What is considered a chronic condition under FMLA?

Certifications can help confirm long-term illnesses

Posted January 22, 2016

Chronic conditions plague many individuals, and some of these individuals are likely employed; some by you. One of the major headaches of administering FMLA leave is when employees take unforeseeable leave on an intermittent basis, usually due to a chronic condition.

The FMLA regulations provide criteria a condition must meet to be considered a chronic one:

  • Requires periodic visits (defined as at least twice a year) for treatment by a health care provider, or by a nurse under direct supervision of a health care provider;
  • Continues over an extended period of time (including recurring episodes of a single underlying condition); and
  • May cause episodic rather than a continuing period of incapacity (e.g., asthma, diabetes, epilepsy, etc.)

So, for chronic conditions, while treatment might be brief, recovery is not. The examples provided are but a few. There is no list of all conditions that could be considered chronic serious health conditions for purposes of the FMLA. Migraines could also be included. Early in the FMLA’s history, then Senator Jeffords, when in discussion of intermittent and reduced leave, stated that “if an employee is afflicted with an unpredictable, episodic illness, like migraines, he is clearly entitled to leave subject to…” the FMLA. Again, there are other conditions that would fit the definition.


To help you determine whether a condition is a chronic condition, you may request a certification from the employee. Some of the specific information you should look for includes the following in Part A (assuming you are using forms from the Department of Labor’s Wage and Hour Division), which reflect the definition:

  • Approximate date condition commenced (this can help you determine how long the employee has had the condition)
  • Probable duration of condition (this can help you determine if the condition continues over an extended period of time, and when you might be able to request a recertification)
  • Will the patient need to have treatment visits at least twice per year due to the condition?

Because chronic conditions last a long time, you might want to request recertification to ensure that leave continues to be protected. When a certification does not specify a minimum duration of incapacity, you may request a recertification no more often than every 30 days. If the certification does specify a minimum duration, you would need to wait until that duration expired if it were longer than 30 days. If the need for leave spans multiple leave years, you might want to request a new certification when the employee first requests leave in a new leave year.


FMLA EssentialsManualJ. J. Keller's FMLA Essentials Manual uses clear, conversational language to help you understand the FMLA (Family and Medical Leave Act) requirements.


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