Second and Third Opinions: The Powerful but Overlooked Tool to Combat FMLA Abuse

By Armando Rodriguez, Compliance Counsel, Matrix; Marti Cardi, VP, Product Compliance, Matrix

Do these scenarios sound familiar? An employee’s vacation request is denied, and the employee asks for the same time off under the Family and Medical Leave Act (FMLA) for a serious health condition. Or another employee requests intermittent FMLA leave to start after exactly12 months of employment for a preexisting chronic condition for which the employee has not previously been absent. You suspect that something is not right. Are your hands tied because certifications from these employees’ healthcare providers support the need for leave?

No! These situations are perfect for exercising an employer’s FMLA second and third opinion process. Many employers shy away from this potent tool because they are unfamiliar with the process, which can be time-consuming and sometimes costly. But the benefits pay off in the long run.

Leave abuse can damage workplace morale while driving up costs because of lost productivity, overtime pay, or the need to hire replacement workers. Challenging a suspicious certification may rein in an employee playing loose with FMLA leaves and allow you to manage the claim effectively. More broadly, it can have a ripple effect when other employees hear about your practice of requiring a second or third opinion to confirm the validity of a healthcare provider’s certification.

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