It is a federal regulation that provides job protection to eligible employees who are out due to:
Family and Medical Leave Act
Any employee employed by an eligible company for 1 year and has worked over 1,250 hours in the past 12 months. Of course they must have FMLA time available.
According to federal regulations, any company with 50 or more employees in a 75-mile radius in the U.S. must offer FMLA. State specific regulations can vary by state. Check our state regulations page (Click here – Link to State Maps) to learn more about your state regulations
The federal regulations mandate that when an employee out on FMLA returns to work, they must be returned to their original or equivalent position.
Eligible employees are allowed up to a total of 12 weeks of consecutive or intermittent leave in a 12-month period. Caregivers for an injured service member can take 26 weeks of leave in a 12-month period
Yes. An employee is allowed 12 weeks total of FMLA time in a 12-month period, regardless of the number of FMLA cases open.
Intermittent FMLA is taking time in periodic increments vs. one straight block. The employer must track the time used.
Yes. If the intermittent FMLA is foreseeable, then the employer may require the employee to transfer temporarily, (i.e. during the period that the intermittent or reduced schedule is required) to an available alternate position for which the employee is qualified and better accommodates the employees recurring periods of leave.
Yes, FMLA does not protect the employee from a downsizing that would have occurred regardless of whether the employee was working or out of work.
When the need for a leave is foreseeable (e.g., expected birth, adoption, planned medical treatment, etc.), an employee must give at least 30-days notice. If 30-days notice is not possible, an employee is required to provide notice as soon as practicable.
The service member must be a spouse, child or next of kin who suffered a serious injury while on active duty within the past five years. FMLA grants 26 weeks in a 12-month period to care for Service Members.
Up to 12 weeks of FMLA time for family members of Active Duty, National Guard and Reserve members to help sort out the affairs of a family member called to active duty.
An employee is entitled to up to 12 weeks to care for a spouse, parent or child with a serious health condition. The regulation has updated the definition of “spouse” and “child”. A legally married same sex spouse is now eligible. Caring for a child under the age of 18 years old includes anyone who steps in to provide care or financial support. This can be a foster parent, grandparent, stepparent, guardian or other relative or unrelated adult.
To qualify for care of a child over the age of 18 the child must be “incapable of self-care because of a mental or physical disability” at the time that the FMLA leave commenced. Incapable of self-care means that the child needs supervision in three or more ADLs (activities of daily living) or IADLs (instrumental activities of daily living). Physical or mental disability means a physical or mental impairment that substantially limits one or more major life activities.
An employee completes the Department of Labor medical certification forms with their healthcare provider and returns them within 15 days to their human resources department or a third party provider. If partnering with Work & Well, the information is reviewed by a Case Manager to ensure it is complete and medically valid. Within two days from receiving the information, Work & Well will either approve or deny the case, or requests additional information.
No, but reduced-schedule time does count. An employee’s acceptance of a “light duty” assignment does not constitute a waiver of the employee’s perspective rights, including the right to be restored to the same or equivalent position the employee held at the time their FMLA leave commenced. The employee’s right to restoration however, ceases at the end of the applicable 12 month FMLA year.
Yes. Failure to do so can be grounds for disciplinary actions. To be counted as FMLA time, the employee must state the absence is for FMLA if they have an approved open FMLA case. If the employee has multiple open FMLA cases, the employee must also indicate which case (i.e. caregiver, self ) they are calling out for.
It is better to inform an employee of FMLA than not to inform them. Always inform an employee of FMLA if they were out of work for more than three consecutive days, if they are frequently calling out, or if you’ve noticed a change in their work habits, possibly due to a medical condition.
A second opinion and/or an Independent Medical Exam (IME) is used to verify an employee’s condition or the medical validity of the paperwork by a doctor other than their own. A second opinion exam is only allowed at the beginning of the employee’s certification year.
In a conspicuous place, employers must post a general notice explaining FMLA provisions and procedures for filing a claim. Failure to do so can result in a fine.
It depends on the timeframe the doctor puts on the paperwork. However, if the doctor does not specify a timeframe, you may request recertification at six months. Additionally, under certain circumstances (i.e. employee requests leave extensions, circumstances have changed significantly, or there is reason to suspect abuse) you can ask for recertification on a more frequent basis.
Work & Well’s Case Managers review every case to ensure its completeness and medical validity. Although the vast majority of cases are legitimate, Work & Well can help detect those cases that do not meet the DOL criteria for FMLA leaves.
Work & Well works to ensure that those employees who meet the DOL criteria receive their FMLA leave entitlement. Our Case Management team reviews out-of-work notes, completed and clarified certifications, second and third opinion examinations and guidelines. Working with the employee, the healthcare provider and our client’s team, we are very successful in ensuring that only those that meet the FMLA’s serious medical condition criteria and are unable to perform an essential job function receive the FMLA leave entitlement.
This diligence enables us to give you quality case management and reduce the days out of work.
When partnering with Work & Well, you have immediate access, 24/7, through our real-time web portal to track any case. Our secure password-protected website provides up-to-the-minute case status. The web portal allows our clients to run semi-customized reports, submit leave information and download application forms.
Our Employee Portal allows employees access to their case status, enter intermittent time, track time and download paperwork.
If you prefer talking with a live person, you can call us and speak to one of our Customer Care Representatives or your Client Team.
With Work & Well managing your cases, we ensure that your employees are FMLA eligible and provide the necessary and complete documentation required to approve the case. Additionally, we utilize many resources to ensure they are using FMLA correctly.
For intermittent approved cases, we monitor the time out of work to the certification. If an employee goes over their certification, we call the employee to see what is going on. Based on the interaction, we determine the next steps and advise both HR and the employee.
For straight leaves, we require that the employee provides a release-to-return-to-work note from their treating health care provider prior to the end of their leave. We then follow-up with to ensure the employee returned to work when scheduled. If they do not, we call the employee to get more information.
Additionally we provide frequent notification to the employee notifying them when they are nearing the end of their FMLA time.
Using these methods, we help to lower the days out of work and help reduce that causal absenteeism that makes it difficult to run your business.
Work & Well operates as an extension of your HR team. Our case managers look at each request to ensure that it is medically valid and meets all DOL requirements. If not, we will return the certification paperwork to the employee or the treating healthcare provider for completion or clarification.
Difficult cases are reviewed by our Nurse Case Managers and if needed our Physician Consultants to ensure medically validity.
Work & Well respects every person’s privacy. However, there are times when we need additional clarification from the employee’s healthcare provider. If the employee has not signed the medical release and we need clarifying information, Work & Well will send the request to the employee. It is then the employee’s responsibility to contact their healthcare provider and get the information back to Work & Well within the required timeframe. Without, this information Work & Well cannot will medically certify that the leave time qualifies as FMLA.
Yes, Work & Well has decades of experience working with organized labor. Our client’s unions cover the entire spectrum; from large, well know unions to clients with small, client specific unions.
Often bundling services is deemed as more cost effective. This may not be the case. If your FMLA is rubber stamped and not monitored, your days out per case will climb. The cost of more absences coupled with lost productivity can have a significant impact on your bottom line.
Additionally, wouldn’t you prefer to have a direct line with the team that managing your leaves. Work & Well assigns a team to every client for easy and effective communication.
Many large carriers do not manage ADA, the largest growing leave type. ADA requires continual monitoring and follow-up. Partnering with Work & Well is like extending your HR department to a trusted friend.
Work & Well works within all state regulations to get the information we need to make a sound and fair determination. We stay on top of the ever changing state leave guidelines to ensure we are managing your cases appropriately.
Work & Well provides a solid, time tested approach for medical leave management. Our full case management services include application administration, complete medical review, documentation, follow-up, tracking and reporting. Our thorough review of each case ensures its medical validity while monitoring for suspicious patterns of time out of work. With our full case management services, we can save you valuable time while ensuring that you are compliant with all federal and state regulations.