Sec.31-51qq-31. How much information may be required in a medical certification for an employee’s own serious health condition or the serious health condition of a family member?

(a) Required information. When an employee requests leave because of the employee's own serious health condition or the serious health condition of a family member, an employer may require an employee to obtain a medical certification from a health care provider that, in addition to identifying the health care provider and type of medical practice (including pertinent specialization), sets forth the following information;

(1) A certification as to which part of the definition of “serious health condition,” if any, applies to the patient's condition, and the medical facts which support the certification, including a brief statement as to how the medical facts meet the criteria of the definition.

(2) The approximate date the serious health condition commenced, and its probable duration, including the probable duration of the patient's present incapacity, if different.

(3) Whether it shall be necessary for the employee to take leave intermittently or to work a reduced schedule as a result of the serious health condition, and if so, the probable duration of such schedule.

(4) If the condition is pregnancy or a chronic condition, whether the patient is presently incapacitated and the likely duration and frequency of episodes of incapacity.

(5) If additional treatments shall be required for the condition, an estimate of the probable number of such treatments. If the patient's incapacity shall be intermittent, or shall require a reduced schedule, an estimate of the probable number and interval between such treatments, actual or estimated dates of treatment if known, and period required for recovery if any.

(6) If any of the treatments referred to in subdivision (5) of this subsection shall be provided by another provider of health services, such as a physical therapist, the nature of the treatments.

(7) If a regimen of continuing treatment by the patient is required under the supervision of the health care provider, a general description of the regimen.

(8) If medical leave is required for the employee's absence from work because of the employee's own condition, including absences due to pregnancy or a chronic condition, whether the employee:

(A) Is unable to perform work of any kind; or

(B) Shall be absent from work for treatment.

(9) If leave is required to care for an employee’s family member with a serious health condition, whether the patient requires assistance for basic medical or personal needs or safety, or for transportation; or if not, whether the employee's presence to provide psychological comfort would be beneficial to the patient or assist in the patient's recovery. The employee shall indicate on the form the care he or she will provide and an estimate of the time period.

(10) If the employee's family member will need care only intermittently or on a reduced schedule basis, the probable duration of the need.

(b) Optional medical certification form. For purposes of compliance with FMLA, the Labor Department has developed optional Form DOL-FME for employees' and optional Form DOL-FMF for their family members' use in obtaining medical certification, including second and third opinions, from a health care provider that meets the FMLA's certification requirements. These optional forms reflect certification requirements so as to permit the health care provider to furnish appropriate medical information within his or her knowledge. Copies of the forms are posted on the Labor Department’s website. Employers may use Form DOL-FME and Form DOL-FMF, or another form containing the same basic information; however, no additional information beyond that specified in subsection (a) of this section may be required. In all instances, the information on the forms shall relate only to the serious health condition for which the current need for leave exists.

(c) If an employee is on FMLA leave running concurrently with a workers' compensation absence, and the provisions of the workers' compensation statute permit the employer or the employer's representative to request additional information from the employee's workers' compensation health care provider, the FMLA does not prevent the employer from following the workers' compensation provisions and information received under those provisions may be considered in determining the employee's entitlement to FMLA-protected leave. Similarly, an employer may request additional information in accordance with a disability plan that requires greater information to qualify for payments or benefits, provided that the employer informs the employee that the additional information only needs to be provided in connection with receipt of such payments or benefits. The employer may consider any information received pursuant to such plan in determining the employee's entitlement to FMLA-protected leave. If the employee fails to provide the information required for receipt of such payments or benefits, such failure will not affect the employee's entitlement to take unpaid FMLA leave.

(d) If an employee's serious health condition may also be a disability within the meaning of the ADA or FEPA, the FMLA does not prevent the employer from following the procedures for requesting medical information under the ADA or FEPA. The employer may consider any information received pursuant to these procedures in determining the employee's entitlement to FMLA-protected leave.

(Adopted effective March 9, 1999; Amended August 3, 2022)