Understanding FMLA: What Qualifies as a Serious Health Condition?

Understanding FMLA: What Qualifies as a Serious Health Condition?

The Family and Medical Leave Act (FMLA) is a federal law that guarantees eligible employees the right to take an unpaid leave from work for specific medical or family reasons. The law provides job protection during the leave period and requires employers to continue providing health benefits.

FMLA doesn’t cover every employee as it has an eligibility criterion, but it includes most of the private sector employees and all state and federal employees. To qualify for FMLA protection, an employee must work for a covered employer and have worked for them for a minimum of twelve months, at least 1250 hours of service.

One of the criteria that make an employee eligible for FMLA protection is the presence of a “serious health condition.” In this article, we’ll explore what a serious health condition is and how it qualifies an employee for FMLA protection.

Defining a Serious Health Condition

From an FMLA perspective, a serious health condition is an illness, injury, or physical/mental condition that requires inpatient care or continuing treatment by a healthcare provider. Some examples include cancer, stroke, heart attack, chronic obstructive pulmonary disease (COPD), severe depression, and immune system disorders.

An employee may still qualify for FMLA protection even when they don’t need hospitalization for their condition. If they are unable to perform their job duties or attend school for more than three consecutive days, they may be protected under FMLA if they receive care from a healthcare provider.

In some cases, a serious health condition may be intermittent. For instance, conditions that cause recurrent episodes like asthma or migraines can qualify for FMLA protection.

Understanding Inpatient Care

Inpatient care refers to any admission to a hospital, hospice, or residential medical care facility for treatment or observation. The care must involve either an overnight stay or counting of multiple treatments. Hospitalization for cosmetic procedures is not covered by the FMLA.

Following Inpatient Care

When returning to work from inpatient care, an employee can take FMLA leave for follow-up treatment and recovery. This may apply when the hospitalization has caused significant residual effects such as complications that require additional treatment.

Continuing Treatment by a Healthcare Provider

Continuing treatment involves any of the following:

1. An absence of more than three days from work or school for illness, injury, or a condition that has led or may lead to incapacity.
2. A period of incapacity due to pregnancy or a chronic condition.
3. Any treatment by a healthcare provider, including visits to a doctor, physical therapy, surgery, or outpatient procedures.
4. A chronic illness that requires regular visits to a healthcare provider.

Key Takeaways

FMLA provides critical protection for employees by allowing them to take an unpaid leave without losing their job or employer-sponsored health insurance if they or their family members have a serious health condition. The law defines what qualifies as a serious health condition, including inpatient treatment, continuing treatment, and pregnancy-related ailments.

Employers must understand the important and complex regulations concerning FMLA to avoid any regulatory compliance issues. Employees, on the other hand, should be familiar with their rights and obligations under the FMLA for the best career advancement and personal well-being.

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