Would you approve this?

KP68

[font size="1" color="#FF0000"]LAST EDITED ON 03-22-05 AT 12:34PM (CST)[/font][br][br]Employee suffered an eye injury, came back to work, then went back out again. Upon receipt of FMLA certification, the reason is "Multiple Treatments (non-chronic condition)", and the only details, other than 'trauma to eye' is that office visits are "as needed", and no mention of any sort of regimen of treatment following.

No hospitalization, nothing was checked (in terms of "yes or no") when asked if employee is unable to perform work of any kind, and "no" was checked for being able to perform functions of the employees current job. It also states, 'no working data entry'. Does this mean she can do other tasks?

(I should add that the employee has been gone for over two weeks due to this).

Would you approve based on this??

HRinFL

I don't think you can make a determination based on the information from the Dr. Send the form back to the doctor with a letter explaining what you need him/her to complete (ie whether the ee is unable to perform work of any kind, frequency of Dr. visits, duration of the impairment, etc.). Also send a copy of the ee's job description and ask the doctor if the ee can perform the necessary duties of the position. Have the Dr. identify tasks that the ee is unable to perform.

You can also send this information to the ee and explain that you do not have enough information to make a determination of whether the time off meets the FMLA guidlelines. Explain that onew you receive the needed information, you can make the proper decision. Give the ee a timeframe to get the required information back to you.

If you have an attendance policy, inform the ee that they will be held to the policy unless the required information is received and what that means to the ee.

KP68

Well, the doctor did state that the duration is "February 2005 through present" and that the frequency of the dr visits is "as needed". Isn't this adequate (or inadequate) enough to deny as it does not seem to meet the definiton of a serious health condition....or does it?

marc

There is still some contrary information - if the duration was from some date to the present, one would first think the event was over and the EE is released to work. Then the other shoe is dropped and the Dr states "No" to the EE being able to perform functions of the current job.

You probably have enough to designate the time up to "present" as FML, but you need additional information for the going forward portion of this eye thing.

There could be some disability issues associated, but I would not volunteer that. Do as HRinFL suggests and attach the letter to the job description asking for specifics re: unable to perform.

Consider classifying the time off as contingent FML - awaiting further documentation. Give the EE 15 days via certified letter.

stilldazed

I would opt for a similar strategy as your other responses: tentative FMLA designation (if EE meets eligibility requirements), notify the employee of that, the requirement for clear, valid medical certification, the risk for failure to produce the information, and give a specific timeline. Send everything certified mail. Include a HIPAA compliant authorization and suggest that you might help the EE if he/she is willing to authorize your assistance.

You might try calling the EE (prior to the mail out) to speed some of the communication and attempt some level of support for the FMLA process. My experience has been that employees are generally turned off by FMLA (primarily by their failure to understand what it is), supervisors are reluctant to show support for the FMLA process and would prefer to show favoritism, and direct dialog (sometimes by phone) will bridge some of the communication gap between the EE and me in that I get to present FMLA in a positive light to the EE.

Another alternative is to refer the employee for independent med exam if you're willing to pay for it. If that is the step you decide to take, you will most likely have to designate FMLA from the leave start date to the date of the exam.

KP68

The tough part is that this has been a 'questionable' issue from day one, and not only that, this employee will run out of FMLA time in early April, due to a previous leave. This tempted me to just burn the rest of the time, but then I counted the days and realized that the employee's 12 months would be the day after her doctor says she can return, qualifying her for another 12 weeks!(we use the rolling forward calc method)

Don D

I agree with Stilldazed, for the most part, except the part about considering an independent medical exam. I don't think this rises to that level of protracted humiliation, which certainly will result.

What you have is a hurried nurse or doctor checking boxes and putting a form in the outmail slot because they are busy. Don't communicate directly with the clinic in any manner if it is not workers' comp. Send the form back to the ee with the needed items highlighted in yellow and explained in the letter, giving her a timeline to return them to you. At this point you should not be concerned with job descriptions or light duty or essential functions. Those are disability and 'return to restricted duty' concerns. The FMLA forms are fairly self-explanatory and any clinic employee should be able to complete the highlighted questions, especially if a patient is standing there with a checkbook waving.

I think you have enough to conditionally approve the leave based on the initial visit and future repeat visits for treatment that the doctor has indicated. That's satisfactory. You cannot expect or demand a diagnosis or specific medical comments. If there is an initial visit followed by a series of followup visits and treatments you have FMLA, notwithstanding the lack of specificity, to which you have no right.

Do you have some reason for doubting this employee's injury or need for continued medical attention based on her apparent eye injury? That's my usual analysis. If not, lean toward approval and line up the few, minor remaining ducks and move on. x:-)

stilldazed

I would not take the IME approach. I think it's too much for too little given the other apparent circumstances, but it is out there as an option. I would give a tentative designation, clearly inform the employee about the information need and risks of not producing requested information, and probably make one attempt at the personal contact approach. If it proved fruitful, you may have salvaged the situation. If it's fruitless, you probably haven't changed the situation much. I would also communicate a clear deadline, send mail certified, and proceed as appropriate when the deadline arrived.

I would also agree with Don's other point. The statement you have may have been put together quickly or by office staff. Not every medical professional understands or wants to understand FMLA. To many it's extra paperwork for which they may not be able to get a fee. The IME situation would be similar, and nothing in your post suggests attemps to abuse FMLA or co. policy. You may just be on the understanding side of an equation where no one else in the formula understands what you're trying to do or what you need. Unless you have a personal issue with this employee, give a little benefit of the doubt just in case. It's safer for your employer in the long run.