Benefits and Compensation, HR Management & Compliance

Employer’s Ambiguous Communications Lead to Trial in FMLA Case

Ambiguous and confusing communications by an employer and benefits administrator to an employee about her Family and Medical Leave Act (FMLA) and short-term disability (STD) leave requests created issues of fact for a trial to decide, a federal district court in Columbus recently ruled.

employee benefits

Facts

Abby Knaup worked for Molina Healthcare of Ohio from April 2017 to November 10, 2018. She claimed three coworkers harassed and bullied her during her tenure at the company. Her primary complaint was that they falsely told HR she was having an affair with her supervisor, which caused her to have to meet with HR three times.

Knaup claims her own harassment charges were ignored except when she complained to the supervisor with whom she was accused of having the affair. According to her, he responded by saying he would put her and the three coworkers in the same room and let them “duke it out.” Consequently, Knaup claims she would get nauseous and vomit if she had to go to work.

On October 10, 2018, Knaup applied to take leave under the FMLA and Molina’s STD policy. The next day, the employer’s third-party administrator let her know she was “eligible,” meaning she “met the requisite criteria to be considered for leave” from October 10, 2018, to January 1, 2019. At the end of that period, however, she would be unable to take additional FMLA leave because she would have exhausted her 12-week leave allotment under the Act, according to the letter.

Regarding Molina’s STD leave and benefit request, the administrator’s letter said her “eligibility status” was “pending determination” and directed her to have her healthcare provider submit supporting medical documentation by October 26, 2018. The letter didn’t say any medical documentation was needed for the FMLA request or that any next steps applied to the latter.

On October 28, 2018, the administrator sent Knaup a second letter stating both her FMLA and STD leave requests had been denied because the requested medical paperwork hadn’t been submitted. The second letter said she could submit the requested information within 60 days for evaluation or could appeal the denial.

Knaup claims she called the administrator upon receiving the second letter and explained the doctor couldn’t see her until November 8. She says she was told that was fine and to have the doctor submit the documentation after the medical exam.

After seeing Knaup on November 8, the doctor let the administrator know he didn’t recommend she stop working altogether. Nevertheless, he said her symptoms were severe enough to preclude her from working in the environment she was experiencing in her job at Molina.

On November 21, the administrator determined Knaup wasn’t eligible for STD benefits under Molina’s policy. The administrator’s letter didn’t reference the FMLA or her FMLA leave request.

On December 12, Molina sent Knaup a letter announcing her employment had been terminated effective November 10, 2018, because she failed to provide the FMLA medical certification. Accordingly, she had been let go under the company’s no-call/no-show policy.

Court proceedings

On January 16, 2019, Knaup sued Molina alleging FMLA interference and retaliation. The employer requested summary judgment (dismissal without a trial) on both claims. On March 3, 2021, Judge Edmund Sargus of the U.S. District Court for the Southern District of Ohio issued his decision.

Molina argued it was entitled to dismissal of Knaup’s FMLA interference claim for two reasons:

  • She had failed to submit a timely medical certification to support her FMLA application; and
  • She hadn’t proven she had a “serious health condition” as defined in the Act.

Regarding the first argument, the court ruled a reasonable juror could conclude from reading Molina’s and the administrator’s letters to Knaup that (1) she wasn’t required to submit an FMLA medical certification, and (2) the request for medical information from her doctor applied only to her claim for STD leave and benefits.

The court also noted that, even if Knaup should have known Molina expected her to submit a FMLA medical certification, the deadline for submitting the information from her doctor had been extended by virtue of the administrator’s statement that it was fine for her to wait until after the November 8 doctor’s appointment, which she did.

Molina’s argument that Knaup failed to establish she had a serious health condition was premised on the doctor’s statement that she was not unable to work “if the environment is appropriate.” The court found the argument unpersuasive. According the court, “because Knaup was seeking leave from her job with Molina, the operative question is whether she could perform that job, not any other job.”

The court did grant Molina’s request for summary judgment on Knaup’s FMLA retaliation claim. It noted she had failed to point to any evidence demonstrating the employer possessed retaliatory intent. Knaup v. Molina Healthcare of Ohio, Inc., S.D. Ohio No. 2:18-cv-166 (Mar. 3, 2021).

Takeaway for employers

If your organization offers STD benefits, it isn’t uncommon for employees to apply for them at the same time they request FMLA leave. While the two benefits have some commonality, it’s important to remember they are distinctly different. It isn’t uncommon for employers to respond to FMLA and STD applications jointly for expediency purposes. If that’s your practice, make sure all communications clearly delineate exactly what is needed for each.

Franck Wobst is of counsel with Porter Wright’s Columbus office. You can reach him at fwobst@porterwright.com.