When does FMLA start??

Here is a good question for you all. We started an employee's FMLA when she had her surgery and was diagnosed (the surgery was actually done to enable the doctor to make a diagnosis). Should it have started earlier since she was seen more than once by a health care provider and on a course of antibiotics? Here are the details:

We have an employee who went to the doctor with what she thought was a bladder infection. When she told the doctor her symptoms, he told her it sounded like interstitial cystitis but since the test for interstitial cystitis included surgery he wanted to rule all other possibilities out. During this first appointment he got a urine sample which was tested in the office - it showed blood. He sent the urine sample to the lab and put her on antibiotics.

The second appointment (which was 3 days later) showed the results of her lab testing. The urine sample showed no infection. He did a PAP test. He put her on another antibiotic until he got the results from the PAP test. They got another urine sample during this appointment. It still was showing blood.

On the third appointment (one week after the second appointment) the doctor told her the PAP test came out fine and he was sure the illness was interstitial cystitis. He referred her to a urologist and she was scheduled for surgery within the week. The surgery confirmed what the doctor suspected. During the surgery - they found what they called a bladder carcinoma, which
they burned off.

When all the information came back from the lab - the doctor told her what they burned off was malignant.

Due to the bedside manner of the doctor - our employee went to another doctor for a second opinion. The second doctor had all her samples run through a different lab and informed her that there was no malignancy and there never had been. She did, however, have the interstitial cystitis and would need to be checked regularly initially to make sure there were no problems with what the first doctor burned off.

The employee has now informed us that her last doctor visit showed the area was doing well and they had the interstitial cystitis under control. She could go on annual checks for it unless there were any other problems.

So, the question is: Should her FMLA have started when she first went to the doctor, or only when she was officially diagnosed? Thank you!

Comments

  • 2 Comments sorted by Votes Date Added
  • Leave starts when an employer reasonably believes that an employee is missing time from work for a medical condition. It is up to the employer to notify the employee that the FMLA clock is ticking. If the time off taken is less than 12 weeks, it is less vital. The employer needs to keep on top of the issue to make sure that an employee does not take 10 weeks of paid time and then turn around and request 12 weeks of unpaid time when paid time runs out. Thus, employees out on sick leave, vacation, workers compensation, or any other type of paid leave can be notified that such leave is considered as FMLA leave. However, there is no need to drive yourself crazy about this if there is no abuse or leave is short term.
  • I had a similar situation a few years ago. Someone at the Department of Labor told me that, if I find out that prior appointments are ultimately related to the medical problem (e.g., physician visits which lead up to surgery), then these visits can be counted towards FMLA, as long as the employee is made aware.
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