What is Considered A Serious Health Condition Under the FMLA?

What is Considered A Serious Health Condition Under the FMLA?

Eligible workers who work for employers that are subject to the Family and Medical Leave Act, or FMLA, are protected when they take off approved FMLA leave from work in order to recover from a serious health condition or to care for a family member who is suffering from one. The Family Leave Act does not provide protection for taking leave for minor ailments such as colds, but it does for more serious conditions.

Serious health conditions

Under the Family Leave Act, serious health conditions are divided into six categories:

  • Conditions that require inpatient care
  • Conditions that cause incapacity for more than three days and for which a health care provider is completing continuing treatment
  • Pregnancy or prenatal care issues causing incapacity
  • Chronic and serious health conditions
  • Some conditions that require multiple treatments
  • Conditions that cause long-term or permanent incapacity

Inpatient care

Inpatient care under the FMLA is defined as a condition that requires an overnight stay in a hospital, residential care facility or hospice. Employees are entitled to take FMLA leave for both the time they spend in the inpatient setting as well as any resulting incapacity or additional treatment that is related to the stay.

Conditions that cause incapacity for more than three days with continuing treatment

When people are incapacitated for more than three days and are receiving continuing treatment for their health conditions, the illnesses are considered to be serious health conditions. The three days must be consecutive and may include weekend days.

Continuing treatment includes receiving at least two treatments by a health care provider or by a nurse or other provider under the direction of the health care provider. The treatments must happen within 30 days of when the person was first incapacitated. The first treatment must happen within seven days of the initial incapacitation.

Pregnancy or prenatal care

Pregnant employees who are unable to work or to complete normal daily activities because of their pregnancies are covered under the FMLA. Prenatal care visits also qualify. Pregnant workers do not need to be incapacitated, and the leave can be used for routine appointments.

Chronic and serious health conditions

Chronic conditions that are ongoing and that require occasional leave are covered by the law if the worker requires regular treatment visits, which are a minimum of two visits each year for the condition with a health care provider or nurse. The condition must be one that will continue for a lengthy duration and it must cause episodic periods of incapacitation instead of ongoing incapacity. Some examples may include asthma, epilepsy and diabetes.

Long-term or permanent incapacity

Workers who suffer from conditions that are not easily treatable and that permanently incapacitate them or do so on a long-term basis have serious health conditions if they are being supervised by health care providers. Examples of these types of qualifying conditions include advanced amyotrophic lateral sclerosis, Alzheimer’s disease or terminal cancer.

Conditions requiring multiple treatments

A worker’s health condition is a serious one when he or she has to miss work to receive multiple treatments for conditions that would otherwise cause an absence of more than three days without treatment or for surgery following an injury or accident. Examples may include chemotherapy or dialysis.

Conditions that do not qualify for leave

While the FMLA does not list conditions that are never considered to be serious, there are several types of minor illnesses that will likely not qualify, including:

  • Earaches
  • Colds
  • Minor bouts of the flu
  • Headaches that are not migraines
  • Routine dental or orthodontic issues
  • Periodontal disease
  • Cosmetic surgeries unless they are related to restoration after an accident

In some cases, even minor conditions may be covered. Each request is looked at individually in order to determine whether or not it qualifies for leave. People who have questions about their rights to leave under the act may contact the employment attorneys at Swartz Swidler.