FMLA Funny Business

Rockie

Have a suspected abuser of intermittent FMLA (imagine that!).

This individual states she has an incapacitated child and had properly completed paperwork. Stated that the child was not incapacitated at time time but may need assistance from time to time. That was all well and good.

Then things started changing. The stories got weirder and weirder! Supposedly, this child now is homebound and cannot go to school. She supposedly has a niece taking care of the child during the day. Also, she stated to supervisor that the child was burning up with fever and the physician made a house call to the child because he did not want him to go out in the night air. Bear in mind that this physician had to travel from an adjoining city (about 45 minutes to an hour away to make this house call). Because it appeared that the circumstances had changed regarding the medical condition of the child, I asked for a recertification. I gave the paperwork to the employee one morning and had it back in my hands by the afternoon. This had to be the record for recertification. The recert did not mention the child was housebound...but stated "not incapacitated at this time".

We suspect that this employee has a friend in the doctor's office who is doing the certification for her and also any doctor's excuses she may need. She has started over the past few months a Monday-Friday pattern of calling off work, either for her own illness or her son's illness.

How would you guys go about getting adequate information about the status of the son and assessing whether this paperwork is valid or not?

joannie

You could have your company doctor call her doctor to verify. Or you could arrange for a second opinion at your cost.

stilldazed

I think I'd exercise the employer opportunity for second opinion, and I would address the absence pattern with the worker. FMLA is FMLA, and attendance and absence patterns are potential disciplinary moves. There is nothing wrong with asking the worker to substantiate the need to be off on days that are adjacent to weekends. Also, if the need is intermittent and foreseeable, you may certainly ask and expect the worker to plan the absences in a manner that works for your company, if there is such.

You might invite the worker to sign a HIPAA-compliant authorization to allow contact with her child's physician and see if she will. If she signs and agrees to your (or your physician's) contact, try to verify validity through that means.

I'm interested in what other posters might have to say and curious about what you ultimately do.

best wishes

cnghr

[font size="1" color="#FF0000"]LAST EDITED ON 02-29-08 AT 11:12AM (CST)[/font][br][br]I'm wondering about the "house call" story....where in this day and age can you find a doctor who actually makes house calls, much less drives for 45 minutes to an hour to do so?! Fever or not, I can't imagine any doctor saying that they didn't want the child "out in the night air". The idea that somehow the "night air" between the house and the car could make an illness worse is extremely old-fashioned at best and just plain ridiculous at worst.

Given that the last thing you got from the doctor said "not incapcitated at this time" I would definitely be trying to get further information from them. We have a HIPAA-compliant "authorization to release information" section built into our FMLA Physician's Certification form, and in the past we have contacted the employee's doctor when we felt there was a possible abuse of FMLA occuring. The doctor answered all our questions and we were satisfied that the need was legitimate.

SMace

It is my understanding that you may not contact an EE's doctor. That is an FMLA rule not a HIPAA rule. I do not believe your HIPAA release would override the FMLA requirement. I'm not a lawyer, though.

cnghr

When we contacted the employee's doctor, it was on the advice of our attorney and using a letter he drafted for us.

FunHRBanker

With written permission from the ee, you can contact the doctor, but it's definitely a grey area. I agree with the other posters. Couldn't you deny the leave most recently requested since the doctor verified that the child was not incapacitated at the time?

Nothing new, but it's the people who abuse the system (and we all have at least one of those) that ruin it for everyone else.

NaeNae55

The new proposed DOL regulations (federal register issued 2/11) specifically allow employers to contact providers for clarification as long as they have a release and you comply with HIPAA. I would think that as long as you have the employee's permission, you could contact the provider and layout your situation and then ask for clarification of the certification. You are not trying to get the scoop on the employee's personal information, just making sure they, and you, understand their limits and need for FMLA.

Good luck!

Nae

stilldazed

We actually have a physician and 2 PAs on our staff who are expected to make housecalls on our campus if called.

FunHRBanker

I hope those proposed regs go through! I'm tired of being in the dark on some of these things.

Nevada HR

Would anyone care to share their release forms? [email]tbostwick@pahrumpnv.org[/email]
I really appreciate it!!

Terry