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FMLA, Worker’s Compensation and ADA:
Navigating Overlapping Rules
Presented by:Betty S.W. Graumlich, Esquire
Michael D. Jones, Esquire
Objectives
Identify recurring problem areas
Update recent changes in law or interpretation
Case Study examples
Family and Medical Leave Act
Warning Signs that the FMLA may apply
Requests for leave to Human Resources
Extended absences
Poor attendance
Conversations with supervisor (training required)
Initiation of FMLA Leave Analysis
FormalRequest
forLeave
Employee onWorkers’
Compensation Absence/Leave
An Employeeis on anextended period
of sick leave
An Employee is out intermittently and hasprovided information that the absences arecaused by a medical
condition
Determineemployeeeligibility
Absencesof over
three (3)days
qualifyas
“serioushealth
condition”
Provideemployeewith DOLmedical
certificationform and
informemployee
of proceduresto request
FMLA leave
Determineif employee
hasindicated
that he/shemay have a
serioushealth
condition
Determineemployeeeligibility
Provideemployeewith DOLmedical
certificationform and
informemployee
ofproceduresto request
FMLA leave
Determineemployeeeligibility
Determineif reasonfor leavequalifies
Determining Employee Eligibility
Employed for at least 12 months(need not be 12 concurrent months)
Has worked 1,250 hours in preceding 12 months(excluding paid, unworked time)
Works at a work site with 50 Employees(within a 75 mile radius)
Has not exhausted his/her annual 12 week entitlement
Determining if Reason for Leave Qualifies
Birthor
Adoption
To care forimmediate familymember or spouse
with serioushealth condition
Employee’s own serious
healthcondition
Within12 monthsof birth orplacement
For the care of a covered service
member or exigency
or
Determining if a medical condition is a “Serious Health Condition”
Inpatient treatment
ofany
duration
Absences of more thanthree (3) days
involving outpatient treatment
which includes:
Chronic medicalconditions
causing absencesof any duration
Two or more visitsto a
health care
provider
One visit to ahealth care
providerfollowed by aprescription medication
or other ongoing
treatment(such as physicaltherapy)
Chronic, long termillness which
causeepisode absences
Examples:migraine
headaches, asthma,
Alzheimer’sand other
illness without definite duration
Absences due to
pregnancy orprenatal care
of any duration
NJ Leave Act – Key Differences 50 employees nationwide Employed 1 year Worked 1000 hours in prior 12 months 12 weeks in 24 months Includes in-laws, excludes self
Paid NJ Family Leave Six weeks paid Child bonding leave during first 12 months Care for ill child, spouse or parent Domestic partners covered Six weeks or 42 intermittent days
Military Family Leave Military Caregiver Leave Eligible employees (spouse, son, daughter,
parent or next of kin) may take up to 26 workweeks of unpaid leave in a rolling 12-month period to care for a covered servicemember with a serious injury or illness
Qualifying Exigency Leave Eligible employees may take up to 12 workweeks
of unpaid leave during the employer’s normal 12-month period for qualifying exigencies arising out of the fact that the employee’s spouse, son, daughter, or parent is on active duty or has been notified of an impending call to active duty, in support of a contingency operation
Military Caregiver Leave Provides for a combined total of up to 26 workweeks
of unpaid leave in a 12-month period;
Eligible Employee: a spouse, son, daughter, parent, or next of kin of a covered servicemember with a serious injury or illness;
“Covered service member” – current member of the Armed Forces, including National Guard or Reserves, who is undergoing medical treatment, recuperation, or therapy, or is in outpatient status, or is on the temporary disability retired list, for a serious injury or illness.
Military Caregiver Leave “Serious injury or illness” incurred in the line of duty on active duty
and may render the servicemember medically
unfit to perform the duties of his or her office, grade, rank, or rating
Military Caregiver Leave “Single 12-month period” begins on the first day the employee takes
leave for this reason, regardless of the 12-month period established by employer for other types of FMLA leave
Americans with Disabilities Act
Qualified Individual Able to perform essential job functions with
or without reasonable accommodation
Excludes marginal job functions
Does not consider long term or degenerative effects of a disability – but “regarded as” claims
Does not permit cost-based disqualification because of increased health insurance or Workers’ Compensation premiums
PhysicalImpairment
MentalImpairment
Prior record ofa mental
orphysical
impairment
Regardedas havinga physicalor mental
impairment
or or or
Substantially limits a major life activity
Disability Defined
NEW DEFINITION OF DISABILITY When in doubt, it is now much safer to
assume that a condition is a disability than to rest your defense on the position it is not.
Major Life Activities Caring for oneself Manual tasks Walking Seeing Hearing Speaking Breathing Learning Working Eating Sleeping Standing
Lifting Bending Reading Concentrating Thinking Communicating Using major bodily
functions, including functions of the immune system, normal cell growth, digestive, bladder, bowel, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions.
“SUBSTANTIALLY LIMITED” Supreme Court held that a person was “substantially
limited” in a major life activity only if the impairment prevented or severely restricted the person from engaging in the activity.
Congress has now rejected that interpretation. “Substantially limits” should be interpreted
consistently with the new amendments’ findings and purpose, which clearly rejected Court‘s “cramped” view.
“SUBSTANTIALLY LIMITED” Under amendments, if an impairment that is inactive or in
remission would substantially limit someone from engaging in a major life activity if it were active, it is a disability, even if it is not currently imposing any such limits.
In major reversal of Supreme Court holdings, amendments say that whether an impairment substantially limits a major life activity must be determined without taking into account the ameliorative effects of mitigating measures, such as: medication, medical supplies, equipment, or appliances,
prosthetics, hearing aids, mobility devices, or oxygen therapy (other than normal eyeglasses or contact lenses);
assistive technology; reasonable accommodations or auxiliary aids or services; or learned behavioral or adaptive neurological modifications.
Interactive ProcessThe EEOC’s guidelines state that... “once a qualified individual with a disability has requested a provision of a reasonable accommodation, the employer must make a reasonable effort to determine the appropriate accommodation. The appropriate reasonable accommodation is best determined through a flexible, interactive process that involves both the employer and the [employee] with a disability.”
Interactive Process
To trigger employer’s obligation to participate in interactive process Employer must know of employee’s
disability; and Employer must know that the
employee may need an accommodation.
Employer’s Good Faith Effort Meeting with the employee Requesting information regarding employee’s
condition and limitations Asking what accommodation the employee
wants Showing signs of having considered employee’s
request Offering and discussing available alternatives if
requested accommodation is too burdensome Consulting outside resources
MODIFYING POLICIES AS REASONABLE ACCOMMODATION The employer may be required to make an exception to a
neutral policy or practice. The Supreme Court has held that “the simple fact that an
accommodation would provide a ‘preference’ – in the sense that it would permit the worker with a disability to violate a rule that others must obey – cannot, in and of itself, automatically show that the accommodation is not reasonable.” U.S. Airways, Inc. v. Barnett, 535 U.S. 391, 398 (2002).
An employer thus may be required to modify or make exceptions to its existing neutral policies regarding leaves of absence, transfers, part-time work, and breaks.
But courts have generally rejected claims that attendance policies must be modified as an accommodation.
And most courts hold that an employer need not lower its quantitative or qualitative standards, including production standards, as a reasonable accommodation.
LEAVES OF ABSENCE AS REASONABLE ACCOMMODATION The EEOC has recognized the following as examples of situations
in which an employee may be entitled to time away from work as a reasonable accommodation: To obtain medical treatment, rehabilitation services, or
occupational therapy To recuperate from an illness or an episodic manifestation of the
disability To avoid temporary adverse conditions in the work environment
(e.g., a breakdown in air conditioning that will aggravate a respiratory disability)
If the employee has paid leave available, the employer should allow its use before requiring unpaid leave. Otherwise, leave granted as an accommodation need not be paid.
Indefinite leaves or with no proposed end date are generally unreasonable and need not be granted.
How long a leave needs to be to be considered a “reasonable” accommodation generally depends on specific circumstances, such as whether the employee has already been given significant time off, whether the requested leave is of a substantial duration, and how likely it is that the employee will be able to return on the proposed end date.
Other Types of Reasonable Accommodation Job restructuring
Part-time/modified work schedules
Reassignment to vacant positions
Acquisition or modification of equipment
Modification of policies
Job coaches
Readers, interpreters
Unpaid leave
ATTENDANCE POLICIES Policies under which all employees who have missed work for
a specified period of time, regardless of the reason, will be terminated The EEOC says such blanket policies violate the ADA, and
even when the deadline runs out, the employer must hold an employee’s position unless it can prove that doing so would impose an undue hardship.
Courts have gone both ways.
Sporadic or unpredictable absences Most courts hold that an employer need not modify its
attendance or leave policies to tolerate such absences where it can show that regular and predictable attendance is an essential function of the job.
But the EEOC takes the opposite view, holding that attendance cannot be considered an essential job function, because the ADA itself recognizes that leaves of absence and modified work schedules are types of reasonable accommodation.
EMPLOYER CONSIDERATIONS FOR JOB RESTRUCTURING Don’t have a blanket policy prohibiting all employees
from working unless they have no restrictions (a “full release”).
Make an individualized assessment of an employee’s restrictions and the job’s essential functions to determine whether you need to eliminate an essential job function (which need not be done).
Consider eliminating marginal job functions, shifting non-essential functions among employees, and redesigning job procedures.
LIGHT DUTY JOBS An employer may choose to temporarily excuse an employee
from performing one or more essential functions while placing the employee on “light duty,” but need not do so.
Courts do not require employers to create a permanent light duty position as an accommodation where none otherwise exists. But if an appropriate light duty position exists and is vacant, assignment to that position may be a reasonable accommodation.
Employers may choose to create light duty jobs only for employees who are injured on the job, and may limit such positions to a specified period of time. Doing so avoids the risk that they will become permanently available as accommodations, or that the employer will be viewed as having changed the essential functions of the job.
PART-TIME OR MODIFIED JOB SCHEDULES Fact-specific determination. No obligation to create a part-time job as a
reasonable accommodation. The ADA does not require providing full-time
compensation or benefits to an employee who has been allowed to work part-time as an accommodation.
Working at home as a reasonable accommodation Generally not required unless other employees are
allowed to work at home or being in the office is not an essential function of the job, in which case such an accommodation may be reasonable.
REASSIGNMENT TO A VACANT POSITION For applicants, no obligation to determine whether he or she is
qualified for any position other than the one being sought. Reassignment is an accommodation of last resort. In general,
it should be used only when there is no reasonable accommodation available that would allow the employee to perform the essential functions of his or her current job.
No duty to create a new position or bump anyone out of a position.
Reassignment is required only if a job is vacant when the employee asks for accommodation or the employer knows that it will become vacant “within a reasonable period of time” (e.g., the employer has posted the position or placed an ad seeking applications, or knows the incumbent is about to move out of the position).
REASSIGNMENT TO A VACANT POSITION (Cont.) EEOC regulations say that if reassignment is appropriate, the
employee should be reassigned to “an equivalent position, in terms of pay, status, etc., if the individual is qualified, and if the position is vacant within a reasonable amount of time.”
Employer need not promote an employee to accommodate. If employee can no longer perform his or her current job,
demotion may be a reasonable accommodation. The employee’s pay may be lowered if the new position pays less (unless the employer “red circles” non-disabled employees who are reassigned to lower positions).
The employee must be qualified for the vacant position. Courts generally hold that an employer is not obligated to train the employee.
REASSIGNMENT TO A VACANT POSITION (Cont.) Does the disabled employee have preferential placement
rights as compared with other applicants for the vacant job? EEOC says yes, and most courts generally agree – that ADA’s
reference to “reassignment” as a possible reasonable accommodation must mean more than just allowing someone to compete.
But other courts say the ADA does not require preferential treatment, and that disabled employees must compete with non-disabled employees for vacant positions, if the employer’s consistent policy is to hire the best qualified applicant.
An employer generally does not need to offer an accommodation that would actually violate a collective bargaining agreement.
Undue Hardship Defense
Significant difficulty and expense
Factors include cost, financial resources, size of employer, size of the facility and impact on business operations
Case-by-case analysis required
Post-Offer Medical ExamsUnder ADA Job-related and consistent with business
necessity Authorizes IME’s under Workers’ Compensation Voluntary exams permissible (Wellness
Programs)
Confidentiality Separate files Under lock and
key Access limited to
those with a “need to know” Litigation
problem
Workers’ Compensation
No Fault System Compensation is
granted for such obscure injuries as an aggravation or recurrence or a pre-existing condition, as well as for mental stress and psychological injuries.
Injury Must Occur in Course andScope of Employment Course and scope of employment, furthering the
employer’s business
On premises vs. off premises injuries
Traveling to and from work
Special missions
Company sponsored events
Recreational activities
Injuries caused by acts of other due to personal disputes
Drug usage or intoxication - injuries suffered while violating the law
Medical Examinations Under WCA
IME
Panel Physician - 90 days
Cannot be used for FMLA purposes
Interaction Between The FMLA, ADA and WCA Employees may be
eligible for leave under more than onestatute.
Employers must determine which of the three statutes apply to a particular employee’s request for leave. More than one statute can apply.
Medical Examinations/Evidence
FMLAEmployee’s Medical Certification
2nd Opinion
3rd Opinion
Return to Work Certification
Medical Examinations/Evidence
ADANo challenge procedure
IME’s permitted if job-related and consistent with business necessity
Medical Examinations/Evidence
Workers’ CompensationIME
Panel Physician
Length and Type of LeaveFMLA ADA WCA• Up to 12 weeks
of unpaid leave (in 12 month period).
• Reinstatement rights only to statutory 12 week period.
• Does not require that employers grant any specific period of leave.
• Only have to grant leave of absence if it is a"reasonable" accomodation.
• Provides paid leave time for an indefinite period of time.
• No right to reinstatement.
• Retaliation protection
Light Duty Jobs Under WCA Many employers have established “light duty”
positions to respond to medical restrictions on workers recovering from job-related injuries, in order to reduce workers’ compensation liability
Such tasks may include answering the telephone and simple administrative work
Useful for Workers Compensation, but create ADA risks.
Cannot require light duty instead of leave under FMLA, but may affect WCA Compensation
Salary and Benefit DilemmaFMLA
FMLA leave can be unpaid leave, but employer must provide employee with same level of benefits as if employee was still on the job.
ADA ADA permits an
employer to reduce the benefitsprovided to the employee when the employee’s reduced work schedule drops the employee’s hours below that required for the applicable benefit plan coverage.
Return to Work Issues The employer cannot refuse to let an individual
with a disability return to work because the worker is not fully recovered from an injury unless: Worker cannot perform essential functions of
the job with or without an accommodation. Would pose a significant risk of substantial
harm that could not be reduced to an acceptable level with reasonable accommodation.
Risk of future WCA claims not a permissible factor.
Sick Leave Employers may
generally require employees to provide a doctor’s note: Must be consistent
with policy
FMLA intermittent leave exempted.
Case Study No. 1Joe Smith is one of your company’s best new employees -- never misses a day and does great work. After work one day, Joe decides to drive to the grocery store instead of going directly home. Leaving the store, Joe is involved in a car accident. Although Joe only suffers a broken leg, a driver in one of the other cars is critically injured. He calls you the next day and tells you he is supposed to be on bed rest for one week. What do you do?
Joe returns to work one week later. He tells you that he can’t comfortably get into and out of his desk and can’t move around his cubicle because of the crutches. What do you do?
Since his return, Joe seems distracted. He begins to miss work one and sometimes two days a week and his performance declines. His supervisor asks if anything is wrong, but Joe consistently says “No.” The following week, you receive a note from Joe’s doctor saying that he needs to be off from work indefinitely because he is suffering from severe depression resulting from his involvement in the car accident. What do you do?
Three months pass and Joe has not yet returned to work. You call him and Joe says that his doctor recommends that he work from home. What do you do?
Joe files a workers compensation claim, stating that he was transporting files to work at home and visiting a client on his way home at the time of the accident. Is he covered?
Case Study No. 2Jane Doe is one of your Company’s worst employees. She works in the accounting department and is always missing deadlines and her work is often full of errors. Her substandard work is exceeded only by her miserable attitude, resulting in constant friction between her and her co-workers and her supervisor.
Jane is one step away from termination under your no-fault attendance policy. When it seemed that you were finally going to be rid of Jane and her lousy attitude, you receive a letter from her cousin, a personal injury lawyer whose TV commercials run constantly during episodes of Judge Judy.
The letter from Jane’s cousin says her absences are because of debilitating migraines and he is going to sue you personally for millions of dollars if she is fired. What do you do?
When you speak to Jane’s supervisor, he says he does remember something about Jane saying she couldn’t come to work because she had headaches on a few occasions when she called out, but he figured she was just hung over, so he never did anything about it. Everyone knows she is a big partier. What do you do?
Now that you are convinced that Jane’s supervisor is an idiot, you decide to eliminate the weak link in the chain and instruct Jane that she must now call out only to you and that she must speak to you in person – no voicemail. Grudgingly you also tell her you will clear her attendance record and giver her FMLA paperwork to fill out.
Jane returns the FMLA certification, which says she will need to miss work intermittently due to migraines. Soon summer arrives. Almost immediately thereafter, Jane begins missing Fridays and Mondays almost every week. You also observe that Jane is very, very tan. You wonder if Jane is calling out to extend her weekends at the shore, what do you do?
You decide to confront Jane and she freely admits that she spends the weekend at the shore. She claims the salt air is good for her migraines. What do you do?
You have had it, you decide to catch Jane in the act. You follow her to the shore and stake out her house for the weekend. Sure enough, she calls out sick on Monday and you spot her sunning by the pool. What do you do?
You receive another letter from Jane’s cousin, saying that you are harassing her and violating her civil rights and that he will sue you personally for millions of dollars. What do you do?
After Jane obtains a restraining order against you for stalking her on the weekends, you decide to lay low for a while. The following Friday, you come in to work and Jane has left you a message saying she is out with a migraine. You think to yourself, “I finally have her, I told her no voicemail, she has to talk to me in person!” Can you finally fire Jane?
Jane’s extended weekends at the shore soon deplete her available sick time. Her cousin sends you a letter indicating that you are discriminating against Jane because you did not solicit employees to donate leave time on her behalf, like you did last year for the employee in the sales department who was being treated for cancer. He threatens to sue you personally for millions of dollars, what do you do?
After you send out the memo soliciting employees to donate sick leave on Jane’s behalf, you get no responses. That’s not entirely true, you do get a few responses of a profane nature, expressing displeasure at having to carry a heavier workload while Jane works on her tan. Recognizing that you have a serious morale problem, you decide to address the troops – what can you say?
Well, you guessed it, another letter from Jane’s cousin the lawyer threatening to sue you for millions of dollars. This time, he says there is a hostile work environment and Jane is being harassed. He says that no one donated sick leave on Jane’s behalf and now none of her co-workers will talk to her or invite her to lunch. This violates her constitutional rights and he demands you eliminate this hostile environment at once. What do you do?
Jane comes to you a week later with an FMLA certification indicating she needs to take leave to care for her elderly mother who has congestive heart failure. The next day, you learn from co-workers that her mother won an all expenses paid weekend in Las Vegas and Jane is taking the FMLA leave to go with her. Can you deny her leave?
Despite the fact you denied her leave, Jane goes AWOL. One of her co-workers forwards a picture from Facebook showing Jane and her mother posing in front of the slot machines at the Bellagio. You think to yourself, “not even my stupid lawyer can deny me now – she’s so fired!”
Two days after you send Jane’s termination letter, you get served with a complaint. Jane’s cousin has sued you personally for millions of dollars. Irate, you call you lawyer demanding that we counter-sue Jane and her cousin. What does your lawyer say?
Ballard v. Chicago Park District(N.D. Illinois Sept. 29, 2012
“There is no statutory or regulating text stating something to the effect that “care” must involve some level of participation in the ongoing treatment of the family member’s condition….”(Ruling in favor of employee’s right to FMLA leave to accompany her mother to Vegas)
