FMLA Q&A for Nurse Practitioners

If you're a nurse practitioners, chances are that thinking about FMLA is accompanied by a groan. FMLA means more paperwork for healthcare providers charged with securing medical leave for patients or their family members. Before whipping out your pen and scribbling responses into the multi-page form, however, it's important that nurse practitioners familiarize themselves with the background of the law and the requirements for advocating for a patient's leave. An FMLA slip-up could leave you legally exposed. Maintain solid relationships with your patients, and follow the letter of the law by understanding the answers to these basic FMLA questions. 

1. What is FMLA, anyway?

The Family Medical Leave Act of 1993, better known as FMLA, was enacted for the purpose of giving employees provisions for handling personal circumstances. The Act allows employees to take up to 12 work weeks of unpaid leave during a 12-month period for medical reasons. It also requires that group health benefits are maintained during the period of leave. 

2. Can nurse practitioners sign FMLA certificates?

When an employee requests extended leave for a medical condition, the employer will typically request an FMLA Medical Certification Form to support the leave request. This form must be completed by a healthcare provider and provide medical information that supports the existence of a serious health condition. 

The Family Medical Leave Act defines "healthcare provider" as:

  1. A doctor of medicine or osteopathy who is authorized to practice.
  2. Any other person determined by the Secretary of Labor to be capable of providing healthcare services. 

Nurse practitioners fall into this second "other" category along with midwives, physician assistants, podiatrists, dentists, and a few other types of clinicians. So, nurse practitioners are permitted to complete FMLA medical certifications for their patients. 

3. What medical conditions qualify for FMLA?

FMLA entitles eligible employees to take leave for a "serious health condition" of either the employee or an immediate family member. A "serious health condition" is defined as any illness, impairment, injury, or physical or mental condition involving inpatient care or "continuing treatment by a healthcare provider". Examples of such conditions include: 

  • Birth and care of the newborn child of an employee (or placement with the employee of a child for adoption or foster care)
  • A medical condition rendering the employee unable to work
  • Care for an immediate family member (child, spouse, or parent) with a serious health condition

The definition of which medical diagnoses and to what degree that qualify for FMLA are vague. As a nurse practitioner, it will be up to you to determine if your patient's health status necessitates leave. 

4. What information is included on the FMLA Medical Certification Form?

In general, the FMLA Medical Certification Form asks for the following medical information from the healthcare provider: 

  • Date the condition commenced
  • Probable duration of the condition
  • Medical facts regarding the condition
  • Statement that the employee is unable to perform the essential functions of his/her job
  • Or, statement that the employee is needed to care for a qualifying family member
  • Dates and duration of any planned treatment
  • Statement of medical necessity for the leave and the expected duration

In some cases, the employer may also request that you as a healthcare provider also submit a certification that the employee is able to return to work at the conclusion of the leave. 

5. What if the employer disagrees with my assessment?

If an employer disagrees with your assessment or has serious questions about your determination that the patient is unable to perform his or her job, the employer may send the employee to another healthcare provider for a second opinion. This is done at the employer's expense. 

How often do you complete FMLA forms as a nurse practitioner?

 

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