FMLA FMLA Serious Health Condition Criteria 1 — Questions and Answers
Question 1: Which of the following conditions does NOT meet the FMLA definition of a serious health condition?
- A chronic condition requiring periodic treatment at least twice a year
- A three-day incapacity with continuing treatment by a health care provider
- A common cold with one doctor visit and one day off work (Correct answer)
- Pregnancy and prenatal care
Correct answer: A common cold with one doctor visit and one day off work
A common cold with only one doctor visit and one day off does not meet the FMLA continuing treatment test, which requires either 3 consecutive days of incapacity plus treatment, or a chronic or permanent condition.
29 CFR 825.113 defines a serious health condition as an illness, injury, impairment, or physical or mental condition involving inpatient care OR continuing treatment by a health care provider. Continuing treatment requires incapacity for 3 or more consecutive calendar days plus either two or more treatment visits within 30 days, or one visit within 7 days followed by a continuing regimen of treatment. A single visit for a common cold does not satisfy these requirements.
Question 2: What is required for a condition to qualify as a serious health condition under the continuing treatment test?
- One visit to a health care provider within 30 days
- A period of incapacity of more than 3 consecutive full calendar days plus a first treatment visit within 7 days and at least one follow-up visit within 30 days (Correct answer)
- Hospitalization for at least 24 hours
- A diagnosis requiring prescription medication
Correct answer: A period of incapacity of more than 3 consecutive full calendar days plus a first treatment visit within 7 days and at least one follow-up visit within 30 days
For the continuing treatment test, the employee must be incapacitated for more than 3 consecutive full calendar days AND receive treatment: first visit within 7 days and at least one follow-up within 30 days.
29 CFR 825.115(a) establishes the continuing treatment test: (1) incapacity for more than 3 consecutive full calendar days; (2) treatment by a health care provider at least once within 7 days; and (3) either a second visit within 30 days OR a continuing regimen of treatment. All elements must be satisfied. Consecutive means calendar days, not just work days.
Question 3: An employee has asthma that flares periodically and requires physician visits twice a year. Does this qualify as a serious health condition?
- No, only continuous conditions qualify
- Yes, it qualifies as a chronic serious health condition (Correct answer)
- Only if the employee is hospitalized during a flare
- Only if the employee misses at least 3 consecutive days during a flare
Correct answer: Yes, it qualifies as a chronic serious health condition
Asthma requiring periodic physician visits at least twice a year qualifies as a chronic serious health condition under FMLA, entitling the employee to intermittent leave for related flare-ups.
29 CFR 825.115(c) defines chronic serious health conditions as those that: (1) require periodic visits at least twice per year for treatment; (2) continue over an extended period; and (3) may cause episodic rather than continuing periods of incapacity. Asthma, diabetes, epilepsy, and migraine headaches are classic examples.
Question 4: Which of the following health care providers may certify an FMLA serious health condition?
- Only medical doctors (MDs)
- Nurse practitioners, physician assistants, and podiatrists, in addition to MDs (Correct answer)
- Only specialists in the relevant medical field
- Only health care providers employed by the employer
Correct answer: Nurse practitioners, physician assistants, and podiatrists, in addition to MDs
FMLA broadly defines health care provider to include doctors of medicine, osteopathy, dentists, podiatrists, clinical psychologists, optometrists, chiropractors, nurse practitioners, nurse-midwives, clinical social workers, and physician assistants.
29 CFR 825.125 lists qualified health care providers including doctors of medicine and osteopathy, podiatrists, dentists, clinical psychologists, optometrists, chiropractors limited to the spine, nurse practitioners, nurse-midwives, clinical social workers, physician assistants, and Christian Science practitioners. The provider must be authorized to practice in the state and within the scope of their practice.
Question 5: Pregnancy without complications may qualify for FMLA leave under which category?
- Inpatient care only
- Continuing treatment for prenatal care visits (Correct answer)
- Only if there are physician-documented complications
- Pregnancy never qualifies without incapacity
Correct answer: Continuing treatment for prenatal care visits
Prenatal care including regular medical visits during a healthy pregnancy qualifies as continuing treatment for a serious health condition under FMLA, even without complications.
29 CFR 825.115(b) specifically provides that incapacity due to pregnancy or the need for prenatal care qualifies as a serious health condition. This means an employee may take intermittent FMLA leave for prenatal medical appointments, morning sickness, and pregnancy-related conditions, even without a pregnancy complication.
Question 6: A condition requiring only over-the-counter medication and one doctor visit without continuing treatment: which FMLA category might still cover it?
- It cannot qualify for FMLA under any category
- Inpatient care requiring an overnight hospital stay (Correct answer)
- A qualifying exigency related to military deployment
- A permanent or long-term condition under physician supervision
Correct answer: Inpatient care requiring an overnight hospital stay
Even without continuing treatment, a condition requiring inpatient care such as an overnight hospital stay qualifies as a serious health condition independently.
29 CFR 825.114 provides that inpatient care, an overnight stay in a hospital, hospice, or residential medical care facility, independently qualifies the condition as a serious health condition. The inpatient care route does not require a minimum duration of stay or a specific treatment regimen. Even a single overnight observation stay qualifies.
FMLA FMLA Serious Health Condition Criteria 1
Which of the following conditions does NOT meet the FMLA definition of a serious health condition?