Serious health condition

Scope

A serious health condition, as defined in the FMLA regulations, can affect an employee or an employee’s family member, such as a spouse, parent, or child.

Regulatory citations

• None

Key definitions

• None

Summary of requirements

For employees, a serious health condition is generally a condition that makes the employee unable to perform the functions of the job. For family members, it involves the inability to work, attend school, or perform other regular daily activities due to a serious health condition.

A serious health condition is an “illness, injury, impairment, or physical or mental condition that involves inpatient care, or continuing treatment by a health care provider.”

Inpatient care is generally an overnight stay in a health care facility.

Continuing treatment is a bit more involved, however. Please note that “treatment” can include exams to determine if a serious health condition exists and evaluations of the condition.

A serious health condition involving continuing treatment includes the following:

• A period of incapacity of more than three, consecutive, full calendar days, and any subsequent treatment that also involves
  • Treatment two or more times within 30 days of the first day of incapacity by a health care provider, or
  • Treatment at least once, resulting in a regimen of continuing treatment.
• Any period of incapacity due to pregnancy or for prenatal care.
• Any period of incapacity (or treatment for) a chronic serious health condition requiring treatments at least twice per year and continuing over an extended period of time. These may cause episodic rather than continuing periods of incapacity. Examples include asthma, diabetes, and epilepsy.
• A period of incapacity for a permanent or long-term condition in which treatment may not be effective. Examples include Alzheimer’s, severe strokes, or the terminal stages of a disease.
• Any period of absence to receive multiple treatments (i.e., chemotherapy, radiation, physical therapy, dialysis), for restorative surgery or a condition that would likely result in a period of incapacity of more than three consecutive, full calendar days in the absence of treatment. Examples include cancer, arthritis, and kidney disease.

For a period of incapacity and treatment under the first bullet, the treatment must be provided via an in-person visit to the health care provider. Whether additional treatment visits or a regimen of continuing treatment is necessary within the 30-day periods is to be determined by the health care provider.

The 30-day period is to be met unless extenuating circumstances exist, such as the health care provider not having any appointment openings within that time frame. In such cases, the employer would need to be flexible.

Generally, common colds, the flu, and other minor ailments are not serious health conditions, but they could worsen into one.

It does not matter whether the condition resulted from involuntary action or not. Elective surgery, therefore, would be a serious health condition if it met the definition. There is no all-encompassing list of conditions that meet the definition.