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FMLA Training

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Title: FMLA Training


1
FMLA Training Part IV presented by The Office of
the State Employer Employee Health
Management Toni McFarland Contract
Negotiations/Administration Cheryl Schmittdiel
2
  • The State of Michigan (SOM) must observe employee
    rights under the FMLA
  • The State of Michigan must observe employee
    rights under an applicable collective bargaining
    agreement (CBA) or Civil Service Rules and
    Regulations (CSRR)
  • The State of Michigan cannot interpret CBA or
    CSRR to diminish rights guaranteed by the FMLA.

3
FMLA BasicsEligibility, Qualifying Reasons
Entitlements
4
Employee Eligibility Qualifying Reason FMLA
Entitlement
5
Employee Eligibility
6
Employee Eligibility
  • To be eligible for FMLA leave an employee must
  • Work for a covered employer and
  • Work for the covered employer for 12 months,
    which need not be consecutive months and
  • Actually work at least 1,250 hours within the 12
    months immediately prior to the FMLA leave.
  • Paid leave hours do not count however,
  • Military leave hours do count toward 1,250 hours
    as time worked.

7
  • For leave to be designated as FMLA leave, an
    eligible employee need not mention the FMLA
    specifically when requesting leave, the employee
    must simply give an FMLA qualifying reason for
    the leave.

8
Qualifying Reasons
9
Qualifying Reasons
  • The SOM, as a covered employer, must grant an
    eligible employee up to 12 workweeks of
    job-protected FMLA leave within a 12-month period
    for the following reasons
  • the birth of an employees son or daughter, and
    to care for the newborn
  • the placement with an employee of a son or
    daughter for adoption or foster care, and to care
    for the newly placed child
  • to care for an employees spouse, son, daughter,
    or parent with a Serious Health Condition (SHC)
    and
  • because the employee's own SHC makes the employee
    unable to perform the essential functions of
    their position.

10
Spouse
  • Husband or wife, as defined or recognized under
    State law for purposes of marriage in the State
    where the employee resides.
  • Common law marriage qualifies in states where it
    is recognized it is not recognized in Michigan.
    Note We have employees who reside in other
    states.

11
Parent
  • A biological parent or a person who stands or
    stood in loco parentis to an employee when the
    employee was under 18.
  • In loco parentis means in the place of a
    parent.
  • Parent does not include parents-in-law.

12
Son or Daughter
  • Son or daughter includes a biological child,
    adopted child, foster child, stepchild, legal
    ward, or a child of a person standing in loco
    parentis.
  • The son or daughter must be
  • under 18, or
  • 18 or older and incapable of self-care because
    of a physical or mental disability.

13
Incapable of Self-care
  • An employees son or daughter is incapable of
    self-care if the child requires active
    assistance or supervision to provide daily
    self-care in 3 or more activities of daily living
    (ADL) or instrumental activities of daily living
    (IADL)
  • ADL include bathing, dressing, and eating
  • IADL include cooking, cleaning, shopping,
    transportation, etc.

14
Physical or Mental Disability
  • An employees son or daughter has a physical or
    mental disability if the child has a physical or
    mental impairment that substantially limits 1 or
    more of the childs major life activities.
  • See the Americans with Disabilities Act (ADA) for
    definitions of these terms
  • physical or mental disability
  • substantially limits
  • major life activities

15
Serious Health Condition
  • A SHC is any illness, injury, impairment, or
  • physical or mental condition that involves
    either
  • Inpatient care (i.e., overnight stay) or
  • Continuing treatment.
  • See Section 825.114.

16
Continuing Treatment
  • 1. Incapacity of more than 3 consecutive calendar
    days with either
  • treatment 2 or more times by a Health Care
    Provider (HCP), or
  • 1 time with a regimen of continuing treatment
    under the HCP supervision
  • Note If this is the reason for FMLA leave, then
    FMLA would also cover any subsequent incapacity
    or treatment relating to the same condition.

17
Continuing Treatmentcont.
  • 2. Any incapacity due to pregnancy or for
    prenatal care
  • Note Need not be 3 consecutive days and need not
    receive treatment during the absence (unless the
    reason for the absence is prenatal care) but must
    be incapacitated.

18
Continuing Treatmentcont.
  • 3. Any incapacity or treatment due to a chronic
    SHC
  • requires periodic visits for treatment by HCP or
    under the supervision of HCP and
  • may cause episodic periods of incapacity,
    examples include asthma, diabetes, epilepsy, etc.
    and
  • continues over an extended period of time,
    including recurring episodes of a single
    underlying condition
  • Note Need not be 3 consecutive days and need not
    receive treatment during the absence but must be
    incapacitated.

19
Continuing Treatmentcont.
  • Permanent or long-term incapacity due to a
    condition for which treatment may not be
    effective
  • must be under continuing supervision of HCP but
    need not be receiving active treatment
  • examples include Alzheimers, a severe stroke, or
    the terminal stages of cancer.

20
Continuing Treatmentcont.
  • Any period of absence to receive multiple
    treatments for, including any period of recovery
    from, either
  • restorative surgery after an accident or injury
    or
  • a condition likely to result in incapacity of
    more than 3 consecutive calendar days in absence
    of medical intervention or treatment examples
    include chemotherapy for cancer, physical therapy
    for severe arthritis, or dialysis for kidney
    disease.

21
Incapacity
  • Incapacity is the inability, due to the SHC,
  • treatment for the SHC, or recovery from the
  • SHC, to
  • Work,
  • Attend school, or
  • Perform other regular daily activities

22
FMLA Entitlements
23
FMLA Entitlements
  • An eligible employee with a qualifying reason is
    entitled to
  • Up to a total of 12 work-weeks of job-protected
    FMLA leave in a 12 month period (unpaid/paid)
    and
  • Benefits protection during the FMLA leave and
  • Job restoration upon return from FMLA leave.

24
FMLA Leave
25
Up to a Total of 12 Workweeks
  • Only the amount of FMLA leave actually taken may
    be counted towards the 12 workweeks.
  • The 12 workweeks are based on the employees
    normal workweek.
  • DCDS records time in hours, not workweeks.
  • For purposes of recording time in DCDS, the
    workweek is converted to hours.

26
Up to a Total of 12 Workweeks
  • 12 workweeks is always 12 workweeks
  • An eligible full-time employee is entitled to up
    to a total of 480 hours of FMLA leave for
    qualifying reasons and every full day of FMLA
    leave used is recorded as 8 hours.
  • An eligible part-time employee who works 4-hour
    days, 5 days a week is entitled to up to a total
    of 240 hours of FMLA leave for qualifying reasons
    and every full day of FMLA leave used is recorded
    as 4 hours.
  • An eligible permanent-intermittent employee who
    works varying hours each workweek is entitled to
    the weekly average of hours worked over the 12
    weeks prior to the beginning of the FMLA leave
    times 12 workweeks.
  • See Section 825.205.

27
Limitations
  • FMLA leave to care for an employees newborn
    child or a newly placed child must conclude
    within 12 months after the birth or placement.
    See Section 825.201.
  • Under the FMLA ,spouses employed by the same
    employer may be limited to a combined total of 12
    workweeks of family leave for
  • birth or care of a newborn son or daughter or
  • placement with an employee of a son or daughter
    for adoption or foster care, and care for the
    newly placed child.
  • If limited, each spouse is entitled to the
    difference between the amount taken individually
    and 12 workweeks within the 12-month period for
    other FMLA qualifying events.
  • Note Consult the employees CBA, it may alter
    this limitation.

28
Employer Substitution of Paid Leave
  • Under the FMLA, an eligible employee is entitled
    to up to a total of 12 workweeks of unpaid FMLA
    leave in a 12-month period for qualifying
    reasons.
  • The employer may require accrued paid sick leave
    be substituted for the unpaid leave if the reason
    for the leave is the employees own SHC or the
    SHC of the employees spouse, son, daughter, or
    parent. (See Section 825.207).
  • If requiring accrued sick leave to be substituted
    for unpaid FMLA leave, the employer must provide
    notice within 2 business days following the
    employees request for leave, or when sufficient
    information is obtained to determine that the
    leave qualifies as FMLA leave.

29
Employee Substitution of Paid Leave
  • If the employer requires substitution of accrued
    paid sick leave for unpaid FMLA leave for a SHC,
    the employee may choose to substitute accrued
    paid annual leave or personal leave instead.
  • If the employer does not require substitution of
    paid sick leave for a SHC, the employee may
    choose to substitute sick leave for the unpaid
    FMLA leave.
  • If the reason for the FMLA leave is other than
    the employees own SHC or the SHC of the
    employees spouse, son, daughter, or parent, the
    employee may choose to substitute accrued paid
    annual leave or personal leave for the unpaid
    FMLA leave.

30
Employee Substitution of Paid Leave cont.
  • Some CBAs permit an employee to certify the need
    to use up to 2 weeks of sick leave, upon the
    birth of their child, prior to the beginning of
    any parental leave.
  • The 2 weeks of sick leave are deemed to be due to
    the SHC of the employees spouse or newborn
    child however, no CS-1789 is required for these
    2 weeks.
  • An employee may not substitute paid compensatory
    time, BLT, or deferred hours for unpaid FMLA
    leave.
  • If an employee uses compensatory time, BLT, or
    deferred hours for FMLA qualifying purposes, the
    time cannot be counted against the employees
    FMLA leave entitlement.

31
A 12-Month Period
  • An eligible employee with a qualifying reason is
    entitled to up to a total of 12 workweeks of
    job-protected FMLA leave during a 12-month period
    beginning on the first date the employee's leave
    is taken. The next 12-month period begins the
    first time leave is taken after completion of any
    previous 12-month FMLA period.
  • Although the FMLA permits alternate ways to
    calculate the 12-month period, this is the method
    the SOM uses, which is incorporated into CBAs,
    and it cannot be changed by a department.

32
Job-Protected Leave
  • The employer is to grant FMLA leave to an
    eligible employee with a qualifying reason
    requesting FMLA leave.
  • The employer is to restore an eligible employee
    on FMLA leave to their position upon expiration
    of the FMLA leave.
  • The employer cannot interfere with an employees
    exercise of FMLA rights.
  • The employer cannot retaliate against an employee
    for exercising FMLA rights.
  • Note not an absolute, unqualified right

33
Intermittent Leave and Reduced Leave Schedule
  • Intermittent leave is FMLA leave taken in
    separate blocks of time due to a single
    qualifying reason.
  • A reduced leave schedule reduces an employees
    usual number of working hours per workweek, or
    hours of work per workday.
  • The leave may be taken in the shortest period
    used to account for absences or use of leave.
  • The employer cannot count more FMLA leave against
    an employees entitlement than is actually taken.

34
Intermittent Leave and Reduced Leave Schedule
cont.
  • FMLA leave may be taken intermittently or on a
    reduced leave schedule when medically necessary
    for
  • planned or unanticipated medical treatment of a
    SHC
  • recovery from treatment for a SHC or
  • recovery from a SHC.
  • Intermittent FMLA leave or a reduced leave
    schedule may be taken for absences where the
    employee is unable to perform the essential
    functions of the position because of a chronic
    SHC.
  • Intermittent leave or a reduced leave schedule
    may be taken only with the employers approval to
    care for a newborn or newly placed adopted or
    foster care child.
  • See Section 825.203.

35
Medically Necessary
  • Intermittent leave or leave on a reduced schedule
    must be medically necessary.
  • Medically necessary means there must be a
    medical need for the leave, which is best
    accommodated through intermittent leave or a
    reduced leave schedule.
  • Employees needing intermittent leave or leave on
    a reduced schedule must attempt to schedule leave
    so the employers operations are not disrupted.
  • The employee may be assigned to an alternative
    position that better accommodates an employees
    intermittent leave or reduced leave schedule.
  • See Section 825.117.

36
Alternative Position
  • The employer may transfer an employee to an
    alternative position during the period of
    intermittent leave or reduced leave schedule if
  • leave is foreseeable based on planned medical
    treatment or
  • the employer has agreed to permit intermittent
    leave or leave on a reduced schedule due to the
    birth of a child, or placement of a child for
    adoption or foster care.
  • Any transfer to an alternative position must be
    in compliance with an applicable CBA, and state
    and federal laws.

37
Alternative Position cont.
  • An alternative position need not be equivalent in
    duties.
  • The alternative position must
  • have equivalent pay and benefits and
  • better accommodate recurring periods of leave
    than the regular position of the employee.
  • The employer may proportionately reduce benefits,
    such as annual and sick leave accruals, that are
    based on the number of hours worked.
  • The employer may not transfer an employee to an
    alternative position to discourage the taking of
    FMLA leave.

38
HRMN Notifications
  • HRMN is now sending notifications to the
    departments when a date is entered that is not at
    least 9 months from the start date of the
    employees FMLA leave, and when the employees
    FMLA qualifying year has expired and the
    expiration date has not been removed or reset.
  • The below employee had an FMLA expiration date
    of entered in HRMN that is less than 9 months
    out from the Date of the "MISCUPDAT2" Personnel
    Action. This action was entered by User000000.
    Please adjust the date to at least 9 months in
    the future.
  • The below employee had a FMLA expiration date
    that is over 14 days ago. Please review the
    employee's record, either reset the expiration
    date or remove it, and zero out the FMLA time
    accrual hours.

39
Benefit Protection
40
Benefit Protection
  • During FMLA leave, an employer must maintain the
    employees coverage under any group insurance
    plan (health, dental and vision) the employee was
    enrolled in prior to the FMLA leave.
  • While on FMLA leave, an employee is entitled to
    any new or changed group insurance plan benefits
    provided by the employer to the same extent as
    the employee would have been if not on leave.
  • The employers obligation ceases if and when the
    employment relationship would have ended if the
    employee had not taken FMLA leave.
  • An employee may choose not to retain group
    insurance plan coverage during FMLA leave.

41
Job Restoration
42
Job Restoration
  • Upon return from FMLA leave, an employee is
    entitled to restoration to the same position or
    an equivalent position as long as the employee is
    able to perform all of the essential functions of
    their position. (See Section 825.214)
  • An equivalent position must have the same
    benefits, pay, and other terms and conditions of
    employment prior to the FMLA leave.
  • A key employee is not necessarily entitled to
    job restoration but this provision rarely applies
    in the state classified service. (See Section
    825.217)

43
CS-1790Employee Request Employer Response
44
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45
Notifying the Employer
  • Notice of the need for FMLA leave may be given
  • in writing
  • orally
  • in person
  • by telephone
  • by fax machine
  • after the employee returns, but within two (2)
    business days
  • by the employees spokesperson
  • An employee is not required to use the CS-1790 to
    notify the employer of the need for FMLA leave.
  • If notification is made in any other manner, the
    employer will complete Sections I and II of the
    CS-1790.

46
Notifying the Employer cont.
  • Notice for foreseeable leave is to be given
  • 30 days or more into the future or
  • as soon as practicable, which is within two (2)
    business days of beginning leave.
  • Notice for unforeseeable leave may be given as
    soon as practicable
  • within two (2) business days of going on leave
    or
  • within two (2) business days of returning from
    leave.
  • Any employer rules regarding call in or
    notification required when an employee cannot
    work remain in effect and are not relieved under
    the FMLA however, a transgression cannot serve
    as a basis for denial if timely notice of the
    need for FMLA leave is given.

47
Medical Certification Documentation Analysis

48
CS-1789Medical Certification Documentation
Analysis
49
Test Your Knowledge of the FMLA
50
  • 1. FMLA allows eligible employees to take time
    off to care for the following family members with
    a SHC
  • child, spouse, grandparent
  • spouse, grandparent, sibling, child
  • child, spouse, parent

51
  • "a" is incorrect!
  • "b" is incorrect!
  • "c" is correct!FMLA allows eligible employees to
    take time off to care for a child, spouse, or
    parent with a SHC.

52
  • 2. Kim had minor surgery and was required to stay
    in the hospital overnight. This condition caused
    Kim to miss one day of work. Since Kim was back
    to work the following day and required no more
    subsequent doctor's visits, Kim's leave should be
    documented as FMLA leave.
  • True
  • False

53
  • True is correct!Kim had an overnight stay in the
    hospital so this should be handled as FMLA leave.
  • The greater benefit.
  • False is incorrect!

54
  • 3. SOM employees must have at least 12 months of
    prior state service and must have worked a
    minimum of 1,250 hours during the previous 12
    months to be considered eligible for FMLA leave.
  • True
  • False

55
  • True is correct!Please note that all that is
    required is total SOM service and not a specific
    department.
  • False is incorrect!12 months of prior SOM
    service and 1,250 hours worked during the
    previous 12 months are the only two requirements
    for FMLA eligibility.

56
  • Kim has a chronic serious health condition
    certified by a health care provider that will
    require being off work for treatments one day per
    week for the next two months. Should the leave
    be designated as FMLA leave?
  • a. Kim will not miss more than three consecutive
    calendar days from work therefore, the absences
    for the treatments should not be counted as FMLA
    leave.
  • b. Although Kim will not miss more than three
    consecutive calendar days from work, the
    condition is chronic. The absence should be
    handled as FMLA leave.

57
  • "a" is incorrect!
  • "b" is correct!Any absence for treatment of a
    chronic SHC condition may be applied to FMLA
    leave. Kim's condition was certified by a HCP
    the absence for treatments of the chronic
    condition in this case may be applied to FMLA
    leave.

58
  • 5. An eligible full-time SOM employee is entitled
    to how many hours of FMLA leave in a 12-month
    period?
  • 340 hours
  • 480 hours
  • 600 hours
  • 1200 hours

59
  • "a" is incorrect!
  • "b" is correct!12 weeks X 40 hours/week 480
    hour
  • "c" is incorrect!
  • "d" is incorrect!

60
CS-1789Medical Certification Documentation
Analysis
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63
Health Care Provider
  • Health Care Providers (HCP) include
  • Licensed M.D. or Osteopath
  • Podiatrists, Dentists, Clinical Psychologists
  • Optometrists, Chiropractors, Clinical Social
    Workers, Counselors
  • Nurse Practitioners and Nurse-midwives
  • HCP authorized to practice in a country other
    than the U.S.
  • Any HCP from whom the State of Michigans group
    health plan will accept certification.

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A Serious Health Condition means an illness,
injury impairment, or physical or mental
condition that involves one of the following1.
Hospital Care
  • Inpatient care (i.e., an overnight stay) in a
    hospital, hospice, or residential medical care
    facility, including any period of incapacity2 or
    subsequent treatment in connection with or
    consequent to such inpatient care.

66
  • Absence Plus Treatment(a) A period of
    incapacity of more than three consecutive
    calendar days (including any subsequent treatment
    or period of incapacity relating to the same
    condition) that also involves (1) Treatment3
    two or more times by a health care provider, by a
    nurse or physicians assistant under direct
    supervision of a health care provider, or by a
    provider of health care services (e.g., physical
    therapist) under orders of, or on referral by, a
    health care provider or
  • ---------------------------------
  • 3 Treatment includes examinations to
    determine if a serious health condition exists
    and evaluations of the condition. Treatment does
    not include routine physical examinations, eye
    examinations, or dental examinations.

67
  • (2) Treatment by a health care provider on at
    least one occasion which results in a regimen of
    continuing treatment4 under the supervision of a
    health care provider.
  • ________________
  • 4 A regimen of continuing treatment
    includes, for example, a course of prescription
    medication (e.g., an antibiotic) or therapy
    requiring special equipment to resolve or
    alleviate the health condition. A regimen of
    treatment does not include the taking of
    over-the-counter medications such as aspirin,
    antihistamines, or salves or bed-rest, drinking
    fluids, exercise, and other similar activities
    that can be initiated without a visit to a health
    care provider.

68
  • 3. Pregnancy
  • Any period of incapacity due to pregnancy, or
    for prenatal care.

69
____________2Incapacity, for purposes of FMLA,
is defined to mean inability to work, attend
school or perform other regular daily activities
due to the serious health condition, treatment
therefore, or recovery therefrom.
  • 4. Chronic Conditions Requiring Treatments
  • A chronic condition which
  • (1) Requires periodic visits for treatment by a
    health care provider, or by a nurse or
    physicians assistant under direct supervision of
    a health care provider
  • (2) Continues over an extended period of time
    (including recurring episodes of a single
    underlying condition) and
  • (3) May cause episodic rather than a continuing
    period of incapacity² (e.g., asthma, diabetes,
    epilepsy, etc.).

70
  • 5. Permanent/Long-term Conditions Requiring
    Supervision
  • A period of Incapacity which is permanent or
    long-term due to a condition for which treatment
    may not be effective. The employee of family
    member must be under the continuing supervision
    of, but need not be receiving active treatment
    by, a heath care provider. Examples include
    Alzheimers, a severe stroke, or the terminal
    stages of a disease.

71
  • 6. Multiple Treatments (Non-Chronic Conditions)
  • Any period of absence to receive multiple
    treatments (including any period of recovery
    therefrom) by a health care provider or by a
    provider of health care services under orders of,
    or on referral by, a health care provider, either
    for restorative surgery after an accident or
    other injury, or for a condition that would
    likely result in a period of Incapacity of more
    than three consecutive calendar days in the
    absence of medical intervention of treatment,
    such as cancer (chemotherapy, radiation, etc.),
    severe arthritis (physical therapy), and kidney
    disease (dialysis).

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79
Employer Options
  • Upon review of the CS-1789, the employer may
  • Accept the form as submitted
  • Determine the form is incomplete
  • Determine the form is confusing
  • Determine the form looks odd and question the
    authenticity or
  • Determine the form looks incongruous and question
    the validity.

80
CS-1789 is Incomplete
  • The employer may seek only the information
    requested on the CS-1789.
  • If the employer accepts an incomplete CS-1789 and
    grants FMLA leave, the employer may not later
    seek further information absent a change in
    circumstances.
  • Return the incomplete CS-1789 to the employee and
    advise the employee of the consequences of an
    incomplete form.
  • Do not contact the HCP directly.

81
CS-1789 is Confusing
  • The employer may seek only the information
    requested on the CS-1789.
  • If the employer accepts a CS-1789 containing
    confusing information and grants FMLA leave, the
    employer may not later seek clarification absent
    a change in circumstances.
  • Return the CS-1789 to the employee with a letter
    of clarification addressed to the HCP and advise
    the employee of the consequences of a form which
    does not substantiate the need for FMLA leave.
  • Do not contact the HCP directly.

82
Letters of Clarification
  • Use the template clarification letters.
  • It is a good business practice to attach a copy
    of the employees regular schedule. With
    re-certification please indicate on a calendar
    the dates and times the employee has been absent
    and the reason the employee was away from work.
  • It is a good business practice to include a
    signature line on the letter and leave space for
    the HCP to answer specific questions on the
    letter itself.

83
Question Authenticity of CS-1789
  • The employer may seek only the information
    requested on the CS-1789.
  • If the employer accepts a CS-1789 which does not
    appear to be authentic and grants FMLA leave, the
    employer may not later question the authenticity
    of the form.
  • Request the employees permission to have a HCP
    representing the employer contact the employees
    HCP for purposes of authenticating the CS-1789
    and advise the employee of the consequences of a
    form which does not substantiate the need for
    FMLA leave.
  • Do not contact the HCP directly.

84
Question Validity of CS-1789
  • The employer may seek only the information
    requested on the CS-1789.
  • If the employer accepts a CS-1789 even though the
    employer doubts the validity of the medical
    certification and grants FMLA leave, the employer
    may not later question the validity of the
    certification.
  • Require the employee to obtain a second opinion
    at the employers expense and advise the employee
    of the consequences of failing to cooperate.
  • Do not contact the HCP directly.

85
Second Opinions
  • If the employer has reason to doubt the validity
    of the medical certification provided by the
    employee, the employer may require the employee
    to obtain a second opinion.
  • The second opinion is at the employers expense.
  • The employer is permitted to choose the HCP to
    furnish the second opinion as long as the HCP
    chosen is not employed on a regular basis by the
    employer (unless the employer is located in an
    area where access to health care is extremely
    limited).
  • If the employee cooperates in the second opinion
    process, the employee is provisionally entitled
    to FMLA leave pending receipt of the second
    opinion.

86
Third Opinions
  • If the second opinion differs from the opinion of
    the employees HCP, the employer may require the
    employee to obtain a third opinion.
  • The third opinion is at the employers expense.
  • The third HCP must be approved jointly by the
    employer and the employee.
  • The employer and the employee must act in good
    faith to attempt to reach agreement on the third
    HCP. If the employer does not attempt to act in
    good faith, the employer will be bound by the
    first opinion if the employee does not act in
    good faith, the employee will be bound by the
    second opinion.
  • If the employee cooperates in the third opinion
    process, the employee is provisionally entitled
    to FMLA leave pending receipt of the third
    opinion.
  • The third opinion is final and binding.

87
Employee Consequences
  • If an employee fails to satisfy the medical
    certification requirements, the employer may
  • delay the taking of FMLA leave until the required
    certification is provided if the need for the
    leave is foreseeable
  • delay the continuation of FMLA leave until the
    required certification is provided if the need
    for the leave is unforeseeable however, the
    employers time frame for providing medical
    certification must be reasonable under the
    circumstances.
  • If the employee never produces the required
    medical certification, the leave is not FMLA
    leave.

88
ADA/FMLA/Workers CompensationWhen More Than
One Applies
89
Test Your Knowledge of the FMLA, ADA
Workers Compensation!
90
  • When might both the FMLA and ADA affect an
    employees leave?  
  •  
  • When the employees family member has a SHC.
  • When the employee has a SHC that requires an
    overnight stay in the hospital.
  • When an employee who has been on FMLA leave for
    12 weeks cannot return to work because of a
    continuing SHC.

91
  • "a" is incorrect!
  • "b" is incorrect!
  • "c" is correct!These laws will overlap when an
    employee takes a leave of absence for a FMLA SHC
    that also qualifies as a disability under the
    ADA.
  • For example, if an employee who has been on FMLA
    leave for 12 weeks cannot return to work because
    of a continuing SHC, the condition also may be a
    disability.

92
  • 2. The ADA requires that all printed material for
    SOM employees or the public be available in an
    alternate/accessible format, if requested.
  • True
  • False

93
  • True is correct!The ADA requires that all
    printed material for SOM employees or the public
    be available in an alternate/accessible format,
    if requested. Materials need not be put into
    Braille or other formats until requested.
  • False is incorrect!

94
  • 3. The ADA, Title I, requires extensive
    renovation of all SOM buildings to make them
    accessible.
  • True
  • False

95
  • True is incorrect!
  • False is correct!As an employer, the SOM is
    responsible under Title I of the ADA for making
    facilities accessible to qualified applicants and
    employees with disabilities as a reasonable
    accommodation, unless this would cause undue
    hardship. Accessibility must be provided to
    enable a qualified applicant to participate in
    the application process, to enable a qualified
    individual to perform essential job functions and
    to enable an employee with a disability to enjoy
    benefits and privileges of employment.

96
  • 4. The ADA, Title II, requires extensive
    renovation of all SOM buildings to make them
    accessible.
  • True
  • False

97
  • True is incorrect!
  • False is correct!The ADA requires SOM programs,
    not all SOM buildings, to be accessible. "Program
    accessibility" is a very flexible requirement and
    does not require the SOM to do anything that
    would result in an undue financial or
    administrative burden. Not every building, nor
    each part of every building needs to be
    accessible. Structural modifications are required
    only when there is no alternative available for
    providing program access.

98
  • 5. FMLA leave must be taken in one lump sum
    period of 12 weeks.
  • True
  • False

99
  • True is incorrect!
  • False is correct!FMLA leave may be taken
    intermittently.

100
  • 6. FMLA law requires the SOM to return an
    employee to the exact same position held prior to
    taking FMLA leave.
  • True
  • False

101
  • True is incorrect!
  • False is correct!FMLA law states that an
    employee may be returned to the same or an
    equivalent position.

102
  • 7. FMLA leave, with the SOM, begins when the
    employees accrued leave expires.
  • True
  • False

103
  • True is incorrect!
  • False is correct!FMLA leave starts when the
    employee begins missing time due to an
    FMLA-related condition. The employees accrued
    leave will run concurrently with any FMLA leave.

104
  • 8. The employee would be required to pay their
    normal monthly premium to maintain their health,
    dental vision coverage if they are on unpaid
    FMLA leave for an entire pay period.
  • True
  • False

105
  • True is correct!The employee will still be
    required to pay their monthly premiums if they
    are on unpaid FMLA leave for an entire pay
    period. The employee would not, however, be
    required to pay the SOM share of the premiums.
  • False is incorrect!

106
  • 9. If an employee is on workers compensation and
    has an FMLA qualifying absence at the same time,
    and a light duty assignment is identified and
    available, the dept may offer the light-duty
    assignment , but they may not require the
    employee to take it.
  • True
  • False

107
  • True is correct!The employee is able to turn
    down favored work or light-duty while on workers
    comp and FMLA. The employees workers comp
    benefit will be stopped and the employee will be
    required to use sick leave, but may substitute
    annual leave, to continue on payroll. The
    employee will not be allowed to buy back their
    leave credits in these circumstances.
  • False is incorrect!

108
  • 10. An employee can no longer perform their
    original position because of a work related
    injury. The ADA requires the dept to create a
    new position or bump another employee from
    their position as a reasonable accommodation.
  • True
  • False

109
  • True is incorrect!
  • False is correct!The ADA does not require an
    employer to create a new position or to bump
    another employee from their position in order to
    reassign an employee who can no longer perform
    the essential functions of their original
    position, with or without a reasonable
    accommodation.

110
  • 11. An FMLA serious health condition is the
    same as an ADA disability.
  • True
  • False

111
  • True is incorrect!
  • False is correct!An FMLA serious health
    condition is not necessarily an ADA
    disability. An ADA disability is an impairment
    that substantially limits one or more major life
    activities, a record of such an impairment, or
    being regarded as having such an impairment. Some
    FMLA serious health conditions may be ADA
    disabilities, i.e., cancers and serious
    strokes, and some ADA disabilities, i.e.,
    diabetes and being HIV positive, may be serious
    health conditions.

112
Definitions
113
The Basics
ADA
FMLA
  • Requires covered employers to give eligible
    employees up to twelve weeks per year of unpaid
    leave for
  • birth or adoption of child
  • placement of foster child
  • serious medical condition of parent, spouse, or
    child
  • Employees own serious medical condition
  • No employment discrimination on the basis of
  • a mental or physical impairment that
    substantially limits a major life activity
  • a record of such an impairment or
  • being regarded as having such an impairment.
  • Not every unfavorable or difficult condition is
    a protected disability!

114
The Basics
  • Workers Compensation
  • Temporary income replacement for covered
    employees who have job-related injuries or other
    medical problems.
  • Retaliation or job discrimination is prohibited
    against employees who are involved in workers
    compensation claims.
  • Injured employee is limited to statutory caps on
    compensation for covered medical conditions.

115
Prohibited Actions
ADA
FMLA
  • Counting FMLA leave against employees who take
    it.
  • Failing to allow FMLA leave under covered
    circumstances.
  • Retaliating against employees who take FMLA
    leave, who file FMLA-related complaints, or who
    assist in FMLA claim actions.
  • Pre-employment medical inquiries, including
    questions about workers comp claim history.
  • Failure to make a reasonable accommodation of a
    known disability when an employee could do the
    essential functions of the job with the
    accommodation.

116
Prohibited Actions
  • Workers Compensation
  • Interfering with an employees right to file a
    workers compensation claim.
  • Discharging or otherwise discriminating against a
    person who has filed a workers compensation
    claim.

117
Coverage
FMLA
ADA
  • Employers with 50 or more employees.
  • Employee has worked at least 12 months total
    time with Employer.
  • Employee has worked at least 1,250 hours during
    12-month period preceding the leave.
  • All Employers in interstate commerce with 15 or
    more employees are covered.
  • Any individual, with a disability, applying for a
    job.
  • Current employees with a disability. There is no
    limit on length of time employed.

118
Coverage
  • Workers Compensation
  • Employees of companies that have workers
    compensation insurance.
  • Employees of independent contractors borrowed
    servants if under first Employers direction
    and control.
  • Job-related injuries and illnesses.

119
Interaction Based on Employee Count
  • Below 15 employees, only workers compensation
    laws are in effect.
  • With 15 to 49 employees, workers compensation
    and ADA are in effect.
  • With 50 or more employees, workers compensation,
    ADA, and FMLA are potentially at issue (With the
    SOM all three should always be taken into
    consideration).
  • Independent contractors are not counted or
    covered.

120
Interaction Based on the Situation
  • Only a job-related medical problem affecting the
    employee will ever potentially involve all three
    laws.
  • A situation involving a family members medical
    problem may involve both ADA (regarded as) and
    FMLA, but not workers compensation.
  • Some medical problems may only involve one law.

121
Interaction Between the Three Laws
  • Some situations may be covered by all three laws,
    but all the coverage requirements for all the
    laws must be fulfilled.
  • Some situations may be covered by two laws.
  • In multiple coverage situations, the outcome that
    is most favorable for the employee must occur.

122
FMLA/ADA Interplay
123
SHC and/or Disability
FMLA
ADA
  • The ADA generally is not intended to cover
    temporary medical conditions.
  • Accordingly, a person is disabled under the ADA
    only if
  • he/she has a physical or mental impairment and
  • that impairment substantially limits a major life
    activity, such as walking, seeing, hearing,
    speaking, and breathing.
  • Generally, most disabilities will qualify as SHC
    under the FMLA.
  • For example, cancer can be both a SHC under the
    FMLA and a disability under the ADA. However, not
    all SHCs will also be disabilities.

124
NOT COVERED BY THE ADA
COVERED BY THE FMLA
  • Short term medical conditions that will resolve
    themselves following an expected course of
    treatment and recovery
  • Examples Appendicitis, Cancer, Gall Bladder
    removal, pregnancy.
  • Temporary disabilities
  • Examples Broken bones or soft tissue injuries
    that result in no or minimal impairment.
  • Short term medical conditions that will resolve
    themselves following an expected course of
    treatment and recovery
  • Examples Appendicitis, Cancer, Gall Bladder
    removal, pregnancy.
  • Temporary disabilities
  • Examples Broken bones or soft tissue injuries
    that result in no or minimal impairment.

125
NOT COVERED BY THE ADA
MAY BE COVERED BY THE FMLA
  • A SHC that involves the ongoing treatment for
  • Sexual behavior disorders, or
  • Compulsive gambling, or
  • Psychoactive substance use disorders (from use of
    illegal drugs).
  • Current illegal drug users
  • Sexual behavior disorders
  • Compulsive gambling
  • Kleptomania
  • Pyromania
  • Psychoactive substance use disorders (from use of
    illegal drugs).

126
COVERED BY THE ADA
COVERED BY THE FMLA
  • Past illegal drug use is covered.
  • Past alcohol use is covered
  • Employer may prohibit use of illegal drugs and
    alcohol in workplace
  • A SHC that involves the ongoing treatment for
  • past illegal drug use, or
  • Past alcohol use.

127
Reasons for Leave
FMLA
ADA
  • SHC of self or family member ( see definition of
    family member)
  • Adoption of a child
  • Birth of a child.
  • Must be related to the employees disability.

128
Reasons for Leave Time Away from Work
FMLA
ADA
  • Obtain medical treatment rehabilitation
    services or physical or occupational therapy
  • Recuperating from an illness or an episodic
    manifestation of the disability.
  • Obtain medical treatment rehabilitation
    services or physical or occupational therapy
  • Recuperating from an illness or an episodic
    manifestation of the disability
  • Obtaining repairs on a wheelchair, accessible
    van, or prosthetic device.

129
Reasons for Leave Time Away from Work cont.
FMLA
ADA
  • Avoiding temporary adverse conditions in the work
    environment (i.e., carpet cleaning).
  • Avoiding temporary adverse conditions in the work
    environment (i.e., carpet cleaning)
  • Training a service animal
  • Receiving training in the use of Braille or to
    learn sign language.

130
Who is eligible?
FMLA
ADA
  • Employee is eligible first day of employment
    regardless if they are full or part-time.
  • Employees who have worked for the SOM for 12
    months, need not be consecutive, and
  • who have worked 1250 hours within previous 12
    months.

131
How Much Time is Available?
ADA
FMLA
  • Up to 12 weeks of leave within 12 month period of
    time.
  • Leave may be taken intermittently (under certain
    circumstances)
  • Day by day
  • Hour by hour
  • Multiple weeks or consecutive days.
  • Based on what is reasonable.
  • May be used intermittently
  • Day by day
  • Hour by hour
  • Multiple weeks or consecutive days.

132
Compensation
ADA
FMLA
  • SOM has a policy that would apply accrued sick
    time for SHC, employee may substitute accrued
    annual leave, against the leave time.
  • Unpaid leave available beyond use of accrued sick
    leave.
  • SOM may allow individual to use accrued vacation
    and sick time toward leave.
  • Unpaid leave available beyond use of accrued
    time.

133
Documentation
FMLA
ADA
  • Documentation of the need for leave and relation
    to disability are required by the employer.
  • The employer has a right to require sufficient
    documentation. There is no formal method of
    resolving conflicts between the employer and
    employee documentation.
  • Documentation of the need for leave required from
    medical provider.
  • Conflict between employee and employer regarding
    documentation resolved through use of 2nd and 3rd
    opinion process.

134
Protections for Employees
FMLA
ADA
  • Position employee held prior to the leave, or
    equivalent position, is available upon return to
    work, as long as the employee can perform the
    essential functions of the job.
  • Employer must maintain benefits during leave
  • Group Health, dental vision Insurance.
  • Position employee held prior to the leave is
    available upon return to work.
  • Employee responsible for any Group Health
    insurance payments related to maintaining
    benefits during leave.
  • Employer may fill the position if able to
    demonstrate business necessity.

135
Reassignment
FMLA
ADA
  • Considered when qualified individual is not able
    to do current position with other reasonable
    accommodations
  • Do not need to create a position.
  • Promotion to a higher position is not a required
    form of reassignment.
  • Reassignment not to violate collective bargaining
    agreement
  • Temporary transfer to an alternative position
    that better accommodates recurring absences may
    be consider when intermittent leave is
    foreseeable because of planned medical treatment,
    i.e., physical therapy or chemotherapy.
  • Must be within employees qualifications.
  • Reassignment not to violate collective bargaining
    agreement.

136
Michigan Supreme Court Decision
  • ADA identifies reassignment as reasonable
    accommodation for qualified individuals.
  • Michigan Rules that Reassignment not required,
    Rourk v Oakwood Hospital Corporation, under
    Handicappers' Civil Rights Act, now known as the
    Persons with Disabilities Civil Rights Act, MCL
    37.1101 et seq. MSA 3.550(101) et seq.

137
Considerations for an ADA Reasonable Accommodation
  • The ADA does not require an employer to eliminate
    the essential functions of the position. If the
    functions an employee cannot perform are
    marginal job functions they may be delegated to
    co-workers, as part of the reasonable
    accommodation.
  • If there is already a vacant position for which
    an employee is qualified, it may be a reasonable
    accommodation to reassign the employee to that
    position. Reassignment not to violate collective
    bargaining agreement.

138
FMLA/ADA/Workers Compensation Interplay
139
FMLA/ADA/Workers Compensation
  • Being awarded Workers Compensation benefits, or
    being assigned a high compensation disability
    rating, does not automatically establish that an
    employee is protected by the ADA, however, the
    employee will be considered to have a SHC under
    the FMLA if their injury results in time away
    from work or the inability to work their regular
    hours.
  • Workers Compensation and FMLA will run
    concurrently if the employee has not exhausted
    their FMLA leave.
  • An employee must be substantially limited in one
    or more major life activities, or be regarded as
    a person with a disability, or have a record of
    disability under the ADA.

140
FMLA/ADA/Workers CompensationConfidentiality of
Medical Records
  • Medical information must be kept confidential and
    not shared with other employees .
  • Disclosure limited to individuals who need to
    know in order to implement accommodation, safety
    concerns, state or federal reporting, and
    insurance.

141
FMLA/ADA/Workers Compensation
ADA
FMLA
  • Once a request for an accommodation has been
    made, the ADA contem- plates an interactive
    process between the employer and the employee.
  • Once the employer is alerted to the need for FMLA
    by an employee, or their representa-tive, the
    employer needs to let the employee know if they
    qualify for leave and what will be required,
    within two business days.

Workers Compensation
  • Once the employer is made aware of a work related
    injury or illness, for which the employee is
    seeking medical treatment, the employer has the
    right to direct the medical treatment for 10 days
    from the inception of medical care.

142
Favored Work?
ADA
FMLA
  • Light Duty, Modified Duty or Disability
    Management Transitional Employment Program
    positions are not required as an accommodation by
    the employer.
  • Participation by the employee in Light Duty,
    Modified Duty or Disability ManagementTransitiona
    l Employment Program positions is not required.

Workers Compensation
  • Participation by the employee in Light Duty,
    Modified Duty or Disability ManagementTransitiona
    l Employment Program positions is required.

143
Discrimination Claims
ADA
FMLA
  • A workers compensation claim does not prevent an
    employee from asserting rights under the ADA or
    from filing a discrimination charge with the
    EEOC.
  • A workers compensation claim does not prevent an
    employee from asserting rights under the FMLA or
    from filing a discrimination charge with the DOL.

Workers Compensation
  • A workers compensation claim does not prevent an
    employee from asserting rights under the ADA or
    FMLA or from filing a discrimination charge with
    the EEOC or DOL.

144
Things to Remember
  • If an employee is receiving workers compensation
    and the Civil Service 2/3 supplement the employee
    is entitled to a an LTD benefit when the 2/3
    supplement ends.
  • In order for the employee to be eligible for the
    LTD Rider, file a LTD claim for the employee as
    soon as possible but no later than near the end
    of the 50/100 weeks. The Rider will cover 6
    months of Group Health Insurance Premiums.
  • (The employee must be enrolled in the LTD Plan
    prior to their injury to be eligible for LTD
    benefits and the LTD Rider.)

145
Scenarios
146
Scenario I
  • An employee you supervise has just told you, in
    confidence, that their spouse has been diagnosed
    with HIV. They are concerned about others at work
    finding out because one of their co-workers saw
    some HIV brochures on their desk a couple of
    months ago. The employee has also told you that
    since then all the other co-workers are behaving
    strangely.
  • What should you do next???
  • Which, if any, laws apply???

147
Scenario I
  • Family members medical problem
  • FMLA and ADA would be at issue.
  • FMLA is the primary law at issue
  • Employee should be given the CS1789 and CS1790
    forms.
  • ADA could be at issue if employer regards
    employee as disabled due to family members
    problem (HIV, AIDS, or other communicable
    diseases). If you think there may be an issue
    here give the employee the CS1668 form and a copy
    of CS Reg 1.04.

148
Scenario II
  • Your employee is having a difficult pregnancy.
    She or her significant other have called in all
    week saying that she is unable to come to work.
    She is due to have the baby next month.
  • Her significant other called today and said that
    the employee most likely will not be back to work
    until after the baby is born. The employee was
    being considered for a promotion.
  • What should you do next???
  • Which, if any, laws apply???
  • What is Title VII????

149
Scenario II
  • Employees difficult pregnancy
  • FMLA involved Employee gets up to 12 weeks of
    leave for pregnancy. The CS 1789 1790 forms
    should be sent to the employee. The employee may
    be entitled to other leave.
  • ADA normal pregnancy is not a covered
    disability. If the employer regards employee as
    disabled, ADA is involved.
  • Problem pregnancy can lead to or reveal
    disabilities. If the employer becomes aware of a
    disability they should provide the employee with
    the CS1668 form and a copy of the CS Reg. 1.04
  • Dont forget Title VII of the Civil Rights Act of
    1964!

150
Scenario III
  • Your employee has just adopted a child with
    medical problems. They have let you know that
    they will need time off to take the child to the
    doctor and to treatment. They are requesting
    Intermittent Leave.
  • How much time do you think the employee is
    entitled to??
  • Can you request that the employee reschedule
    appointments??
  • They are the only employee doing this job right
    now but Joe could do the job and you need someone
    there full-time. What could you do??? What or who
    would you need to consult before doing
    anything???

151
Scenario III
  • Employee gets child with medical problems
  • FMLA involved Employee gets up to 12 weeks of
    leave for new family situation. They may be
    entitled to more leave through their CBA or CS
    Rules.
  • If an Employee request Intermittent Leave the
    employer may ask them to reschedule appointments
    so that they are least disruptive to the
    employer. The employer may temporarily reassign
    an employee to a position that better suits the
    need for Intermittent Leave. Intermittent
    Leave for bonding purposes is at the discretion
    of the employer. Always consult the employees CBA
    before reassigning.
  • ADA if employer regards employee as disabled
    due to having a child with problems, ADA is
    involved

152
Scenario IV
  • Your employee has a work related injury and is
    off work. They have requested a Reasonable
    Accommodation so that they may return to work.
    It does not look like their restrictions are
    permanent. They are going to be re-evaluated in
    6 months. Workers Compensation just called and
    asked if you had favored work for this
    employee.
  • What would you do next???
  • What, if any, laws apply???
  • Is this a SHC???
  • What is Favored Work and if you have it how
    long will you allow an employee to work in it???

153
Scenario IV
  • Work Related Injury
  • The employee should be notified that their FMLA
    will run concurrently with their time away from
    work for the work related injury. This would be
    considered a SHC if the injury prevents the
    employee from being able to return to work.
  • Temporary medical problems are not protected
    disabilities under the ADA. Give the employee the
    CS 1668 and a copy of the CS Reg 1.04.
  • Favored Work has many names such as Light Duty,
    Modified Work, Disability Management-Transitional
    Employment. Typically favored work is no longer
    than 6 months. Consult the employees CBA to see
    what is available.

154
Scenario V
  • It is 730 am and your employee has just shown up
    at work from an FMLA leave and told you they can
    no longer perform the essential functions of
    their job, but they have a full release to return
    to work. The only reason they returned is
    because their insurances were going to stop and
    they were going to be placed on a medical layoff.
  • What do you do next???
  • What laws, if any, apply???
  • Should you let them stay at work???
  • Should you send them home??? for an IME?? If so
    what would support this???

155
Scenario V
  • Employee just showed up at work from leave
  • Under the FMLA there is no duty to return
    employee to the same job.
  • ADA may well be involved. Reasonable
    accommodation may mean the employee could be
    offered an alternative position, if one exists
    within their restrictions.
  • Go hom
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