reasons. Qualified medical and family
reasons include: personal or family illness, family military leave, pregnancy,
adoption, or the foster care placement of a child. The FMLA
was intended “to balance the
demands of the workplace with the needs of families.”
According to the US Department of Labor, the FMLA entitles eligible employees
of covered employers to take unpaid, job-protected leave for specified family
and medical reasons with continuation of group health insurance coverage under
the same terms and conditions as if the employee had not taken leave. Eligible
employees are entitled to the following benefits:
–Twelve workweeks of leave in a 12-month period for:
·        
the birth of a child and to care for
the newborn child within one year of birth;
·        
the placement with the employee of a
child for adoption or foster care and to care for the newly placed child within
one year of placement;
·        
to care for the employee’s spouse,
child, or parent who has a serious health condition;
·        
a serious health condition that
makes the employee unable to perform the essential functions of his or her job;
·        
any qualifying exigency arising out
of the fact that the employee’s spouse, son, daughter, or parent is a covered
military member on “covered active duty;” or
–Twenty-six workweeks of leave during a single 12-month
period to care for a covered service member with a serious injury or illness if
the eligible employee is the service member’s spouse, son, daughter, parent, or
next of kin (military caregiver leave). 
More information is available at this website: http://www.dol.gov/whd/fmla/ .
But there are some qualifiers for someone who is employed
that wants to use this as a legal way to take time off from work for medical or
family reasons. In order to be eligible for FMLA leave, an employee must have
been at the business at least 12 months, and worked at least 1,250 hours over
the past 12 months, and work at a location where the company employs 50 or more
employees within 75 miles. The FMLA covers both public- and private-sector
employees, but certain categories of employees are excluded, including elected
officials and their personal staff members.
Generally,
the FMLA requires an employee to give his or her employer 30 days’ notice of
intention to take FMLA leave, and the reason for the leave, according to
FindLaw.com. There is no “magic language” that the employee must use
in notifying the employer, nor does the employee need to mention the FMLA by
name. Instead, the notice must give the employer enough information to know the
employee is requesting time off, and why.
This
allows the employer to determine if the request qualifies under the FMLA, and
allows time to find a replacement for the employee. When the need for FMLA
leave arises suddenly, like an unexpected medical emergency, employees may take
FMLA leave without prior notice. However, employees must give the employer as
much notice as is reasonable under the circumstances. More detailed material
about this law is available at this site: http://employment.findlaw.com/family-medical-leave/family-and-medical-leave-act.html
.
According
to the National Partnership for Women and Families (NPWF), America’s workers
have used the FMLA at least 200 million times to take time off when they need
it most, without having to worry about losing their jobs or their health
insurance. However, About 40 percent of the workforce is not eligible for leave
under the FMLA. More info is located at this website: http://www.nationalpartnership.org/issues/work-family/fmla.html
.
The FMLA
can be abused by employees in some cases, especially on intermittent leave.
Employers have some options to monitor the requests. One of the biggest
employer complaints about FMLA is the productivity problems caused by
employees’ use—and abuse—of FMLA intermittent leave. T
he problem: employees with chronic
health problems often take FMLA leave in short increments of an hour or less.
According to Business Management
Daily, here are four tips on certifying FMLA intermittent leave requests:
1. Ask about the specific condition.
Medical certification must relate only to the serious health condition that is
causing the leave. Employers can’t ask about the employee’s general health or
other conditions.
2. Give 15 days to respond.
After requesting certification, give employees at least 15 calendar days to
submit the paperwork. If the employee’s medical certification is incomplete or
insufficient, specify in writing what information is lacking and allow the
employee seven days to cure the deficiency.
3. If the need for leave is doubted,
investigate the certification. Under the updated FMLA
regulations, an organization can contact the employee’s physician directly to
clarify the medical certification. The contact person can be a health care
provider, a human resources professional, a leave administrator (including
third-party administrators) or a management official, but not the employee’s
direct supervisor.
4. If the request is still not
convincing,
require (and pay for) a second opinion. Use an independent
doctor selected by the employer, not a doctor who works for your organization.
If the two opinions conflict, the employer can pay for a third and final,
binding medical opinion
According
to FMLAOnline.com, the Family and Medical Leave Act is an on-going challenge
for HR professionals. Because its rules are so complex, companies are
vulnerable to FMLA abuse, exploitation, and miscomprehension. It takes only one
confused or misinformed employee to cost a business tens of thousands of
dollars in FMLA lawsuits. There are three different kinds of FMLA leave:
·        
Continuous
FMLA leave:
An
employee is absent for more than three consecutive business days and has been
treated by a doctor.

·        
Intermittent
FMLA leave:
An
employee is taking time off in separate blocks due to a serious health
condition that qualifies for FMLA. Intermittent leave can be in hourly, daily,
or weekly increments. Intermittent FMLA is often taken when an employee needs
ongoing treatment for their condition.

·        
Reduced
schedule FMLA leave:
An
employee needs to reduce the amount of hours they work per day or per week,
often to care for a family member or to reduce stress.
All FMLA
forms and information about an employee’s FMLA leave and condition must be kept
confidential and separate from other employee files. It is an FMLA violation
for an employer to share information about an employee’s FMLA leave with other
employees. Additional material on FMLA policies is located at this site: http://fmlaonline.com/ .
According
to HRHero.com, employers must keep accurate records pertaining to the leave and
either physically or electronically post a notice of employees’ rights under
the FMLA so that the information is accessible to both employees and job
applicants. Furthermore, the FMLA requires employers to maintain the employee’s
group health benefits while on leave on the same terms that it provided them
when the employee was working.
Leave taken under the FMLA is job-protected, which means
that employees must be given the same job or an equivalent job when they
return. Employees or the Department of Labor can sue the employer for lost
wages, benefits, reinstatement, attorneys’ fees, and liquidated damages for
willful violations. Additional information is located at this site: http://topics.hrhero.com/family-and-medical-leave-act-fmla/
.
The FMLA
is a definite benefit for qualified employees, and employers have certain
protections under the law if there is suspected abuse or violation of FMLA. Going
forward, both employees and employers must know the law and follow it to avoid
any problems. Both family and medical leave is important in circumstances that
mandate time away from work. The key is to understand how it works and how to
manage it.

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