Sinus Infections

Hello all. I wanted to get opinions from you all about whether you would approve this employee's serious health condition or not.

I received the med cert yesterday and the doctor states that the employee has recurring sinus infections that may spread to lungs causing bronchitis. Each episode may last 1-5 days every 3-4 months. She goes to the doctor each quarter and is on allergy medication as well as occasionally antibiotics when it's a true infection.

What do you all think? Would you approve a person with this health condition? This one is gray to me so any advice would be most appreciated!!

Comments

  • 29 Comments sorted by Votes Date Added
  • If you have the medical certification, you can certainly rely on that to substantiate a serious health condition to approve FMLA leave. The definition of serious health conditions includes those that incapacitate an individual for 3 or more days and require medical treatment. It appears that this certification clearly qualifies the illness for FMLA leave.

    FYI - it is usually in the employer's best interest to designate leave as FMLA because that gets the timeline started for the 12 weeks of leave. Look at it this way, if you don't designate as FMLA- this person may be out of work 3-5 days each month (for a total of 36-60 days a year, or between 7 and 12 work weeks) and then have another reason for FMLA leave (pregnancy, new baby, another serious helath condition, serious health condition of child or spouse, etc.) and be able to take off the full 12 weeks then - for a total of 19-24 weeks off of work with the full protection of FMLA for the final 12 weeks! And if you do it for one person ...

    Anne Williams
    Attorney Editor
    M. Lee Smith Publishers, LLC
  • I, too, would treat sinus infections of three days or more as FMLA. However, I would not treat this as a chronic condition. Meaning that each time ee is out for a sinus infection, they (and you)have to do the paperwork.
  • [font size="1" color="#FF0000"]LAST EDITED ON 04-21-04 AT 10:01AM (CST)[/font][br][br]Why would this not be treated just like migraines, as approved intermittent leave? And not requiring more than 3 days each occurence?
  • That's what we are trying to determine. While most condition are approved, we really scrutinize the med certs so we aren't blanket approving any and every condition that someone presents to us. We do this because we have such a stringent no-fault attendance policy that FMLA abuse is huge (I manage 150 employees on intermittent leave) and we are careful not to set precendents if possible. To me personally, sinus infections are like the cold except for those who may chronically have them on numerous occasions, that's why I wanted to see what others thought. Lots of individuals have sinus infections, probably averaging at least once a year and lasting a couple of days but since this one employee has the doctor mentioning she has them quite often, I guess I want confirmation that it is FMLA qualifying.

    Thank you to those who have replied!
  • This might take the thread in a different direction, but I am interested in hearing more from you - and others- about the FMLA abuse you mentioned. I'm currently researching for an unpcoming Special Report on managing absenteeism and am very interested in what you have to say about FMLA abuse and what techniques you have found to best deal with it.

    Thanks!

    Anne Williams
    Attorney Editor
    M. Lee Smith Publishers, LLC
  • I'm not speaking as an answer to the question posted, but as an add on to Don D and others about abuses. The only thing I can see those posters overlooked is the unemployment comp aspect. I've been burned on that several times, even if FMLA was managed properly and allowed to expire, knowing almost without doubt that abuse was going on. We lose unemployment hearings 100% of the time if we terminate someone for absences if doctor statements get produced, even after the 12 FMLA weeks are allowed to expire. I've had countless cases of situations where I practically begged an employee to give us a Dr. stmt and couldn't get any response--like the employee fell off the face of the earth. We terminate, and guess who shows up at the unemployment office with a Dr. stmt? And guess who gets to pay unemployment??

    FMLA is good motivation for employers who want to do what is right for their employees, but it sure is a challenge when an employee happens to be savvy enough to figure out how to abuse the system. We have several who have figured out that FMLA is a good insulator from discipline for bad attendance.
  • In my opinion, if the condition exists, then it is FMLA qualifying. I would question the truthfulness of a certification which indicates this infection is likely to arise and repeat over and over every few months.

    And to AWilliams' question, my input is this: The most damaging thing we face right now is the FACT that doctors on whichever streetcorner will certify and 'find' whatever the patient wants them to 'find'. FMLA h as been a spear in the side of manufacturing for sure. The abuse is tremendous. And the number one enabler to the abuse is the fact that most medical people will write out whatever you want them to. My interaction with current employees reveals that one of the most frequent questions the doctor will ask the patient is, "How long do you want to be out?" We've had this problem with 'comp' injuries for years because 'comp' pays promptly. Now we're having the same with FMLA because it encourages repeat clinic visits. The employer is the loser. And to the previous poster, yes, it is very true that the tighter your attendance policy, especially with the no-fault points systems, the greater your incidence of FMLA.
  • Agree with Don. One of the problems is we are not entitled to a diagnosis. For example,on another thread there is a discussion of cosmetic surgery. If the doctor puts down that the patient will be out for one week for liposuction it isn't covered. However, if the doctor puts down that the patient will be out for one week for surgery, it will be covered.
    And, you do not want to get me started on lawyers who refer the patients (who have been in an accident) to doctors who will put down what the lawyer wants to hear.
    Finally, there is an increase of requests for FMLA to care for suddenly sick parents (in another state) around Christmas and Easter time.
  • Based on the information you provided it appears that there may be an underlying medical condition causing the more frequent sinus infections but I wouldn't recommend delving into that. Based on the information above it appears that this condition would be one that would fall under the "Permanent/Long Term" arena and FMLA, it appears, qualifying.

    To Anne -
    I agree with Don's comments about the abuse of FMLA. The intent of the law is NOT what it has become, at least for many employees. This job protection statute has become additional time off from work without regard to the employers' interests and gives the employer very little they can do to control absences. I have seen quite a bit of abuse of this law and am seeing more and more of what Don describes regarding time off from work. Granting intermittent FMLA is the worst. With the addition of the HIPAA Privacy Regulations, it has become even more difficult.

  • Thank you all for responding! Ditto from me on all points mentioned. The tremendous abuse that occurs is why we really question these forms and if there's a condition that definitely isn't qualifying, we are definitely not approving it. Sinus infection, to me, will almost allow them to call in when they have a cold, but since the employees just state FMLA when calling in, there's very little we can do other than count it and hope they run out of time eventually. I do have many employees who are on intermittent FMLA for eternity, just because their doctor's appointments will count against them in our attendance policy. Guess I'd do the same if I had anything chronic or not that required me to go to the doctor more often than average.

    As far as trying to handle the abuse, we make them use up sick (for themselves only) and vacation time. It doesn't do much but if they have to waste vacation time on illness or appointments, it may deter some. Also, when I get notice of an absence (we use a time off form with hours missed) I log that absence and start noticing if absences are more frequent than they have been or should be according to the condition and doctor's info. We approve on specifics, from approximate number of appointments to number of days of incapacitation predicted because of the attendance policy. Employees will be written up or termed after three absences (including dr. appts), so managers must know specifically what is FMLA and what isn't. Very hard to manage, but I appreciate your feedback on the sinus infections.
  • I understand the concerns over the potential for abuse of the FMLA system...but I have to caution all HR professionals from trying to be doctors.

    A sinus infection may seem minor, but from the information provided, it appears that this employee is prone to bronchitis...which will have the ee out for maybe two weeks, instead of 3-5 days while the infection is getting under control.

    It's hard when we KNOW that an ee is doing an end run around the rules...but most of us are not medical specialists. You could always ask for the ee to see another dr. at your expense, if you're feeling unsure about the certification...

    we just have to pick our battles.


  • LindaS, could you please elaborate on your reference to HIPAA Privacy rules in relation to FMLA? I thought FMLA (and Workers Comp.) was independent of HIPAA so now I'm beginning to wonder what I'm missing.

    Also, we do not have any abuse of FMLA that I'm aware of even though we pay for up to 12 weeks of qualified leave. I'm sure it is related to our size (50 employees) and the culture of trust and respect that exists. Does anyone else have a similar situation?
  • I would like to give you all one person's perspective on sinus infections and allergies. I have been discriminated against all my life because of allergies. There are many times when my eyes become painfully swollen, irritated and itchy. I don't feel like going out anywhere when that happens; and it is not allways as easy as everyone thinks to just avoid whatever is causing the allergic reaction. I have also often had episodes where I can not breath.

    My son unfortunately inherited my allergies too. He has been hospitalized because his blood oxygen count was too low. The first doctor diagnosed asthma, the second DR diagnosed allergies. Allergies can mimic all kinds of illness, colds, asthmas etc.

    Allergies really can intefere with a person's productivity and quality of life.

    Just wanted you all to see another's perspective.
  • Hi NG, I too have allergies and if I did not take medication I would not be able to function. Luckily the medication helps me and it does not affect my life. You say you have been discriminated against all your life. How does a person with allergies get discriminated against?
  • By everyone thinking right off the bat that you aren't really sick and are abusing sick leave!!
    Growing up - hay fever type allergies - not as much was known about it. I was constantly blowing my nose - it was either blow my nose or let the mucus embarrassingly drip out my nose. People were allways telling me I was gross. Then there was allways the swimming pool phenomena - as soon as you jump in the pool the flood gates to your nose open up!!! It is not something you can control and people make fun of you. (I grew up in Fla. and not swimming - not realistically an option) I could go on, and on.

    Am I traumatized by it? No, I'm not trying to say that. Just that it does happen, and only recently has the public been understanding of what people with allergies go through. Only the past couple of years has there been so much advertising for Zyrtec, Clariden, etc.
  • When I was a teen I developed HORRIBLE allergies...swollen eyes and sinus problems...I lost a waitressing job because I didn't LOOK like I should be serving food! Not that I could disagree...but sometimes even medication didn't bring them under control...


  • Wow, I had no idea. I'll consider myself lucky that I've never had the problems you and Denise have had.
  • [font size="1" color="#FF0000"]LAST EDITED ON 04-22-04 AT 01:10PM (CST)[/font][br][br]You guys hold on.........I'm getting a violin.

    (edit) x:-)
  • [font size="1" color="#FF0000"]LAST EDITED ON 04-22-04 AT 01:20PM (CST)[/font][br][br]Will you play "Devil went down to GA"?

    EDIT: Wait a second....that was a fiddle. I don't know any violin songs. x:D


  • Seeeeeee, Don, You just proved my point!!!!People just don't seem to take allergies seriously. Hence the discrimination. x:'( No, I'm not necessarily upset about it. And yes I can still go on living getting plenty of sleep at night too. (unless of course I can't breath out of my nose- which happens alot and I don't get a good night's sleep)
  • Don...thank you for the musical interlude!!!!!
    xclap

    I guess the point is that allergies can be serious and sometimes uncontrollable. Thankfully, kind researchers developed Zyrtec-D. I can now breathe and sound like the intelligent adult that I really am, insteady of a stuffy kid. Communication is much much easier!!!

    The worst part...is that the symptoms may lead someone (a potential boss, maybe) to believe that an ee is sickly and likely to take a bunch of time off...or be unreliable. Just sends the wrong message!
  • Some people take allergies seriously. I'm not an allergy sufferer, but I also have no reservations about considering allergic reations to antigens as serious medical issues if circumstances warrant. Allergic reactions are health conditions, like many others. Maybe the real culprits are advertisers who blatantly advertise that their products return sufferers to normal lives--running in the park, watching a beautiful sunset on a beach, working among the flowers, playing with the pet. That's a very attractive message. I'd like to do more of that kind of stuff.

  • This is an FMLA covered event and is probably one of those events that FMLA was designed to protect.

    It does affect productivity each time an employee is absent, however, if the employee is a solid quality preformer it is easier to for the manager to deal with.

    If an employee doesn't perform well when he or she is at work, it makes it harder for managers to be sensitive to them when there is an FMLA event. The managers then often approach HR to discipline those employees for attendance issues, when in fact, it may be work performance that's the real root of the problem.
  • AMEN.

    I'm dealing with an issue like that today and have had to firmly advise a supervisor this morning to back off of issuing a warning for attendance related to one employee's current FMLA-protected leave and at the same time consider changing a different "favorite" employee to part time (from full time) for consistent low work hours (with medical cert.) after FMLA has long since expired.

    Oh, what a beautiful morning,
    Oh, what a beautiful day; . . .
  • Thank you Julia and Stilldazed! You have renewed my faith. I agree 100% I think the issue is work performance and not attendance. As with ANY kind illness or reason an ee is sick.
  • OOPS I wanted to add that you are very insightful and smart!
  • But she wouldn't be singin' that song today, since it's Monday!
  • Mondays are beautiful, too. They can't help where they fall in the week.

    Now, I'll wish you all a great week.
  • We have an employee who uses up her maximum FMLA allowance every year on intermittent leave for sinus infections. The medical certification from her physician states that this is a chronic condition, that it is incapacitating during acute exacerbations, and that it will last for the rest of her life. We've sent her for a second opinion, which questioned the mode of treatment provided by her regular physician, but not the existence or seriousness of the condition. Everybody "knows" that she's abusing it, but she continues to bring in doctor's excuses every time she misses work.

    Anne -

    I would love to echo what several of my fellow Forumites have expressed regarding the abuses of intermittent leave under FMLA. Out of our hourly workforce of about 250 employees, we have about 65 of them who have certified chronic serious health conditions. These range from migraines to gout, from asthma to severe menstrual cramps, from bipolar disorder to back pain. Once a condition is certified by a physician as "chronic", the employee no longer needs to miss more than three days for an absence to be considered under FMLA. Even patterns of absence (like every Sunday, the day before or after every holiday, etc.) haven't given us enough ammunition to successfully challenge intermittent leave's validity, and heaven knows we've tried.
Sign In or Register to comment.