FMLA for Tonsillitis Surgery?

Christinet

If this is an outpatient surgery does it qualify for FMLA?

LindaS

Inpatient hospitalization is only one aspect of determining a serious health condition under the federal FMLA. You would also need to look at follow-up care, absence of three days or more, etc. Don't look at just the condition but the facts surrounding the condition to determine FMLA qualifying. If the physician has indicated the person needs to be off work, school, etc. for three days or more and requires follow-up visits with the physician, or prescription medication, it would probably qualify under FMLA.

mmurnahan

If the physician indicates the employee can not work, then it should be FMLA. I recently had an employee who used FMLA for this. I've heard the recovery time is different than a child's tonsillectomy. I wouldn't question it.

Margaret Morford

I think outpatient surgery still involves a hospital stay if even for a few hours. I've always certified outpatient surgery (not voluntary) as FMLA. What does everyone else say?

Margaret Morford
theHRedge
615-371-8200
[email]mmorford@mleesmith.com[/email]
[url]http://www.thehredge.net[/url]

rad

I agree, its still a medical procedure from which the employee needs to recuperate and miss work.

psrcello

The definition of serious health condition includes "Inpatient care (i.e., an overnight stay) at a hospital, hospice, or resitential medical care facility ..." In the event of outpatient surgery, I've looked to other sections of the definition.

I also at one point had an FMLA brochure designed for employee communications (a supervisor walked off with it a while back) that stated that ordinarily, an outpatient surgery in and of itself wouldn't qualify under FMLA - only if there were complications or the condition fell within the "continuing treatment" definition of the law.

Whatever

Unless it is a really unusual circumstance, the group insurance company will not cover an in-patient tonsillectomy. Since insurance companies are "urging' (I use that term very loosely), that more and more procedures be done on an out-patient basis, if the doctor certifies, I don't question it.

njjel

If the doctor certifies it, I give the FMLA.

NicoleLee

I have unfortunatly had to undergo numerous outpatient surgeries personally. Just because the surgery is outpatient does not mean it is not serious. Many surgeries nowadays are considered outpatient by insurance. In my case, I needed two full weeks for recovery and follow-up care. Mine was FMLA approved by my HR VP at the time.