Extreme stress "at this moment"

Not sure if this should be posted under ADA or FMLA, but I'll start here.
Employee presented us with a letter from a counseling center stating that he "has depressive and panic symptoms related to a current personal situations". It goes on to read, "because of the extreme stress is his facing at this moment...he should be excused for the past five days....", and that "he is not able to do the activities he used to do before, and I would like you to discuss w/him alternatives that may help him regarding his job during this time."

It does not say he cannot work, and it refers, as you can see, to a "current" personal situation causing this.

Where would you start with this??

Comments

  • 23 Comments sorted by Votes Date Added
  • Sounds pretty vague.

    What we have done, in the past, is provide the physician with the employees position description so it can be determined if he is able to do the "activities" he used to do before, or what limitations should be set forth and for what length of time.

    The word "activities" as used in the letter from the counselor seems a little off as does "alternatives to help him regarding his job during this time".

    I recommend checking the validity of the letter from the counseling center since it says "excuse for the PAST five days". Physicians usually do not BACK DATE return to work notices. And while you are checking on that, maybe you can fax his position description.....

    Just a thought.
  • That was one of my thoughts, to go that route. I will be sending FMLA and disability letters, and they will be stated to reference, "IF you are in need of a leave...". Just to show the ol' good faith effort on our part.
    The past five days the counselor is referring to have not been entirely consecutive, either. On two occasions he was here a couple hours, then left. So would this qualify for the MORE THAN three-calendar day rule under FMLA if there were a couple days he came in briefly? I know it's supposed to be more than three consecutive calendar days, but is this splitting hairs, so to speak? And yes, we are concerned about this being addressed after-the-fact as well.

  • I now have the CHP in my hands. And, the time off is being back dated by the LCSW to 3/5/04 and I was not made aware of this missed time until 3/17.
    Do I have to honor all of this time as FMLA? If I don't, when can/should I make FMLA effective in this situation?


  • I think you will probably find that the employee of the counseling center who authored that letter does not meet the federal definition of 'health care provider'. I would look at this from the angle that the 'counselor' is not a person "authorized to practice in the state....one who is authorized to diagnose and treat physical or mental health conditions without the supervision of a doctor or other health care provider." (29 CRR 825.118)

    Two reasons: (1) No medical practitioner, including a licensed marriage and family therapist or a psychologist would write you that note. (2) the wording itself reveals that it was written by an unlicensed counselor aide, trainee or clinician without proper credentials or education.

    I have found that many state and local counseling centers, particularly pro-rata-pay facilities, utilize non-graduates, people in pursuit of a degree, former program completers and others. Most of them are not recognized as having any particular level of expertise and certainly no credentialing.

    In any event, I would not honor the 'letter'. If you would like, you can give the individual the proper FMLA paperwork and tell him/her that it requires the attention of a medical practitioner, not a group home counselor or treatment center assessment personnel.

    Note: The preceeding is my personal opinion and has no value beyond that. Although it may be 'sorta offensive' or 'indeed offensive' to someone out there, it is offered without regard to that possibility. Should you find yourself alarmed by my post, you may privately mail me to protest or you may alert the principal's office. x:-)
  • Thank you! It's a good feeling to have my "gut feelings" affirmed by colleagues.
    There is a recent update - one of his supervisors just told me he is a no show today, and when he called the employee at home, he said he wouldn't be in until Monday (coincidence that his direct manager is out of town until then???)
    So - plan of action is send out the DOL's CHP form, and I'm also toying with the idea of taking the "reasonable accommodation" route by sending this counselor a job description to clarify what accommodations are recommended, if any.

    Would you do the same in this scenario?
  • Does anyone know what a "LCSW" is? That is the acronym after the signature on this letter from the counseling center.
  • Licensed Clinical Social Worker

    Brad Forrister
    Director of Publishing
    M. Lee Smith Publishers


  • and does that qualify for FMLA documentation purposes?
  • [font size="1" color="#FF0000"]LAST EDITED ON 03-18-04 AT 12:27PM (CST)[/font][br][br]it could, depending on what their license in your state allows them to do.

    From the FMLA regulation 29CFR825.118

    "A health care provider includes....Nurse practitioners, nurse-midwives and clinical social workers who are authorized to practice under State law and who are performing within the scope of their practice as defined under State law."

    If they can diagnose the psychiatric condition and/or treat it, then for your purposes the LCSW's "sign-off" would be sufficient if all the other requirements to establish a "serious heatlh condition" are met.
  • A part of 29CFR825.118 that we might be overlooking is (b)(5)(c) "...authorized to practice in the State as used in this section means that the provider must be authorized to diagnose and treat physical or mental health conditions without supervision by a doctor or other health care provider." If I'm not mistaken, in this state, the LCSW would not meet that last part of the definition since they provide counseling and support services under the oversight and clinical direction of a psychiatrist, psychologist or physician. I think you'll find they aren't diagnosing and treating with independant authority, but I could be wrong. LCSWs are a dime a dozen in this state. It basically requires a masters degree in counseling with a few required core courses. These are not 'health care providers' as contemplated by the Act in my opinion. State agencies are full of them as are nursing homes, private counseling centers, for-profit group homes for misbehaving kids, orphanages and some head start centers have them on staff. I would explore further before accepting and acting on this document from the LCSW.

    Note: The preceeding is my personal opinion and has no value beyond that. Although it may be 'sorta offensive' or 'indeed offensive' to someone out there, it is offered without regard to that possibility. Should you find yourself alarmed by my post, you may privately mail me to protest or you may alert the principal's office. x:-)
  • This employee is in Illinois.
  • [font size="1" color="#FF0000"]LAST EDITED ON 03-18-04 AT 12:54PM (CST)[/font][br][br]Ditto Hatchetman. Check with your state Counselor/Social Worker Licensure Board. The alphabet soup varies from state to state. Easier yet, call your local Mental Health Clinic or Board for clarification.


  • Do you have any particular questions you would suggest they be asked?


  • [font size="1" color="#FF0000"]LAST EDITED ON 03-18-04 AT 03:43PM (CST)[/font][br][br]Probably something right out of your post, or similar. ."could you tell me in this state is a LCSW able to INDEPENDENTLY diagnosis and treat.. ?" As I recall (and you know it's been a while and it was Ohio).. that was the key. .and as also as you noted, that you did not have to have your Clinical work signed off on by a Doc or more "highly" licensed clinican. Hope that helps?
  • I have done research on this "LCSW" issue, in terms of whether or not it is legit for FMLA purposes (that is who signed the CHP).
    All of the info I found for Ilinois is about as clear as mud.
    Would anyone out there have any background on this?
  • You need to contact the State licensing board for clinical social workers and ask the question about whether the license allows them to diagnose or treat psychiatric illness (either independently or under a physician/psychiatric's review).


  • [url]http://www.dpr.state.il.us/apply/sw.asp[/url]

    Try this web page for phone #'s and information.

    This seems to have gone on a while. I agree with Don, that it is poorly written. At this point maybe it would be easier to just to do as Don and sw suggest above?
  • Social Work Examining And Disciplinary Board
    Dept. Of Professional Regulation
    320 West Washington Street, 3rd Floor
    Springfield, IL 62786
    217-785-0800


    I posted earlier, but it seems to have gotten lost in cyber space. This information is more specific
  • I now have the CHP in my hands. And, the time off is being back dated by the LCSW to 3/5/04 and I was not made aware of this missed time until 3/17.
    Do I have to honor all of this time as FMLA? If I don't, when can/should I make FMLA effective in this situation? This is in response to an earlier comment made about not 'retroactively' designating the time as FML.


  • IF, and that's a large IF, you have decided that you will accept the authority of a LCSW to fill out and sign the certification, independent of medical oversight, I would suggest that it will not be wise to split hairs over when the leave began and which dates it included.





  • I agree with Don.

    Also, I think in this case, IF you decide to accept the LCSW's statement as meeting the requirements under FMLA as a health care provider (based upon your state's clicnial social work regulations), you should and would consider the FMLA to be from the first day of leave. I'm assuming everyone acted timely. You don't explain what you mean that you recieved notice on March 17. When did the emplyee notify the supervisor that leave was needed?

    While the employee has 15 days to get the verfication in from the health care provider, that is a minimal time set by the law. Your policy or practice can provide for more time.

    It would be best to start the FMLA from the first day of leave, IF you are accepting the LCSW's certification, since you KNOW those days are used now. You would either put those days on the front end, from March 5 through March 24 or on the back end of the leave as counting toward the 12 weeks. Since your appears not to have delayed in meeting its requirements under FMLA and under the "Ragsdale v. Wolverine" decision an employee is not legally entitled to more than 12 weeks FMLA in a "benefit year" even if the employer fails to timely notify the employee that it will be counted as FMLA, you should just run the FMLA from March 5 and advise the employee as such along with the expiry date of the FMLA leave and what the employee needs to do at that point.
  • Thanks for the great feedback - I will be designating it retro to his first day out. The LCSW stated he'd only need to be out until April 12th, so it will be interesting to see what happens.
    I placed a call w/the state two days ago to find out about the LCSW signing off on the CHP, but oddly enough, nobody has returned my call.



  • As an aside, independent of this particular situation, for the future.....you are certainly at liberty to call the LCSW and ask him/her to advise you as to their level of authority. Not to sign off on paperwork, but to diagnose and treat independent of a medical doctor. Ask him/her to educate you so you won't have this dilemma in the future. If they get up in your face over it, they're not authorized.




    Note: The preceeding is my personal opinion and has no value beyond that. Although it may be 'sorta offensive' or 'indeed offensive' to someone out there, it is offered without regard to that possibility. Should you find yourself alarmed by my post, you may privately mail me to protest or you may alert the principal's office. x:-)
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