FMLA Patient Assessment & Evaluation 3 — Questions and Answers
Question 1: An employer receives a completed WH-380-E form but some sections are left blank. What is the correct procedure?
- Deny the leave for incomplete documentation
- Allow 7 days for corrections before denial
- Notify the employee in writing of the deficiencies and allow 7 days to cure (Correct answer)
- Immediately request a second opinion
Correct answer: Notify the employee in writing of the deficiencies and allow 7 days to cure
When a certification is incomplete or insufficient, the employer must notify the employee in writing and provide at least 7 days to cure the deficiency.
Question 2: A chronic serious health condition under FMLA must require which of the following?
- Continuous hospitalization for at least 72 hours
- At least one treatment visit per year and periodic flare-ups
- Treatment visits at least twice per year over a period of time (Correct answer)
- Surgery within the past 12 months
Correct answer: Treatment visits at least twice per year over a period of time
A chronic serious health condition requires at least two visits per year to a healthcare provider and causes periodic episodes of incapacity.
Question 3: Which standard applies when a physician certifies that a patient's condition is 'permanent or long-term' with no effective treatment?
- Continuing treatment prong
- Permanent/long-term condition prong (Correct answer)
- Inpatient care prong
- Multiple treatments prong
Correct answer: Permanent/long-term condition prong
FMLA's permanent or long-term condition prong covers conditions like Alzheimer's or terminal cancer where the patient is under supervision but treatment may not work.
Question 4: An employee is absent for four days with the flu and sees a doctor once. Does this meet the FMLA serious health condition standard?
- Yes, because incapacity exceeded three consecutive days
- No, because one treatment visit is insufficient under the continuing treatment prong (Correct answer)
- Yes, because the flu is always a serious health condition
- No, because the flu never qualifies under FMLA
Correct answer: No, because one treatment visit is insufficient under the continuing treatment prong
Incapacity of more than three days alone is insufficient; the continuing treatment prong also requires two or more treatment visits or a regimen of continuing treatment.
Question 5: Which form is used by an employer to certify FMLA leave when the employee is caring for a covered family member?
- WH-380-E (Employee's Own Serious Health Condition)
- WH-380-F (Family Member's Serious Health Condition) (Correct answer)
- WH-384 (Qualifying Exigency)
- WH-385 (Military Caregiver Leave)
Correct answer: WH-380-F (Family Member's Serious Health Condition)
Form WH-380-F is the DOL's optional certification form for leave to care for a covered family member with a serious health condition.
Question 6: Under FMLA, who bears the cost of obtaining an employer-required second opinion?
- The employee
- The employee's health insurance
- The employer (Correct answer)
- Split equally between employer and employee
Correct answer: The employer
The employer must pay for any required second or third opinion medical examinations, including reasonable travel expenses.
Question 7: If the second and third medical opinions conflict, which opinion is determinative under FMLA?
- The employee's original healthcare provider's opinion
- The employer's chosen second-opinion provider
- A third opinion from a mutually agreed-upon provider, which is final and binding (Correct answer)
- The Department of Labor resolves the conflict
Correct answer: A third opinion from a mutually agreed-upon provider, which is final and binding
When second and third opinions conflict, a third opinion from a mutually agreed-upon provider is obtained and that opinion is final and binding on both parties.
FMLA Patient Assessment & Evaluation 3
An employer receives a completed WH-380-E form but some sections are left blank.
What is the correct procedure?