Weighing Work Accommodations, Work Withdrawal, and Return to Work

Abstract

When a patient experiences work impairment due to a mental disorder, clinicians should be familiar with interventions that will help patients work safely and productively, facilitate their withdrawal from the workplace when necessary, and permit them to resume working when they are ready to do so. Mental health professionals should be familiar with workplace protections laws such as the Americans with Disabilities Act and the Family Medical Leave Act, since some patients will need documentation of mental disorders to be eligible for time away for health care appointments, workplace modifications, or withdrawal from the workplace. If patients withdraw from the workplace, clinicians should assess the patient’s progress toward returning to work during each clinical session, and maintain returning to functional status as a treatment goal from the beginning of discussions regarding work withdrawal.

Appendices

Appendix I

The Family Medical Leave Act Certification of Health Care Provider for Employee’s Serious Health Condition (Family and Medical Leave Act) [edited to indicate instructions and requested information and current as of 5/1/12]

Section I: For Completion by the EMPLOYER INSTRUCTIONS to the EMPLOYER:

The Family and Medical Leave Act (FMLA) provides that an employer may require an employee seeking FMLA protections because of a need for leave due to a serious health condition to submit a medical certification issued by the employee’s health care provider. Please complete Section I before giving this form to your employee. Your response is voluntary. While you are not required to use this form, you may not ask the employee to provide more information than allowed under the FMLA regulations, 29 C.F.R. §§ 825.306-825.308. Employers must generally maintain records and documents relating to medical certifications, recertifications, or medical histories of employees created for FMLA purposes as confidential medical records in separate files/records from the usual personnel files and in accordance with 29 C.F.R. § 1630.14(c)(1), if the Americans with Disabilities Act applies.

Section II: For Completion by the EMPLOYEE INSTRUCTIONS to the EMPLOYEE

Please complete Section II before giving this form to your medical provider. The FMLA permits an employer to require that you submit a timely, complete, and sufficient medical certification to support a request for FMLA leave due to your own serious health condition. If requested by your employer, your response is required to obtain or retain the benefit of FMLA protections. 29 U.S.C. §§ 2613, 2614(c)(3). Failure to provide a complete and sufficient medical certification may result in a denial of your FMLA request. 20 C.F.R. § 825.313. Your employer must give you at least 15 calendar days to return this form. 29 C.F.R. § 825.305(b).

Section III: For Completion by the HEALTH CARE PROVIDER INSTRUCTIONS to the HEALTH CARE PROVIDER

Your patient has requested leave under the FMLA. Answer, fully and completely, all applicable parts. Several questions seek a response as to the frequency or duration of a condition, treatment, etc. Your answer should be your best estimate based upon your medical knowledge, experience, and examination of the patient. Be as specific as you can; terms such as “lifetime,” “unknown,” or “indeterminate” may not be sufficient to determine FMLA coverage. Limit your responses to the condition for which the employee is seeking leave. Please be sure to sign the form on the last page.

Part A: Medical Facts

Part B: Amount of Leave Needed

Signature of Health Care Provider Date