Navigating the legal landscape surrounding employee medical leave and health-related accommodations continues to be a complex task for employers. From evolving vaccine policies to statutory leave entitlements, human resources professionals and business owners must carefully balance compliance obligations with operational needs.

Making Sense of Federal, State, and Local Laws

Helen Bloch, an attorney with expertise in employment law, emphasizes that legal obligations depend largely on the size of the employer and the location of its workforce. For example, employers with 15 or more employees are subject to the Americans with Disabilities Act (ADA), while those with 50 or more employees within a 75-mile radius must comply with the Family and Medical Leave Act (FMLA). Smaller employers may still be governed by a patchwork of state and local laws, particularly municipal human rights ordinances. Bloch encourages employers to assess all applicable jurisdictions to ensure compliance, particularly in multi-state operations.

Understanding FMLA’s Scope and Eligibility

Amit Bindra of Prinz Law Firm outlines the foundational elements of the FMLA, which provides eligible employees with up to 12 weeks of unpaid, job-protected leave. Eligibility requires that the employee has worked at least 1,250 hours during the prior 12 months for an employer covered under the act.

Qualifying reasons include:

• The employee’s own serious health condition
• Care for a qualifying family member with a serious health condition
• Birth, adoption, or foster care placement of a child
• Certain types of military family leave

The definition of a serious health condition hinges on either inpatient care or continuing treatment by a healthcare provider. The latter includes conditions such as pregnancy, chronic health issues, and incapacities requiring multiple treatments. Ordinary illnesses, such as colds, headaches (unless migraines), and routine dental work, typically do not qualify. Another important consideration is ‘intermittent leave,’ which is permissible for medical necessity but not automatically allowed unless the employer consents.

Important to note is that in situations where the FMLA does not apply, the ADA may still impose obligations. Employers must consider unpaid leave as a form of reasonable accommodation if the employee has a qualifying disability under the ADA, provided it does not cause undue hardship. Employers are not necessarily required to grant the full 12 weeks mandated under the FMLA in those cases, but they may still be required to provide some leave if it enables the employee to return to work.

Paid vs. Unpaid Leave

While FMLA leave is unpaid, Bindra notes that other forms of compensation, such as short-term disability, paid time off (PTO), and workers’ compensation, may overlap with unpaid FMLA leave. Employers can require the use of accrued PTO concurrent with FMLA leave, as long as their policies are clearly communicated and consistently applied. However, specific state laws may place limitations on how these benefits are used. For instance, Bloch points out that in certain jurisdictions, workers’ compensation benefits may replace wages during medically-related leave, and those benefits cannot be ‘topped off’ with PTO unless state law permits.

Obligations Under FMLA

Employer

• Notice Requirements: Employers must issue general and specific FMLA notices to employees regarding their rights, responsibilities, and eligibility.
• Health Plan Maintenance: Group health insurance must be maintained during the leave on the same terms as if the employee had continued working.
• Job Restoration: Upon return, the employee must be reinstated to the same or equivalent position unless an exception applies.
• Recordkeeping: Accurate records of leave time, certifications, and communications must be retained.

Employee

• Providing sufficient and timely notice of their need for leave.
• Submitting medical certifications and updates as requested.
• Complying with internal leave procedures, absent exceptional circumstances.

Medical Screening and Workplace Safety

Max Barack, partner at Garfinkel Group, LLC, explains that medical inquiries, such as temperature checks, symptom screening, or exposure questions, are permissible if they are applied uniformly across the workforce, job-related and consistent with business necessity, and temporarily required in response to specific health threats like a communicable disease outbreak. In these cases, employers must also provide clear return-to-work protocols and avoid overly restrictive exclusion policies.

Vaccination Policies and Legal Considerations

While COVID-19 brought issues such as mandatory vaccination to the forefront, the legal framework remains grounded in established ADA principles.

Bloch advises that employers may mandate vaccinations if they are job-related and consistent with business necessity. However, they must accommodate employees who decline vaccination due to medical conditions or sincerely held religious beliefs, unless doing so would create an undue hardship.

Bindra suggests employers should evaluate the sincerity of such beliefs and the feasibility of accommodations on a case-by-case basis. Prior refusals of other vaccines, for example, may support a claim of religious belief consistency.

Balancing Compliance and Operational Integrity

Ultimately, laws such as the FMLA and ADA are intended to create a more equitable and predictable work environment for both employees and employers. These statutes provide a framework for addressing serious health issues without jeopardizing job security, while also ensuring that employers maintain operational continuity within defined legal boundaries. Although compliance can be complex, especially when multiple laws interact, maintaining up-to-date policies and engaging in clear, good-faith communication are critical.

To learn more about this topic view Leaves of Absence and Medical Issues. The quoted remarks referenced in this article were made either during this webinar or shortly thereafter during post-webinar interviews with the panelists. Readers may also be interested to read other articles about human resource issues. 

This article was originally published here.

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