SECTION 6.90 (A)  FAMILY AND MEDICAL LEAVE ACT POLICY

Last Update:  3/07

 

 

I.          BACKGROUND

 

The Family and Medical Leave Act (FMLA) was signed into law on February 5, 1993.  The Act guarantees employees the right to take leave without loss of employment or status for the birth, adoption, or foster placement of a son or daughter, the employee’s own serious illness, or to care for a seriously ill son, daughter, spouse or parent.  The following information is intended to assist you in administering the FMLA.  The State uses as guidance, Title 29, Part 825 of the Code of Federal Regulations to implement this policy.

 

II.         EFFECTIVE DATE

 

A.         FMLA leave was effective for noncontract employees on August 5, 1993 and for contract-covered employees on February 5, 1994.

B.         Only leave taken on or after the effective date of the Act is considered FMLA leave.

 

III.        DEFINITIONS

 

Adoption means a legal process whereby a child becomes a permanent member of a family into which he or she was not born.

 

Continuing treatment means a period of incapacity of more than three consecutive calendar days, and any subsequent treatment or period of incapacity relating to the same condition that involves: two or more visits to or treatments by a health care provider; or one visit that results in a planned course of treatment; or any period of incapacity due to pregnancy or prenatal care; or any period of incapacity due to a chronic serious health condition.

 

Employer means the State of Iowa through the Department of Administrative Services – Human Resources Enterprise (DAS-HRE).  When applicable, it also means an appointed or elected chief administrative head of a department, commission, board, independent agency, or statutory office or that person’s designee.

 

Essential functions means those job functions that an individual must be able to perform in order to hold a position.  Essential functions within the meaning of the Americans With Disabilities Act focus on what must be done and not on how they are accomplished.

 

Health Care Provider means a licensed doctor of medicine or osteopathy or “any other person determined by the Department of Labor (DOL) to be capable of providing health care services.”  The DOL has determined that the following qualify as health care providers:


 

podiatrists

dentists

clinical psychologists

optometrists

nurse practitioners (if authorized by state law)

nurse midwives (if authorized by state law)

clinical social workers

chiropractors that are authorized to practice in their state or “other persons capable of providing health care services.” [their certifications, however, must be limited to treatment consisting of manual manipulation of the spine to correct subluxation as demonstrated by an x-ray]

foreign licensed health care providers authorized to practice in that country

Christian Science practitioners listed with the First Church of Christ, Scientist in Boston, Massachusetts are also included in the definition of “health care provider”

any health care provider from which the State’s health insurance plans will accept certification that a serious health condition exists

a health care provider listed above who practices in a country other than the United States, who is authorized to practice in accordance with the law of that country, and who is performing within the scope of his or her practice as defined under such law.

 

Incapable of self-care means that the individual requires active assistance or supervision to provide daily self-care in several of the “activities of daily living” or “instrumental activities of daily living.”  Activities of daily living include adaptive activities such as caring appropriately for one’s grooming and hygiene, bathing, dressing and eating.  Instrumental activities of daily living include cooking, cleaning, shopping, taking public transportation, paying bills, maintaining a residence, using a telephone and directory, using a post office, etc.

 

Intermittent Leave means leave taken in separate periods of time due to a single illness or injury, rather than for one continuous period of time, and may include leave taken on an occasional basis for medical appointments, or leave taken several days at a time spread over a period of several months, such as for chemotherapy.

 

Medically Necessary means that there must be a medical need for the leave (as distinguished from voluntary treatments and procedures), and it must be that such medical need can be best accommodated through an intermittent or reduced leave schedule.

 

Needed to care for a spouse, son, daughter or parent means both physical and psychological care.  It includes situations where, because of a serious health condition, a parent is unable to care for his or her own basic medical, hygienic or nutritional needs or safety, or is unable to transport himself or herself to the doctor, etc.  The term also includes providing psychological comfort and reassurance to a seriously ill son, daughter, parent or spouse with a serious health condition who is receiving inpatient or home care.  The term also includes situations where an employee may be needed to fill in for others who are caring for the family member, or to make arrangements for changes in care, such as transfer to another medical care facility or nursing home.

 

Parent means a biological parent or an individual who stands or stood “in loco parentis” to an employee when the employee was a child.  Persons “in loco parentis” include persons with day-to-day responsibilities to care for and financially support a child, regardless of whether the person has a legal or biological relationship to the child.  The term “parent” does not include parents “in-law.”


 

Physical or Mental Disability means a physical or mental impairment that substantially limits one or more major life activities of an individual.  The American With Disabilities Act, Title 42 United States Code section 12101 et sec. further defines the terms.

 

Reduced Leave Schedule means a leave schedule that reduces the usual number of hours per workweek, or hours per workday of an employee.

 

Serious Health Condition means an illness, injury, impairment, or physical or mental condition that involves one of the following:

 

1.         Hospital Care

 

Inpatient care (i.e., an overnight stay) in a hospital, hospice, or residential medical care facility, including any period of incapacity 1 or subsequent treatment in connection with or consequent to such inpatient care.

 

2.         Absence Plus Treatment

 

(a)        A period of incapacity 1 of more than three consecutive calendar days (including any subsequent treatment or period of incapacity 1 relating to the same condition), that also involves:

 

(1)        Treatment 2 two or more times by a health care provider, by a nurse or physician's 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

(2)        Treatment 2 by a health care provider on at least one occasion which results in a regimen of continuing treatment 3 under the supervision of the health care provider.

 

3.         Pregnancy

 

Any period of incapacity due to pregnancy, or for prenatal care.

 

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 physician’s 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 incapacity 1 (e.g., asthma, diabetes, epilepsy, etc.).


 

5.         Permanent/Long-term Conditions Requiring Supervision

 

A period of incapacity 1 which is permanent or long-term due to a condition for which treatment may not be effective. The employee or family member must be under the continuing supervision of, but need not be receiving active treatment by, a health care provider.  Examples include Alzheimer’s, a severe stroke, or the terminal stages of a disease.

 

6.         Multiple Treatments (Non-Chronic Conditions)

 

Any period of absence to receive multiple treatments 2 (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 1 of more than three consecutive calendar days in the absence of medical intervention or treatment, such as cancer (chemotherapy, radiation, etc.), severe arthritis (physical therapy), kidney disease (dialysis).

 

_______________________

1       Incapacity,” 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.

 

2       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.

 

3       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.

 

Examples of a serious health condition include heart attack, many heart conditions, most cancers, stroke, back conditions requiring extensive therapy or surgery, spinal injury, pneumonia, pregnancy, miscarriage, complications or illness relating to pregnancy, the need for prenatal care, childbirth and recovery from childbirth, severe allergies, migraine headaches or stress.  Substance abuse also may be a serious health condition.  However, FMLA leave may only be taken for treatment of substance abuse by a health care provider or by a provider of health care services on referral by a health care provider.  An absence because of the employee’s use of the substance, rather than for treatment, does not qualify for FMLA leave.

 

Transitory or minor health conditions for which treatment and recovery are very brief do not constitute serious health conditions for the purposes of the FMLA.  Ordinarily, unless complications arise, the common cold, the flu, ear aches, upset stomach, minor ulcers and headaches, other than migraines, are examples of conditions that do not meet the definition of a “serious” health condition.  Likewise, cosmetic treatment, such as most treatments for acne or orthodontia which are elective and not medically necessary do not constitute serious health conditions.  Additionally, routine physical examinations are specifically excluded from the definition of a serious health condition.

 

Son or daughter means a biological, adopted or foster child, a stepchild, legal ward, or a child of a person standing “in loco parentis,” who is either under the age of 18, or age 18 or older if “incapable of self-care because of a mental or physical disability,” as defined in Title 29, Part 825, Section 113 of the Code of Federal Regulations.


 

Spouse means a husband or wife as defined or recognized under state law in the state where the employee resides for purposes of marriage, including common law marriage in states where it is recognized.  Iowa recognizes a common law marriage.

 

IV.        ELIGIBILITY

 

A.         Any employee who has been employed for at least 12 months and has worked for at least 1,250 hours in the previous 12 month period is eligible.

 

1.         The 12 months that the employee must have been employed need not be consecutive.  If the employee has been maintained on the payroll for any part of a week, including any periods of paid sick, vacation, or unpaid leave during which other benefits or compensation are provided by the employer (e.g., workers’ compensation, group health benefits, etc.), the week counts as a week of employment.  Reserve and National Guard troops may count their active military service as time worked in order to establish eligibility for FMLA.

2.         Whether an employee has worked the minimum 1,250 hours of service is determined according to the principles of the Fair Labor Standards Act for determining compensable hours.  Hours worked is calculated based upon hours actually worked, not hours in pay status.  The previous 12 month period is defined as the 12 months immediately preceding the date FMLA leave is to begin.

3.         The 1,250 hours may be worked intermittently, and may involve multiple job classes.

 

B.         Eligibility determinations will be made as of the date that the FMLA leave is to begin. However, employees who are not eligible initially will become eligible as soon as they meet the criteria in A (1, 2 and 3).

 

V.         NOTICE REQUIRED

 

A.         When an employee provides initial notification of the need for an absence, the employee must provide sufficient information for the employer to determine whether the absence can properly be considered a FMLA qualifying event.  The failure to follow sick leave policies could be a basis for discipline.  All health care provider certifications must be on a “Certificate of Health Care Provider” (CFN-552-0610) form.  If the employee qualifies for Workers’ Compensation benefits, his or her medical documentation will be accepted for FMLA purposes.

 

B.         An employee must provide the employer with not less than 30 calendar days notice of his or her intention to take foreseeable FMLA leave.  In situations involving birth, adoption, foster placement or planned medical treatment for an illness, the employee must provide notice within two work days, or as soon as practicable, after the employee learns of the need for leave.  In unforeseen circumstances, however, the employee must provide notice as soon as practicable, either orally or in writing.  Untimely requests or failure to provide mandatory information to the employer may result in delay or denial of the FMLA leave (see, VI. Approval Criteria, para. F).

 

C.         When the employee is unable to provide notice because of his or her illness or injury, notice may be given by a family member or a spokesperson as soon as practicable.


 

D.         The employer may require compliance with published leave procedures.  FMLA leave, however, cannot be denied for an employee’s failure to comply with published leave procedures that are more stringent than FMLA requirements.

 

E.         The employer will make a FMLA designation or tentative designation based on an oral notification containing sufficient information to make a FMLA eligibility determination.

 

F.         The employer will provide an employee with information pertaining to his or her eligibility for FMLA leave should the employee appear not to understand his or her rights and obligations under the Act.

 

G.         The employer will notify the employee using the “Employer Family and Medical Leave Act Response Form” (CFN 552-0627) within two work days.

 

H.         An employee may not be required to take more FMLA leave than necessary to address the circumstances that precipitated the need for leave.

 

VI.        APPROVAL CRITERIA

 

A.         FMLA leave will be designated for the birth, adoption or foster placement of a son or daughter, or to care for a son, daughter, spouse, or parent with a serious health condition.

 

1.         The birth, adoption, or foster placement must be within 12 months of the date FMLA leave is to begin.

2.         The son or daughter must be under 18 years of age, unless incapable of self-care because of a physical or mental disability.

 

B.         FMLA leave will be designated for the employee’s own serious health condition that renders the employee unable to work at all or perform any one of the essential functions of his or her job.

 

C.         The employee, family member, or spokesperson must complete a “State of Iowa Family and Medical Leave Act (FMLA) Application” (CFN 552-0599) form and submit it to his or her supervisor.  If the employer has reason to know that the employee qualifies for FMLA leave, then FMLA applies whether the employee has submitted certification or not.

 

D.         Every employee will be given the opportunity to get medical certification for the FMLA leave.  The employee will be provided with the “Certification of Health Care Provider” (CFN 552-0610) form.  An employee can be disciplined for failing to return the appropriate medical certification.  If the employer requests medical certification for an absence, the employer must also advise the employee of the anticipated consequences of an employee’s failure to provide adequate certification.  Medical certification shall be obtained and returned to the employer within 15 calendar days of the request or upon return to work from an absence that may qualify as FMLA leave (absent extenuating circumstances).  It is the employee’s responsibility to pay the fee for completion of the medical certification and travel costs (if applicable).  If second or third opinions are required, the employer is responsible for the costs.

 

E.         The health care provider must complete the “Certification of Health Care Provider” (CFN 552-0610) form to satisfy the certification requirement when the request for leave is for self-care or a family member’s serious health condition.  Medical confirmation is required except in the case of birth, adoption, or foster placement.


 

F.         If leave is taken for a FMLA reason but the employer is not aware of the reason and the employee desires that the leave be counted as FMLA leave, the employee must notify the employer within two business days of returning to work of the reason for the leave. In the absence of such timely notification by the employee, the employee may not subsequently assert FMLA protection for the absence.

 

G.         If the employer has a reasonable basis to know that leave is taken for a FMLA qualifying reason, the employer will designate the leave as FMLA leave even if the employee does not desire the leave to be designated as such.

 

H.         An employee who fraudulently obtains FMLA leave from the employer is not protected by FMLA’s job restoration or maintenance of health benefits provisions.

 

VII.       LEAVE ENTITLEMENT

 

A.         An employee is entitled to 12 weeks of FMLA leave in a fiscal year on either a continuous, intermittent, or reduced leave schedule basis.  This leave may be paid or unpaid (see Section VIII).

 

B.         When FMLA leave is taken intermittently or on a reduced leave schedule, full-time employees are entitled to 480 hours of leave in a fiscal year.  There is no limit on the size of an increment of leave when an employee takes intermittent leave or leave on a reduced leave schedule.  However, an employer may limit leave increments to the shortest period of time that the employer’s payroll system uses to account for absences or use of leave provided it is one hour or less.

 

C.         Hours for part-time employees are prorated based on the average number of hours worked weekly during the previous six months of state employment.  For example, if the average weekly hours worked by a part-time employee for the previous 6 months were 20 hours, he or she is entitled to a maximum of 240 hours (12 weeks times 20 hours) of FMLA leave in a fiscal year.

 

D.         If an employee’s health care provider certifies that an intermittent or reduced work schedule is “medically necessary,” approval of the request is mandatory.  A brief description of the employee’s course of treatment that is planned by the health care provider is required for certification of intermittent or reduced work schedules.  Any adjusted schedule may end at the expiration of the FMLA leave entitlement.

 

E.         If an intermittent or reduced leave schedule is necessary and the leave is based on a planned course of medical treatment, the employer may temporarily assign an employee to another position, or alter his or her current position during the period that the leave is required to better accommodate recurring periods of leave.  The assignment or position altering cannot result in a loss of pay or benefits for the employee on an intermittent or reduced work schedule.  Assignment of the employee will be in accordance with DAS-HRE rules or applicable collective bargaining agreement.

 

F.         Intermittent or reduced schedule leave may be taken to provide care or psychological comfort to an immediate family member with a chronic or serious health condition.


 

G.         Intermittent or reduced schedule leave may be taken for absences where the employee is incapacitated or unable to perform the essential functions of the position because of a chronic serious health condition even if he or she does not receive treatment by a health care provider.

 

H.         Intermittent leave may be taken for a serious health condition which requires treatment by a health care provider periodically, rather than one continuous period of time, and may include leave periods from one hour or more to several weeks.  Examples of intermittent leave would include leave taken on an occasional basis for medical appointments, or leave taken several days at a time for chemotherapy.  A pregnant employee may take leave intermittently for prenatal examinations or for her own condition, such as periods of severe morning sickness. An example of an employee taking leave on a reduced leave schedule is an employee who is recovering from a serious health condition and is not strong enough to work a full-time schedule.

 

I.          When both spouses are employed by the State, they are limited to a combined total of 12 weeks of FMLA leave in a fiscal year for leave involving the birth, a bonding period, care after birth, adoption, foster care of a son or daughter or the care of a parent with a serious health condition.  For example, if one parent of each spouse needed care during a fiscal year and the leave entitlement was divided evenly between them, each would be allowed only six weeks of FMLA leave to care for his or her own parent.

 

J.          When both spouses are employed by the State, they are each entitled to 12 weeks of FMLA leave in a fiscal year for leave involving the care of a son, daughter or spouse with a serious health condition, or leave that involves the employee’s own serious health condition.

 

K.         If an employee unequivocally advises the employer in writing that he or she does not intend to return to work for a reason other than the immediate serious health condition, the employee’s entitlement to continued FMLA leave and associated benefits ceases.

 

L.         When leave is taken after the birth or placement of a child for adoption or foster care, an employee may take leave intermittently or on a reduced leave schedule only if the employer agrees.  The employer’s agreement is not required, however, when leave is medically necessary during which the mother has a serious health condition in connection with the birth of her child or if the newborn child has a serious health condition.

 

M.        An employee who requests FMLA leave after the birth, adoption, or foster placement of a son or daughter must take the leave within 12 months of the event.

 

N.         Employees on FMLA leave that crosses fiscal years need not submit new medical certification because of the start of the new fiscal year, but they must meet eligibility requirements.  However, once the original medical certification expires, the employee must reapply and provide new medical certification.  If information about the employee’s FMLA leave changes, the employee will be asked to have his or her original request updated.  In some instances, the updated information may be as simple as a written communication from the employing unit.


 

VIII.      PAID AND UNPAID LEAVE

 

A.         FAMILY LEAVE:  An employee taking FMLA leave for the birth, adoption, or foster placement of a son or daughter, or the care of a seriously ill son, daughter, spouse, or parent is required to exhaust any family (enforced leave) leave, accrued vacation, and personal leave for any part of the 12 week FMLA period before unpaid leave is granted.  Employees covered by the State Police Officers Council (SPOC) collective bargaining agreement may, but are not required to, substitute accrued paid leave for any part of the 12 week period.  Substitution of paid leave may be elected to the extent the circumstances meet the usual requirements for that leave.  [For central payroll: when paid leave is exhausted, the employee must be placed in a leave code 53 with a leave expiration date of no more than the remaining 12 weeks.  This allows the State’s share of life and long term disability (LTD) insurance to be paid automatically.]

 

B.         MEDICAL LEAVE:  For the employee’s own serious health condition, the employee must exhaust accrued sick leave, accrued vacation, or personal leave before unpaid leave is granted.  Employees covered by the State Police Officers Council (SPOC) collective bargaining agreement may, but are not required to, substitute accrued paid leave for any part of the 12 week period.  [For central payroll: when paid leave is exhausted, the employee must be placed in leave code 54 with a leave expiration date of four months from the last day worked.  This allows the State’s share of life and LTD insurance to be paid automatically.]

 

C.         COMPENSATORY LEAVE:  An employee may, but is not required to, use accrued compensatory leave in lieu of FMLA leave.  Use of compensatory leave will be permitted if the employee follows normal application procedures located in DAS-HRE rules and the applicable collective bargaining agreement for a qualifying absence. Compensatory time will NOT count against the employee’s 12 weeks of FMLA leave entitlement.

 

D.         MATERNITY LEAVE:  An employee who requests FMLA leave after the birth of a child and who has not received a medical release to return to work must exhaust any accrued sick leave, vacation, or personal leave before unpaid leave is granted.  When the employee’s physician releases the employee to return to work, the employee is no longer eligible to use paid sick leave, however, the employee may use personal leave or accrued vacation.

 

E.         LEAVE RETENTION:  Noncontract covered employees and employees covered by the American Federation of State, County, and Municipal Employees (AFSCME) collective bargaining agreement who are qualified for FMLA leave are eligible to retain up to two weeks (80 hours) of accrued annual leave (vacation) each fiscal year.  This includes Regents and Community Based Corrections employees who are covered by the AFSCME collective bargaining agreement.  Employees covered by the State Police Officers Council (SPOC) collective bargaining agreement may, but are not required to, substitute accrued paid leave for any part of the 12 week period.  These options are not available to employees covered by the United Electrical/Iowa United Professionals (UE/IUP) collective bargaining agreement.


 

IX.        FITNESS FOR DUTY

 

A.         When the leave involves the employee’s own serious health condition, the employer may require a written release from the employee’s health care provider as evidence that the employee is able to perform the essential functions of his or her position.  The employee is required to pay for any costs associated with the release including travel.  Failure to provide a written release may result in discipline up to and including discharge.

 

X.         RETURNING FROM LEAVE

 

A.         Upon returning from FMLA leave, an employee is entitled to the same position, or an “equivalent position.”  An equivalent position is one with the same pay, benefits and working conditions (shift and schedule) and the same or substantially similar duties, conditions, privileges, and status which require equivalent skill, effort, responsibility and authority.

 

1.         If a reduction-in-force occurs while the employee is on leave, the employee’s right to a position shall be established in accordance with the DAS-HRE Rules Chapter 11, the applicable collective bargaining agreement, or the applicable Regents Institution’s policies.

2.         The employee’s pay increase eligibility date shall be adjusted for unpaid absences of more than 30 calendar days.

3.         The FMLA does not prohibit an employer from accommodating, consistent with the Americans With Disabilities Act, an employee’s request to be restored to a different shift, schedule, position, or location which better suits the employee’s personal needs on return from leave.  However, accommodating an employee in this manner must also be in compliance with any applicable collective bargaining agreement.

 

B.         If the employee is unable to perform an essential function of the position because of a physical or mental condition, including the continuation of a serious health condition, the employee has no right to restoration to another position under the FMLA.  The employer’s obligations may be governed by the Americans With Disabilities Act (ADA).

 

C.         An employee may be placed in a position in the same class, and must be reinstated to the same or a geographically proximate work site (i.e., one that does not involve significant increase in commuting time or distance) from where the employee had previously been employed when he or she returns from FMLA leave.

 

D.         Upon returning from FMLA leave, an employee is entitled to no more rights or benefits than he or she would have received had the leave not been taken.

 

E.         An employee must work at least 30 calendar days after his or her return to be considered “returned” to work.

 

F.         If the employee does not return to work because of a serious health condition, the employer will require written certification from the health care provider.  If the employee fails to respond within 30 calendar days, the employer may recover all of the State’s share of his or her health and dental plan premiums for this period.


 

G.         If the employee does not return to work and the reason for not returning to work is not due to the employee’s serious health condition or is for circumstances beyond the employee’s control, the employer will require certification that the employee is unable to return and will recover its share of health and dental plan premiums paid for the employee during the period of leave.

 

H.         If the employee does not or cannot return to work and the reason for not returning to work is due to the employee's serious health condition, the employer will discuss with the employee the possibility of applying for long term disability insurance (LTD) benefits.

 

I.          The employer may request periodic updates from the employee concerning the employee’s status, and the date he or she intends to return to work.  Requests for periodic updates will be made no more often than necessary depending on the facts and circumstances of each case.  The employer’s policy must take into account all of the relevant facts and circumstances related to the employee’s leave situation.

 

J.          If an employee is unable to return from FMLA leave on the expected date and FMLA leave has not been exhausted, the employee shall contact his or her supervisor about an extension.  If FMLA leave has been exhausted, published leave procedures will apply.

 

XI.        PAY AND STATUS CHANGES

 

A.         An employee’s pay will be adjusted for across-the-board increases, and pay grade or pay plan changes that may occur while he or she is on FMLA leave.

 

XII.       MEDICAL OPINIONS

 

A.         At the employer’s discretion, an employer who has reason to doubt the validity of a medical certification may require the employee to obtain a second opinion at the employer’s expense (including travel).  The employee must submit the claim to his or her health care provider for payment, the employer is responsible for the remaining dollar amount, if any.  The employer is permitted to designate the health care provider to furnish the second opinion, but the selected health care provider may not be employed on a regular basis by the employer.  Pending receipt of the second medical opinion, the employee is provisionally entitled to FMLA leave.

 

B.         If the opinions of the employee’s and the employer’s designated health care providers differ, the employer may require the employee to obtain a third medical opinion at the employer’s expense.  The third opinion shall be final and binding.  The health care provider selected for a third medical opinion must be acceptable to both the employee and employer.  Upon request, the employee shall be provided with any medical documentation used in making the final decision within two business days.


 

XIII.      CLARIFICATIONS

 

A.         At the time the employer requests certification, the employer must also advise the employee of the anticipated consequences of an employee’s failure to provide adequate certification which could include: delay, denial, designation without certification or discipline.  The employer shall advise an employee whenever the employer finds a certification incomplete, and provide the employee a reasonable opportunity to rectify any such deficiency.

 

B.         If an employee submits a correctly completed certification signed by a health care provider, the employer may not request additional information from the employee’s health care provider regarding certification.  However, a health care provider representing the employer may contact the employee’s health care provider, with the employee’s written permission, for purposes of clarification and authentication of the medical certification.

 

C.         If an employee is on FMLA leave that is running concurrently with a workers’ compensation absence, the employer may contact the workers’ compensation provider directly for the purpose of clarifying or checking the authenticity of a medical certification.

 

XIV.      RECERTIFICATION OF MEDICAL CONDITIONS

 

A.         For pregnancy, chronic, permanent, or long-term conditions under the continuing supervision of a health care provider, an employer may request recertification no more than every 30 calendar days and only in connection with an absence by the employee, unless:

 

1.         circumstances described by the previous certification have changed significantly (e.g., the duration or frequency of absences, the severity of the condition, complications); or

2.         the employer receives information that casts doubt upon the employee’s stated reason for the absence.

 

B.         If the minimum duration of the period of incapacity specified on a certification furnished by the health care provider is more than 30 calendar days, the employer may not request recertification until that minimum duration has passed unless:

 

1.         the employee requests an extension of leave; or

2.         circumstances described by the previous certification have changed significantly (e.g., the duration of the illness, the nature of the illness, complications); or

3.         the employer receives information that casts doubt upon the continuing validity of the certification.

 

C.         The employer may request recertification at any reasonable interval, but not more often than every 30 calendar days unless:

 

1.         the employee requests an extension of leave; or

2.         circumstances described by the previous certification have changed significantly (e.g., the duration of the illness, the nature of the illness, complications); or

3.         the employer receives information that casts doubt upon the continuing validity of the certification.


 

D.         For FMLA leave taken intermittently or on a reduced leave schedule basis, the employer may not request recertification in less than the minimum unless one of the conditions set forth below is met:

 

1.         the employee requests an extension of leave; or

2.         circumstances described by the previous certification have changed significantly (e.g., the duration of the illness, the nature of the illness, complications); or

3.         the employer receives information that casts doubt upon the continuing validity of the certification.

 

E.         The employee must provide the requested recertification to the employer within 15 calendar days after the employer’s request unless it is not practicable under the particular circumstances.  Any recertification shall be at the employee’s expense.

 

XV.       DENIAL CRITERIA

 

A written explanation provided on the “Family and Medical Leave Act (FMLA) Response” (CFN 552-0627) form denying FMLA leave must include one of the following reasons:

 

1.         The employee has not been employed at least 12 months and worked at least 1,250 hours in the previous 12 months; or

2.         The employee’s fiscal year FMLA leave entitlement has been exhausted; or

3.         The employee or family member is not a son, daughter, spouse, parent or a person standing “in loco parentis” as a son, daughter or parent; or

4.         The employee’s family member does not have a serious health condition, or the health condition does not render the employee unable to perform the essential functions of his or her position; or

5.         The FMLA leave request was more than 12 months after the birth, adoption or foster placement of a son or daughter, or the son or daughter was over eighteen years of age and capable of self-care.

 

XVI.      LEAVE DESIGNATION

 

A.         The employer shall designate all FMLA qualifying absences as FMLA leave.  It is the employer’s responsibility to make FMLA leave designations.

 

B.         The 12 week limitation will be counted starting at the “from” date on the State of Iowa “Family and Medical Leave Act (FMLA) Application” (CFN 552-0599) form.

 

C.         Personnel assistants must use the attached “State of Iowa Family and Medical Leave Act (FMLA) Application” (CFN 552-0599) form to track leave usage.  A separate form is required for each request.</