Intermittent Leave and Migrains

Good morning. I have a person who is on intermittent leave for migrain headaches. Her certification states that these episodes could last 24 hours. She has taken a day or two off. I received a doctor's note yesterday that she needs to be off for the next week. I found out that her child is on spring break that week. There have been suspicions in the past. Any suggestions on how to approach this?


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  • You could ask for more specific information from the doctor as to why she needs to be out for a week and see what comes back. The biggest problem I have with intermittent leave is the doctor's notes. They are advocates for their patient, and short of falsifying a diagnosis will put down almost anything the patient wants.

    I am curious, though. Is she taking PTO or vacation to be paid for this time? If so, there isn't much difference to the company than if she booked the week for vacation. If she's allowed to take unpaid time and this is going to increase the total amount of time she takes off for the year, that's a different story.
  • Thanks for the reply. With this latest doctor's note she has exhausted her paid time off. Again, thank you.
  • Loseyp,

    Glad to see your posts. Welcome to the Forum!


  • If employee's doctor is stating that the leave is necessary, I think your practical options are limited. The FMLA regs do provide the employer with the option of requiring the employee to see another doctor for a second opinion, at employer's expense, if the employer has reason to doubt the treating doctor's certification. However, unless there is reason to doubt the existence of the migraine condition as a whole, this option would probably not help the employer question intermittent episodes of leave because an examination would probably not be scheduled in time. Also, if the treating doctor and 2nd opinion doctor disagree, the employee is entitled to seek a third opinion, again at employer's expense, and the 3rd opinion is binding. The employer and employee must act in good faith to agree on the 3rd opinion doctor. See 29 CFR 825.307.