FMLA for Partial Hospital Patients

Posted on 03. Dec, 2009 by Liz in Return to Work

PHP leads in Creating a Healthy Workforce

The Family and Medical Leave Act (FMLA) was enacted in 1993 and offers employees up to 12 weeks of excused absence from their jobs every year. It was enacted to aid employees in balancing work and personal obligations, without having to choose between the two in times of crisis.

In Partial Hospital, a majority of our patients are working adults. We often get referrals from Employee Assistance Programs (EAPs), but sometimes we have patients admit to Partial without having talked to their employer. At intake, Partial Hospital will often ask about employment and resulting absences if admitted. Patients often fear disclosing their mental health care to an employer. However, providing good care means good case management. In Partial we know that employment contributes to wellness. Loss of employment due to ‘job abandonment’ would contribute to significant psychosocial stress.

What Your Working Patient Needs to Know about FMLA

Employees qualify for FMLA leave when they suffer from a “serious health condition.” The condition must either prevent the worker from performing his or her job. Admission into a Partial Hospital Program precludes the patient/employee from attending and performing his or her job.

Working Partial Hospital patients can use FMLA for:

Chronic mental health conditions,
Long-term conditions – difficulty in stabilizing a mental health condition,
Hospitalization (which Partial is a form of), or
A condition that requires ongoing (intermittent) treatment – like aftercare psychotherapy or psychiatric appointments.

FMLA has many restrictions. Employees must have worked at their company for more than 12 months. They also must have worked at least 1,250 hours during the previous year.

Smaller employers are not required to provide FMLA leave to their employees. If a company employs fewer than 50 people within 75 miles of the employee’s worksite, the employee does not qualify for FMLA leave. This regulation was enacted to accommodate employers — small companies would find it more difficult to send a replacement far away if a needed employee were to take leave.

The leave that FMLA regulations guarantee is unpaid. It is up to the employer to provide benefits and pay while an employee takes medical leave (example: short-term or long-term disability).

There are three different kinds of FMLA leave:

Continuous FMLA leave: An employee is absent for more than three consecutive business days and has been treated by a doctor.
Intermittent FMLA leave: An employee is taking time off in separate blocks due to a serious health condition that qualifies for FMLA. Intermittent leave can be in hourly, daily, or weekly increments.
Reduced schedule FMLA leave: An employee needs to reduce the amount of hours they work per day or per week, often to care for a family member or to reduce stress.

When they return from leave, FMLA guidelines require that companies return employees to their former position, assuming they are able to perform the essential functions of that position.

Successful Return-to-Work

Based upon the research of Dr. Dan Bilsker at the Consortium for Organizational Mental Healthcare, a successful Return-to-Work is ‘graduated’. In an effort to minimize the Partial Hospital patient’s potential for relapse, it is recommended that a recovery week from Partial should be considered. This recovery week can focus on initial aftercare appointments or groups and transitioning coping skills training from the hospital to daily living (A Return-to-Work Skills Workbook). Often, we recommend the first week back to work be a reduced schedule week with a return to full-time duty usually following. This extended graduated return-to-work is contraindicated for Partial patients that exhibit work avoidant behaviors.

The FMLA Medical Certification Form

The employee’s healthcare provider must complete a certification form in order to ensure the validity of the employee’s serious health condition. The employee must return the certification within 15 calendar days of receiving the form. Partial Hospital can expedite this process by making this form available early on in treatment.

Each company has it’s own version of the standard government form. But this links to the U.S. Department of Labor’s form: http://www.dol.gov/regs/compliance/whd/fmla/wh380.pdf

Be sure to estimate tentative recovery or reduced schedule time needed by the Partial patient.