FMLA Coordination with Other Leave Policies & Benefits 2 — Questions and Answers
Question 1: When an employer requires an employee to substitute paid leave for FMLA leave, when does the FMLA entitlement begin running?
- Only after the paid leave is exhausted
- Concurrently from the first day the FMLA-qualifying condition exists (Correct answer)
- After a 3-day waiting period
- Only when the employee requests FMLA designation
Correct answer: Concurrently from the first day the FMLA-qualifying condition exists
FMLA leave runs concurrently with paid leave substitution. The substitution of paid leave does not extend the 12-week FMLA entitlement; both clocks run simultaneously.
Under 29 CFR 825.207, when an employer substitutes paid leave for FMLA leave, the paid leave runs concurrently with FMLA leave. The employee's FMLA entitlement is not extended by the paid leave substitution. This prevents employees from receiving both paid leave and then additional FMLA-protected time.
Question 2: An employee is receiving workers compensation benefits for a work-related injury that also qualifies as a serious health condition. Can the employer designate this time as FMLA leave?
- No, workers compensation and FMLA are mutually exclusive
- Yes, the employer may designate the workers compensation leave as FMLA leave if it qualifies (Correct answer)
- Only if the employee consents in writing
- Only if the workers compensation claim is fully approved
Correct answer: Yes, the employer may designate the workers compensation leave as FMLA leave if it qualifies
Workers compensation leave and FMLA leave may run concurrently when the injury meets FMLA's definition of a serious health condition. The employer can and should designate it as FMLA leave.
29 CFR 825.702(d) permits employers to designate workers compensation leave as FMLA leave when the underlying condition qualifies as a serious health condition. Running the leaves concurrently prevents the employee from using the full workers compensation leave period and then claiming a separate 12-week FMLA entitlement.
Question 3: Under what circumstances may an employer require an employee to exhaust accrued paid sick leave before taking unpaid FMLA leave?
- Never, the employee always chooses whether to use paid leave
- When the employer's established paid leave policy requires it for the type of absence (Correct answer)
- Only when the employee's leave exceeds 5 days
- Only for planned medical procedures
Correct answer: When the employer's established paid leave policy requires it for the type of absence
An employer may require employees to substitute accrued paid leave during FMLA leave if the employer's paid leave policies would ordinarily require it for that type of absence. The employer must notify employees of this requirement.
Per 29 CFR 825.207(a), both employers and employees have the right to require or elect substitution of paid leave. However, an employer may only require substitution if its established paid leave policies would apply to the absence. For example, if the employer's sick leave policy covers the employee's medical condition, the employer may require sick leave substitution.
Question 4: An employee on FMLA leave is also receiving state-mandated short-term disability benefits. How should the administrator treat this situation?
- FMLA cannot run concurrently with state disability benefits
- The state disability period may run concurrently with FMLA if the condition qualifies (Correct answer)
- The employee must repay the disability benefits if FMLA is also designated
- FMLA only starts after the disability period ends
Correct answer: The state disability period may run concurrently with FMLA if the condition qualifies
State-mandated disability benefits and FMLA can run concurrently when the underlying health condition qualifies for both programs, maximizing the employer's ability to count the time against FMLA.
29 CFR 825.702 addresses coordination between FMLA and state laws. When a state disability or family leave law provides similar or greater protections, both laws apply. Running FMLA concurrently with state disability benefits is permissible and often advantageous for employers because it prevents additional FMLA time following exhaustion of the disability period.
Question 5: During FMLA leave, an employer is required to maintain group health insurance under which conditions?
- Only if the leave is paid
- On the same terms as if the employee had continued working (Correct answer)
- At a reduced rate based on partial pay
- Only for the first 6 weeks of leave
Correct answer: On the same terms as if the employee had continued working
Employers must maintain group health insurance coverage during FMLA leave on the same terms and conditions as if the employee had not taken leave, including paying the same employer contribution.
29 CFR 825.209 requires employers to maintain group health plan coverage during FMLA leave at the same level and under the same conditions as if the employee had continued working. If the employee was paying a portion of premiums, the employee remains responsible for that share. Failure to maintain coverage can constitute interference with FMLA rights.
Question 6: If an employee's health insurance coverage lapses during unpaid FMLA leave due to non-payment of premiums, what must the employer do when the employee returns?
- The employer has no further obligation to restore coverage
- The employer must restore coverage immediately upon return without any waiting period or pre-existing condition exclusions (Correct answer)
- The employer may impose a new waiting period
- The employer may require a new enrollment period
Correct answer: The employer must restore coverage immediately upon return without any waiting period or pre-existing condition exclusions
Upon return from FMLA leave, the employer must restore the employee's health insurance to the same terms as before the leave, without any waiting period or exclusions for pre-existing conditions.
Per 29 CFR 825.215(d), when an employee returns from FMLA leave, the employer must restore all employee benefits, including health insurance, to the same level as before leave. Even if coverage lapsed due to non-payment of premiums during leave, the employer cannot impose new enrollment requirements, waiting periods, or pre-existing condition exclusions upon return.
FMLA Coordination with Other Leave Policies & Benefits 2
When an employer requires an employee to substitute paid leave for FMLA leave, when does the FMLA entitlement begin running?