How To Detect and Deal With FMLA Fraud

In yesterday’s CED, we looked at one expert’s remedies for family leave headaches. Today we look at her suggestions for dealing with family leave fraud, including FMLA/CFRA’s most-abused provision – intermittent leave.

 

Although most employees use family leave appropriately, says Beverly Kish, SPHR, there are always going to be some who work the system. You’ll pick up on most of that if you monitor leaves for patterns that might indicate fraud, she says. Kish is director of Human Resources at National Flight Services.

 

Here are the abuse patterns Kish is on the lookout for:

 

–Monday/Friday absences. FMLA isn’t a long-weekend program, notes Kish.

–Annual timing. When employees take family leave the same week every year, or always seem to have that medical flare-up between Thanksgiving and New Year’s, you might be suspicious, says Kish.

–Unreal circumstances. Kish remembers one employee who had a parent in Italy who “got sick” each summer. “Summers in Italy are brutal and the old folks suffer the most,” Kish noted dryly.

–Consistent exhaustion of leave time. If an employee has exactly 12 weeks of health problems every year, that merits investigation.

–Use of family leave to avoid attendance policies. Some employees’ family leave requests are conveniently timed to save them from violating attendance policies.

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When you spot these patterns (and you will), says Kish, the first step is to rigorously review the certification. Then, require recertification if the original certification has run out, or if you reasonably suspect fraud.

 

Final Tips from the Field

 

Kish shared a few miscellaneous family leave tips for readers.

• The 12 months of work employees need to qualify for family leave don’t have to be continuous. For example, a summer intern who worked 3 months for 4 summers would have his or her 12 months.
• Be sure to use a rolling method for calculating the 12-month eligibility period. If you don’t, employees can take 12 weeks’ family leave at the end of one calendar year, and then turn around and take 12 more weeks at the beginning of the next year.
• Carefully consider the status of temps, especially those you later wind up hiring full-time. Their temp time may count toward the 12 months and 1,250 hours in a year that spell family leave eligibility even though, as temps, they were not eligible, she says.

Family Leave: Information Is Power

 

You don’t stand a chance against crafty employees without a solid working knowledge of the ins and outs of family leave. That’s where our brand-new HR Management & Compliance Report, How To Comply with California and Federal Leave Laws, comes in.

 

This information-packed 118-page guide, written by an experienced California employment lawyer, features in-depth coverage of all the topics you need to know about in an easy-read, quick-reference style:

 

• Overview of California and federal leave laws

 

• Pregnancy and parental leaves

 

• Required notices

 

• Employee notifications of illness, injury, or disability

 

• Responding to leave requests

 

• Computing leave entitlement duration

 

• Medical exams and inquiries

 

• Reinstating and terminating employees

 

• Leave for military members’ families

 

• Avoiding leave-related bias claims

 

• And much more!

 

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