What Health Conditions Are Covered Under the FMLA?

The Family and Medical Leave Act (FMLA) provides eligible employees with the right to take time off work to recuperate from a serious health condition or to look after a member of his/her family who is suffering from a serious health condition.

The FMLA uses the word “serious” so that those with minor ailments are not encouraged to apply for leave. Of course, there are situations where what begins as a minor health issues turns more serious unexpectedly. For example, a cold can sometimes develop into pneumonia or a pregnancy could involve a serious, debilitating infection that requires a longer stay in hospital.

The FMLA applies to employees in certain situations, depending on whether the employer is covered. A covered employer is one of the following:

• a private-sector employer who employs 50 or more workers for twenty or more weeks in the current or preceding year,
• a public agency which includes state, federal and local agencies with any number of workers.

A worker eligible for leave is someone who is employed by a covered employer and

• has worked for this employer for no less than twelve months;
• has accumulated at least 1,250 hours of service for that employer in the twelve month period prior to taking the leave;
• is employed at a location where the employer employs at least 50 employees within 75 miles.

What Health Conditions Are Covered Under the FMLA

The health conditions covered typically involve the worker being incapacitated in some way. This normally means unable to undertake daily activities including going to work.

Under the FMLA health conditions which qualify include:

• cancer;
• Alzheimer’s;
• epilepsy.
• diabetes;
• depression;
• anxiety.

To qualify for any of the conditions above the condition must be ongoing for a long period and must need frequent trips to a medical facility for treatment. Examples of this include an absence of 3 days or more for treatment of kidney disease or chemotherapy for cancer or restorative surgery required as the outcome of an accident.

Employees may also qualify if they need to take time off work for several treatments and the condition is expected to last for more than three days so requires continuing treatment which means two treatments needed within thirty days of the first day of incapacity.

The first treatment is expected to be administered in the 1st week and the condition isn’t expected to last that long including a bad bout of the flu, pneumonia, chicken pox or an infection where a course of antibiotics is required. Pregnancy that involves morning sickness qualifies under the FMLA leave categories too, as does time required to stay in bed to rest before the pregnancy takes place.

What Conditions Are Not Covered By the FMLA?

The FMLA regulations do not cover the following conditions, unless there is a need to be admitted to hospital or complications develop which require treatment:

• cosmetic treatments;
• the common cold;
• a bout of flu unless complications occur and a stay in hospital is required;
• an ear ache;
• an upset stomach;
• minor ulcers that don’t require a course of antibiotics;
• headaches but not migraine,
• routine dental or orthodontic problems or dental treatment related to
• periodontal disease.

Even the above health conditions are not excluded automatically from coverage. For example, if an employee has an upset stomach but it is not caused by consuming food contaminated with salmonella or other undesirable bacteria but turns out to be caused by colon cancer or Crohn’s disease, then the employee should be eligible through FMLA rules.

How to Determine if a Medical Condition is Qualified by the FMLA

The employer cannot make the decision whether a medical condition is protected by the FMLA but the employee needs to get a medical certification which is a form completed by both the employee and his/her physician. The physician can judge whether the employee meets the terms set out in the FMLA. However, situations do change and an employee could find a decision is made that disallows him/her from eligibility as ruled by the FMLA. If this happens, the matter should be taken up with a lawyer.

When You May Need a Lawyer

Because what the FMLA defines as serious isn’t clear, you could get your leave denied which could have a serious effect on your employment prospects if you are unable to work. It is important to talk to a lawyer who can appeal any decision made regarding your eligibility as determined by the FMLA.