FMLA Leave for Chronic Health Conditions Requires Proof of Periodic Doctor’s Visits
By Katrin U. Schatz
When an employee takes medical leave, treatment by a healthcare provider is often assumed, and the frequency of doctor’s visits is rarely scrutinized. The Pennsylvania federal court’s recent decision in Watkins v. Blind and Vision Rehabilitation Services of Pittsburgh alerts us that this is not always a wise approach. In evaluating FMLA leave entitlements, verifying continuing medical treatment can be well worth the trouble.
Watkins, a military veteran who suffers from PTSD, worked for Blind and Vision Rehabilitation Services (BVRS) as an employment specialist. In July 2015, Watkins fell victim to a random act of violence when an unknown individual fired multiple bullets at her car while she was driving. Her tires were shot, her window was shattered, and one bullet lodged itself in the driver’s side headrest, barely missing her head. The event caused a flare-up of Watkins’ PTSD symptoms. After the shooting, Watkins had difficulty functioning, experienced irritability, anxiety, stress and loss of concentration, and was fearful of leaving her home.
A year later, in June 2016, Watkins’ supervisors learned that Watkins had been submitting inaccurate client information for financial reimbursements. She was given a notice of unsatisfactory work performance and told to remedy the situation and submit needed documentation. She failed to comply and was counseled further, but her performance issues continued. On July 5, Watkins failed to report to work as directed to complete backlogged paperwork and claimed she had suffered a mental health emergency. BVRS received a letter from Watkins’ healthcare provider the next day, stating that Watkins was being treated for PTSD symptoms and would be able to report back to work on July 7. Watkins did not return to work on July 7 and remained absent thereafter with only sporadic intermittent attendance. She was ultimately discharged for job abandonment.
Watkins sued BVRS for interference with her FMLA rights, alleging that BVRS had failed to provide her with FMLA benefits to which she was entitled. BVRS asked the court to dismiss the case on summary judgment, in part because Watkins could produce no evidence that she had a serious health condition entitling her to FMLA leave. The court agreed. Since Watkins was never hospitalized and never went through inpatient treatment, she had to show she was receiving continuing treatment from a healthcare provider for her chronic health condition. The court recognized that PTSD can be a chronic ailment that continues over an extended time period. But under the FMLA regulations, Watkins had to further show that she received continuing treatment for PTSD, which means periodic doctor’s visits occurring at least twice a year. While Watkins testified that she had been in treatment with her doctor for seven years and had initially seen the doctor quite regularly, she admitted that her visits had tapered off and were now only on an as needed basis. Indeed, she could not even remember if she physically went to see her doctor on July 5, the day of her mental health emergency. Because Watkins failed to establish that she visited a healthcare provider at least twice a year for PTSD, she could not show that she had a serious health condition and was entitled to FMLA leave.
The bottom line? When an employee requests FMLA leave for a chronic health condition, take a careful look at the certification form completed by the employee’s healthcare provider. Does the provider identify a period of hospitalization or identify recent dates of treatment? Does the provider confirm that the employee will need periodic visits at least twice a year? If the answer is negative, the employee may well not qualify for FMLA leave.
***This article originally appeared on the Jackson Lewis’ Disability, Leave & Health Management blog and was reposted on the DMEC website with their permission.***