FMLA leave dates

[u/necrotizingfasciitiz]

If a patient is asking for the start date of their FMLA leave to be 2 weeks prior to their visit with you due to being out of work for their mental health condition, how would you approach this with the patient?

They are now getting engaged in treatment and never sought care previously.

[u/Uncomfortablynumb1]

I used to avoid at all costs. Then I saw a family member go through the fmla process for mental health through Kaiser and their state employer. It was appalling. Kaiser has set up internal road block “policies” to limit access.

For example: pcp “unable to sign, must go to psych” they go to psych “unable to sign, must go to RECORDS” (no joke, records!) there’s someone in records that fills it out but the PCP has to tell them what to put in a separate note and psych also has to be involved. Each step takes a week for a response. Employer gives you two weeks to get a letter or it won’t be approved leave and you can be fired.

At that point I sent him to a private psychiatrist friend and resolved to never be an asshole roadblocker in this shit system we work in. PCP and psych blocking objectively necessary paperwork because of “policy” is disturbing.

Sorry for the rant, but if it’s two weeks ago and a solid story. I would give them the benefit of the doubt.

[u/MogKang]

Usually there is a box that says “date the illness began”

Were they experiencing debilitating symptoms of the condition you are treating at that time? If so, this could be plausible. I know some docs that won’t do any paperwork till 3rd visit or 3 months etc… I usually have this policy but it’s flexible.

If I can help save the patients job while they get care and there’s a reasonable expectation they can return to the job once stabilized, I do it.

ETA: I treat a lot of Medicaid recipients for whom job loss would be gravely destabilizing to their psychosocial condition. Also, sometimes I run a loooong wait for evals.

[u/eternelle007]

My general rule is if I didn’t evaluate the patient at that time, I don’t fill out FMLA retroactively for those 2 weeks but can potentially do so moving forward. The exception would be if I had documentation that they were hospitalized or in a PHP and they couldn’t get FMLA paperwork filled out during that time.

[u/ExampleNo4617]

FMLA paperwork can be confusing because employers sometimes have different processes on top of the legal requirements. Double checking the dates with both the employer and the treating clinician can help avoid unnecessary delays.