Yes, you may obtain information from sources other than a certification
June 24, 2024
When employers are put on notice of the need for leave under the federal Family and Medical Leave Act (FMLA) by an employee, their response often involves a certification supporting the need for leave.
Employers are not mandated to ask for a certification, but may do so for an employee’s own condition. Employers also don’t have to stick to the U.S. Department of Labor’s model certification forms.
While a certification might be the only source of information in many employee FMLA leave situations, when employees take leave for their own conditions, employers might have other options. These other sources might come in handy when employees balk at providing a requested certification.
Workers’ compensation
If an employee suffers a workplace injury or illness, workers’ compensation gets involved. The employee will obtain health care treatment from a doctor. Since employers ultimately pay for occupational injuries and illnesses, employees or the workers’ compensation medical provider will share medical information regarding the claim with the employer.
Employers may not ask for medical information beyond the workers’ compensation claim. If, for example, a claim indicated that an employee had a carpal tunnel injury, the employer could not ask for information outside of the carpal tunnel, such as the employee’s irritable bowel syndrome. Often, such information includes whether the employee sought treatment for the condition in the past.
Employees can feel that such information sharing is a violation of the federal Health Insurance Portability and Accountability Act (HIPAA). Workers’ compensation cases, however, have a limited exception under HIPAA, allowing relevant (and only relevant) medical information to be released without individual authorization from the injured employee.
Short-term disability
Another potential source of information is a disability claim.
When employees suffer injuries or illnesses that are not work related, they might file short-term disability claims to have some income while they miss work to recover.
Short-term disability plans usually require employees to submit documented proof from a health care provider of their medical condition and inability to work. Plan administrators, employers, or insurers have submission forms for filing claims. They review the forms and employees’ medical records to decide whether to approve or deny a claim.
Employers might use that information to process an FMLA leave request, as well.
If employees want the disability benefits, they must provide the information. They can do so either by giving the health care provider authorization to disclose the information to the employer, plan administrator, or insurer, or gather the information on their own and submit it.
Key to remember: When employees take leave for their own condition and don’t want to provide an FMLA certification, employers have other options to gather the information.
June 24, 2024
AuthorDarlene Clabault
TypeIndustry News
Industries{not populated}
Related TopicsFamily and Medical Leave Act (FMLA)
Governing BodiesWage and Hour Division (WHD), DOL
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