FMLA: Who Qualifies and How Managers Should Handle Claims

Paid – or unpaid – leave can be a huge assist to workers should they get sick or injured. Even if the leave is unpaid, it still guarantees they’ll have a job when they get well enough to return to work. This is where the Family and Medical Leave Act – or FMLA – comes in.

Passed in 1993, FMLA requires employers to provide employees with job-protected, unpaid leave for qualified medical or family reasons. This leave can last for 12 weeks, which, pending employer approval, don’t have to be taken consecutively. While this leave is unpaid, it still allows the employee to receive company health benefits.

What is a "qualified medical reason?"

Sometimes phrases like this are included in laws, and it requires more research to figure out exactly what that phrase means. You’re not a lawyer, but because you’re responsible for accepting or denying an employee’s FMLA request, it’s your obligation to at least know the basics of what qualifies for FMLA. The Department of Labor lists those reasons:

• for the birth of a son or daughter, and to bond with the newborn child;
• for the placement with the employee of a child for adoption or foster care, and to bond with that child;
• to care for an immediate family member (spouse, child, or parent – but not a parent “in-law”) with a serious health condition;
• to take medical leave when the employee is unable to work because of a serious health condition; or
• for qualifying exigencies arising out of the fact that the employee’s spouse, son, daughter, or parent is on covered active duty or call to covered active-duty status as a member of the National Guard, Reserves, or Regular Armed Forces.

Anxiety, depression, and dissociative disorders also qualify as a serious health condition. FMLA requests for mental health reasons are just as valid as any request made for physical injury or sickness.

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Interested in learning more? Sign up for the SkillPath webinar, FMLA Basics for Managers

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Can independent contractors qualify for FMLA?

No. Only those who are at least part-time employees can make an FMLA request.

This is why it’s important to properly classify the type of worker. If you try to say they’re not eligible for FMLA when they actually are, it could bring your company legal trouble.

If they’re paid by the project, aren’t reimbursed for expenses and are allowed to seek work elsewhere, they’re a contractor. If they’re paid salary or hourly, are offered benefits, and will work for your company indefinitely, rather than being under contract for a predetermined period of time, then they’re an employee.

How should managers respond to FMLA claims?

Part of a manager’s responsibility is recognizing when a leave request might qualify for FMLA. If the employee makes an FMLA claim straight away, perhaps the most important thing to know is that the company has five days to respond to it. There are some requests that an employer is allowed to make, and they should be done within this timeframe. This includes, but isn’t limited to:

• The employer can make a request for medical certification. The employee must be allowed 15 days to obtain this. This DOES NOT mean that the employer can ask for medical records.
• Employer is allowed to require a second or even third opinion, but this is done at the employer's expense.
• The employer can contact the employee’s medical provider, but only to clarify the medical certification. Under no circumstances should they ask for individually identifiable medical information.
• The employer can ask the employee to get a fitness-for-duty certification, signifying they are able to perform the essential functions of their job.

All employer requests should be made in writing. It’s crucial to keep accurate paperwork involving every aspect of an FMLA claim, so the entire process can be tracked and recalled if necessary.

There’s a lot to remember when it comes to FMLA claims, and as a manager you can’t possibly prepare for every reason an employee might file a claim. Give them your prompt attention, and know when to involve your company's HR department so there's no confusion or legal issues.

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