Failure to Back up Child's Diagnoses Sinks Mom's bid for FMLA During Pandemic

Fort Wayne, IN (WorkersCompensation.com)–A mere diagnosis is not enough to establish a serious health condition for purposes of the FMLA. 

That’s what an accounts receivable representative discovered in Connor v. Professional Medical Billing, No. 1:20-CV-183-HAB (N.D. Indiana 06/16/22), when she tried to claim FMLA leave to care for her daughter whose school was closed during the COVID-19 pandemic. 

The employer, a medical reimbursement management company, denied the employee’s request for paid medical leave. The representative challenged that decision in federal District Court. 

The court explained that an employee is entitled to FMLA leave if she takes the leave to care for her child with a serious health condition. A "serious health condition” under the FMLA is an illness, injury, impairment, or physical or mental condition that involves: 1) inpatient care in a hospital, hospice, or residential medical care facility; or 2) continuing treatment by a health care provider. 

Here, the court observed, the representative, failed to show that her daughter's mental and behavioral issues fell into one of these categories. 

The court remarked that “[w]hen COVID-19 hit, Plaintiff, like most parents of young children, faced the unenviable task of balancing work with childcare.” However, that didn’t obviate her obligation to establish that she was entitled to paid leave.  

The court opined that the only reference the employee made to her daughter’s condition was in an April 21, 2020, email to the company in which she claimed that her daughter, whose daycare had closed because of the pandemic, was having "serious behavior issues," and had been diagnosed with ADHD, anxiety disorder, impulsive behavior, and sleep disturbances. The court noted that employee did not provide any medical records, either to the company or to the court, to support her claim. 

The court acknowledged that the representative stated she intended to call a doctor to testify that she needed FMLA leave to care for her daughter during the pandemic. But that statement in combination with a list of diagnoses wasn’t enough to allow her to proceed. 

Further, because the employee didn’t indicate her daughter had "inpatient care in a hospital, hospice, or residential medical care facility," the court stated it was compelled to assume the claim of a serious health condition was based on the daughter's need for continuing treatment. But to establish such a need, the court observed, the employee had to show that the condition: