FMLA Medical Certification and Certification Forms

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If a worker or their immediate family member has a serious medical condition, the Family and Medical Leave Act (FMLA), passed into law in 1993, allows for that employee to take up to 12 weeks of unpaid time off from work. Qualified workers can also take off for reasons related to an immediate family member’s military service.

A private business falls under the FMLA is it employs over 50 employees who all live inside of 75 miles of the main worksite. A worker is entitled to FMLA leave if they have been employed by their company for a minimum of one year and have worked more than 1,250 hours in the past year, neither of which need be consecutive. All public employers are covered under the FMLA.

Asking for FMLA Medical Certification

The law permits organizations to ask for an FMLA medical certification to support a worker’s necessity for leave within five business days after the initial request – or following the start of an unforeseen leave. Workers must typically supply this validation within 15 days unless the company gives the worker longer.

The worker seeking FMLA leave has the responsibility to make sure the medical certification is provided by a doctor in a timely manner and follow up with the doctor if it is not. However, organizations must allow more time for workers who are unable to offer the validation within 15 days due to unusual circumstances and despite the worker's good-faith attempts. It is the worker's responsibility to keep the company apprised of his or her attempts to obtain the necessary validation.

Whether or not the worker has made thorough, good-faith attempts to submit a timely validation is based on the circumstances, including the worker's attempts to schedule medical appointments. Because acquiring the medical validation is dependent upon medical workers, and family members, the commentary to the FMLA laws cautions organizations not to penalize workers for situations outside their control.

Under the law, a company may require a medical doctor to give for proof that a condition is covered by the FMLA. The Department of Labor (DOL) has created two new optional FMLA medical certification forms for this purpose: one for validation by the worker's own medical doctor and a different for validation by the medical doctor of the worker's family member in need of care.

Organizations may use an FMLA medical certification form of their own, but organizations may not require any further information beyond what is specified in the FMLA rules. It is important that the information on the validation relates only to the significant health problem that requires FMLA leave.

However, companies and organizations can seek further data for issues not related to FMLA, such as workers' benefits or paid disability. While an organization may deny these types of benefits in certain situations, the denial must not affect the worker's right to take FMLA leave.

Clarifying a Medical Certification

An FMLA medical certification form is incomplete or invalid if the is a lack of essential medical information, or if the medical details supplied are vague or ambiguous.
The company must tell a worker whenever it finds an FMLA medical certification letter to be incomplete or insufficient and must provide documentation on what other data must be supplied. The company must offer the worker a minimum of one calendar week to fix any problems. As before, the worker must be allowed further time if they cannot get the appropriate validation, despite numerous good-faith attempts.

If a worker offers only an incomplete medical certification – or none at all – the company may deny the leave. At the time, the validation is requested; organizations must inform workers what might happen if they fail to supply the completed FMLA medical certification form.

Contacting a Medical Doctor Regarding FMLA Medical Certification

Subject to certain limitations, organizations can make contact with the medical doctor who sent in the FMLA medical certification letter, for purposes of validation and clarification, after the worker has been given the chance to fix any deficiencies.

Organizations can make direct contact with the medical doctor only if they have a question about a certification’s validity or to clarify any relevant information, such as the length of leave medically required. If the company does not use its own medical doctor or a human resources worker to make contact, it may not have the worker's direct supervisor who makes contact.

To protect the worker's privacy, the company must follow the rules of the Health Insurance Portability and Accountability Act (HIPAA) when an HIPAA-covered medical doctor shares a worker's individually-identifiable health details. If the worker refuses to offer the company with the consent allowing it to obtain medical certification and does not otherwise simplify the validation, the company may deny the leave.

When the procedures are followed, a company may acquire validation by offering a copy of the medical certification form to the medical doctor and seeking verification that it was, in fact, filled out or authorized by that particular medical doctor. A company may contact the validating medical doctor about any handwriting issues or other potential miscommunications on the FMLA leave form. In either case, a company may not ask for further medical knowledge beyond what is required for FMLA, unless getting that knowledge is for other reasons, such as disability benefits.

A company, which questions the credibility of a medical certification, may pay for the worker to get a second opinion. The company may specify the medical doctor for this second opinion, with the exception that the medical doctor doesn't regularly work for the company. If the second opinion conflicts with the first, the company may require a third and final opinion from a medical doctor jointly chosen by the company and worker, again at the company’s expense.

When the worker's need for leave due to a substantial health condition lasts more than a single leave year, the company may require the worker to offer a new medical validation for each following leave year.

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