Intermittent FMLA Abuse

Client

National internet publishing company based in the South with 2,000 employees nationwide and call-center sites in VA and TX.  Prior to Work & Well, Family and Medical Leave Act (FMLA) was administered by in-house benefits staff.

Situation
An employee with a history of taking many intermittent FMLA days off work, called Work & Well to request additional intermittent FMLA leave time.

Action Taken
During the Work & Well intake interview, the case manager determined that the employee was actually requesting intermittent FMLA time for four separate conditions. Work & Well treated each condition as a separate leave request, asking for four medical certifications. Upon reviewing the medical certification information and requesting clarification and additional documentation for each certification, we learned it had been more than a year since the employee had been treated for the first condition. She was taking medication for the second condition that was controlling the problem. She did not submit a separate medical certification for the third condition.

Results
Work & Well determined that only one of her conditions qualified for intermittent FMLA time, not four. This dramatically reduced the amount of intermittent FMLA time the employee would be taking.

Savings
Three months after Work & Well began handling the case, the employee used 29.5 hours of intermittent FMLA time versus 76 hours for the three months prior to Work & Well medical management. Her out-of-work time was decreased by more than 60%.

Company-wide, the savings was dramatic. After six months, Work & Well’s program reduced intermittent FMLA usage by more than 60%, from an average of 1,600 hours per week to 600 hours per week.