You might become responsible for any related work comp issues, you might be held liable if the employee was not well enough and causes harm to a third party, AND you set a precedent so you will have to do so in the future no matter how ill the employee might seem.
As always, Nae said it very well. My biggest concern with allowing employees back prior to being medically released is one of liability. The last thing you want is some employee saying "I felt pressured to return to work even though I was on FMLA, so I came back before my doctor released to me. And that made my condition so much worse!" Now all the sudden you're responsible for a whole host of potential issues.
We require fitness for duty notes from physicians any time an employee has had 5 consecutive days of illness, and we are even thinking of cutting that time frame down!
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We require fitness for duty notes from physicians any time an employee has had 5 consecutive days of illness, and we are even thinking of cutting that time frame down!