Elective Surgery Request for June

kmaries · January 2004

Hello all -

I have an employee that notified her supervisor today that she has a surgery that she is going to have in June. She will be off June, July, and August.

I work for a Healthcare Organization so we have many outlying clinics throughout different counties, so she works in a clinic of only 5 employees.

This employee has taken FMLA leave for the same purpose for the last three years over the months of June, July, and August. The staff at this clinic have been very upset in the past because one employee out for the summer means hardly to no vacation requests for any of them. So her clinic manager is already dreading that she has another summer request off.

Is there anything we can do? I know she will get all the certification she will need, but can we ask her to have surgery at a different date? August vs. June so that others may keep their vacations?

Any thoughts from anyone? I know I am shooting in the dark, but I thought I would check before disappointing the clinic manager.

Thanks
Kris

Rockie · January 2004

You need to find out if this "elective" surgery qualifies for FMLA. It seems mighty suspicious that this keeps occurring every year. Is this the same surgery? Three months seems like a long time to be out for "elective" surgery.

At the very least, I would call this to the attention of the employee and if it is truly elective, there is no reason she could not either (1) choose to have it earlier or (2) choose to have it later so the rest of the staff could have their vacation time.

I can't find anything in the law that would preclude you from asking employee to schedule elective surgery at a more convenient time for staffing purposes.

Sounds to me like this person has purposely scheduled herself out of the office during the months that kids are out of school.

marc · January 2004

This is an interesting scenario.

FML requires a 30 day notice which you are obviosuly getting, however the ER can require the EE to make every effort to schedule medical appointments, treatments, etc, so that the EE impacts the company as little as possible.

In cases where your company has legitimate business needs that will be negatively impacted by taking leave, the company has the right to require the EE to reschedule the tratments, with the health care providers blessing.

So you can require the health care provider to make a call about the timing of this procedure. If it can be delayed or accelerated without danger to the EE, then you can require the date changes, if the operational interruptions and inconvenience for scheduling can rise to the level of business necessity. I think you can make a case.

Ruskanen · February 2004

An employee has an elective surgery once a year? Do you even know what the surgery is? It should be listed on the certification for health care provider form. I was under the impression that elective surgery, if not medically beneficial, was generally not approved under FMLA (i.e. breast augmentation). I am curious to know what kind of surgery is required once a year, and requires 3 months recovery.

kmaries · February 2004

[font size="1" color="#FF0000"]LAST EDITED ON 02-04-04 AT 02:26PM (CST)[/font][br][br]This employee has had surgery on her shoulder for the last 4 years. Each year she elects to schedule her surgery over June, July and August. The surgery is not cosmetic, but it isn't something she must have immediately either. Her physician told her at the end of December that she may need another procedure done. She has decided she will take the full 12 weeks over those three months.

I don't know why she continues to need surgery. There are other issues with her leaves too - Small clinic and small town, so her co-workers are always calling me with stories of what she allegedly says or does.

I am suspicious of her and do believe that she may be abusing the Act.

Ruskanen · February 2004

Could you exercise your right to request a second or third opinion, at your expense? I don't know anything about her condition, but I wonder if she could return to work earlier than the 12 weeks if she is able to perform all the essential functions of her job.

kmaries · February 2004

I have not ever requested a second opinion in the past. More so because we are a health care organization and when I ask for a second opinion it looks as though I do not trust the judgement of our own physicians. So it can get sticky and believe me, the physician will complain to the Med Directors that he is being second guessed. However, I do believe that I can get the backing to do so given the situation.

Ruskanen · February 2004

I have never had to request a second opinion either, but if you suspect the policy is being abused it would be a good reason to do it. A third opinion might also influence when the procedure is done...saying that it was not medically necessary to do until September. It seems it would cause a conflict of interest when the doctor is serving a patient and they share the same employer, but I don't think there is anything you can do to prevent that. Let us know how it turns out.

Beave · February 2004

I agree with Ruskanen. A second opinion, even if it affirms the need for surgery, tells the employee your on to her and you are aware of the situation. Sounds as though she has found a convient way to spend the summer at the lake or home with the kids. Can you explore getting a temp during her time off?

SMace · February 2004

Huh? Is your employee seeing a physician of the clinic she works for?

kmaries · February 2004

She may be. I have not seen the paperwork yet or even had a conversation with her about the leave yet. I work for a Healthcare Organization of 3000 employees which includes an HMO, corporate office, and many, many clinics and hospitals throughout many counties. In addition, we oversee the operation of a second organization which has 1000 employees. "Our" HMO includes our own doctors so she very well may see either a doctor at her own clinic or one that is employed by us unless she carries insurance through her spouse.

Whew!!!

SMace · February 2004

I see. I don't care if the physician works for you or not, I would second guess him/her. If he/she complains, explain to them why they are shooting you in the foot. That should shut them up.

Elective Surgery Request for June

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