FMLA: How to handle first, second, (and even third) opinions
Every now and then employers receive a certification for leave under the federal Family and Medical Leave Act (FMLA) that doesn’t quite look legit. They might ask for a second opinion, which ends up differing from the original. What next? May employers run with the second opinion?
No, and here’s why.
The FMLA indicates that if a second opinion differs from the first, employers may ask for a third opinion (i.e., a tie breaker). If employers do not ask for a third opinion, they must accept the original certification.
One employer thought differently, relying only on a differing second opinion, which did not support an employee’s taking of leave. The issue went to court.
Case law illustrates
In the case, an employee took intermittent FMLA leave for migraines. The employee provided a certification, but the employer had issues with it. As allowed, the employer requested a second opinion from a doctor of its own choosing. The second opinion found that the employee’s condition did not warrant FMLA leave.
Second opinion in hand, the employer denied the employee’s leave and told her that she would no longer be able to take FMLA leave for her migraines. Nonetheless, the employee took more leave and was fired. She sued.
In court, the employer argued that it was not required to obtain a third opinion (remember the word “may”?).
The court agreed that a third opinion was not required, pointing out, however, that “…it is downright wishful to think that the statute allows for anything but two options when a second opinion conflicts with the first: the employer may either accept the first or seek (and pay for) a binding third.”
Wert v. Pa. State Univ., Middle District of PA, No. 4:19-CV-00155, April 15, 2022.
Second opinions
Employers that doubt the validity of a medical certification may require employees to obtain a second opinion at the employer's expense. The employer also gets to choose the health care provider for the second opinion.
That, however, doesn’t mean that, if the second opinion differs from the first, it rules the day. Quite the opposite.
First or third opinion
If the first and second opinions differ, employers have two options:
- Accept the initial certification, or
- Proceed to a third opinion.
For a third opinion, the employer and employee must agree on the health care provider. The employer, however, must pay for it. Employers and employees must accept the third opinion as the tie breaker.
Additional opinions can be costly and take time – sometimes months. They can, however, help employers curb FMLA leave abuse, sending a strong message that they take these matters seriously.
Key to remember: If a first and second FMLA certification differ, employers may not take the second opinion as the final word on whether a serious health condition is involved. They must either accept the original or ask for a third opinion.