What Qualifies As A Serious Medical Condition Under FMLA?

Posted on October 5, 2017 · Posted in FMLA

While you may understand that the Family Medical Leave Act (FMLA) covers those with serious health conditions, the definition of a serious health condition may vary from employer to employer and may be up to discretion of the employer.

Most commonly, conditions that qualify for leave are any conditions requiring overnight stays in a hospital or other medical facility; conditions that incapacitate you or your family member for more than three consecutive days and have ongoing medical treatment (either multiple appointments with a health care provider, or a single appointment and follow-up care such as prescription medication); chronic conditions that cause occasional periods when you or your family member are incapacitated and require treatment by a health care provider at least twice a year; and pregnancy (including prenatal medical appointments, incapacity due to morning sickness, and medically required bed rest)

If you suffer from a chronic serious health condition, you may be able to use FMLA for any period of incapacity or treatment for a serious health condition.

The regulations continue to define a chronic serious health condition as one that (1) requires “periodic visits” for treatment by a health care provider or nurse under the supervision of the health care provider, (2) continues over an extended period of time, and (3) may cause episodic rather than continuing periods of incapacity. The regulations clarify this definition by defining “periodic visits” as at least twice a year.

Even though it is your right to take a FMLA leave in many situations, the employer may require you to show proof of the seriousness of yours or your loved one’s condition. Generally, this may be proven with a certification by the sick person’s health care provider. If the employer has reason to doubt the authenticity of the claim, they may require a second or third medical opinion at the employer’s expense and the employee would be required to comply to continue seeking FMLA leave.

In most cases, the employer must request medical certification at the time the leave is requested or within five business days. An employer may ask for recertification of the seriousness of the condition no more often than every 30 days.

If you are unsure if your condition qualifies or have had your employee question the validity of your FMLA request, it is crucial to speak with one of our expert Arlington attorneys who can help you navigate the FMLA leave laws and regulations.