Hard-Core Approach to Intermittent FMLA Gets Results

Dahlen says she’s "not a lawyer and doesn’t play one on TV." But she is an HR manager who has practical solutions for FMLA hassles. Dahlen, who works at Bellefontaine Habilitation Center in St. Louis, made her remarks at the recent SHRM Annual Convention and Exposition in New Orleans. (For more on Dahlen’s tips on managing intermittent leave, go here.)

Don’t Accept Vague Certifications

"Don’t accept vaguely worded ‘certs,’" Dahlen says. For example, one says "Not presently incapacitated, needs to transport patient to cardiology appointments 2-3 times a year." "That leaves me open to the person calling in any time they want and there’s nothing I can do about it because of the way the approval is written. It should have been written ‘Approved to take the person to appointments 2-3 times with prior notification of those appointments.’"

Another cert reads: "Unable to determine due to episodic nature of condition." This is not acceptable, Dahlen says. If the caregiver has been treating the patient, he or she should be able to tell you how many episodes per month and how many hours for each episode. "Send these vague forms back and ask for additional information," Dahlen says.

Be Specific

When you certify, be specific and use dates, Dahlen says. For example, if leave is starting on 1/5/09, for a week, state, "Approved for 1/5/09 through 1/12/09 only. Absences beyond the dates approved will require additional paperwork."

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Pragmatic Approach Works for Her

In dealing with the FMLA, you just have to be practical and let things go sometimes, says Dahlen.

For example, for chronic conditions under the FMLA, there have to be two doctor visits per year, and you may make your certification provisional until both visits are completed. "Tracking and waiting for the second visit is extra work for HR," Dahlen says. With these conditions, almost invariably, the employee will end up making that second visit, Dahlen says, even if it’s just to renew prescriptions. Certainly, if they suffer from asthma or have a heart condition, chances are they are going to have that second visit. "So we are not enforcing that second visit rule. We just assume the second visit will take place, and authorize the leave," Dahlen says.

Second and Third Opinions

She also takes a pragmatic stance with regard to second and third opinions. Even though you have to pay for those second and third opinions, it can be worth it because it gives you a chance to get that number of FMLA days down, she says. But don’t waste second and third opinions when the employee is certified for 1 or 2 days a month, says Dahlen. "I go for second opinions on certs for 5 days a month or more," she says.

SASE—a Small Effective Gesture

When you return a cert that is incomplete or insufficient to the physician, list the specific questions that are incomplete (e.g., "Questions 3, 5, and 7 are incomplete or insufficient."). Be as specific as possible, Dahlen says. "Tell the doctor ‘unknown illness time’ is not an answer, you need to be more specific." Give the doctor 7 days to return the completed cert.

Always send a stamped, self-addressed envelope with anything you send to the doctor. She has not had one doctor not return forms, Dahlen says.

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Several Handwriting Styles on the Cert

Dahlen notes that HR managers are often put off by seeing different people’s handwriting on the cert. It may not seem authentic. But what she has found is that often the nurse starts the paperwork, the clerical staff finishes it, and the doctor signs it. When she encounters multiple handwriting, she calls the doctor’s office, reads what’s on the cert to them, and if it’s consistent with what’s in the file, it’s OK.

As her annual certs have come up for renewal, Dahlen is ratcheting the approvals back. One went from 480 hours to office visits every 3 to 4 months. Another went from 4 weeks’ leave to 4 days’ leave.

In tomorrow’s Advisor, we’ll get more tips from Dahlen, the story of Bristol, the FMLA abuser, and word about a timely webinar on new techniques for intermittent leave management.

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