The FMLA provides up to 12 weeks of unpaid, job-protected leave for employees with serious health conditions. But what qualifies as "serious" enough? Many employees don't realize their conditions qualify—or employers wrongly deny leave for covered conditions. Understanding what qualifies helps you assert your rights.
Defining Serious Health Condition
A serious health condition under the FMLA is an illness, injury, impairment, or physical or mental condition involving inpatient care, or continuing treatment by a healthcare provider. The definition is broader than many employees and employers realize.
"Inpatient care" means any overnight stay in a hospital, hospice, or residential medical facility. "Continuing treatment" covers several scenarios explained below.
Incapacity Plus Treatment
A condition qualifies if it causes incapacity (inability to work or perform daily activities) for more than three consecutive calendar days AND involves either two or more treatments by a healthcare provider, or one treatment followed by a continuing regimen of care.
The "more than three days" requirement trips up many claims. A bad cold lasting two days doesn't qualify, but bronchitis keeping you home for four days with a doctor visit and prescription does.
Pregnancy and Prenatal Care
Pregnancy is a serious health condition, even without complications. Prenatal appointments are covered—employers cannot penalize pregnant employees for routine pregnancy care visits. Morning sickness or other pregnancy symptoms causing incapacity also qualify.
Chronic Conditions
Chronic conditions qualify if they require periodic visits for treatment, continue over an extended period, and may cause episodic rather than continuing incapacity. Examples include diabetes, asthma, epilepsy, and migraines.
Chronic conditions qualify even without the three-day incapacity requirement. An employee whose migraines occasionally cause single-day absences is covered if they're receiving ongoing treatment.
Permanent or Long-Term Conditions
Conditions that are permanent or long-term and require continuing supervision qualify even without active treatment. Alzheimer's disease, terminal illness, or severe stroke are examples—the person may not be "treated" in a curative sense but needs ongoing care.
Conditions Requiring Multiple Treatments
Conditions requiring multiple treatments qualify if the condition would result in incapacity for more than three days without treatment. Cancer requiring chemotherapy, severe arthritis requiring physical therapy, and kidney disease requiring dialysis all qualify under this provision.
What Doesn't Qualify
Some conditions don't meet the FMLA definition. Short-term illnesses like colds, flu, upset stomach, and minor injuries typically don't qualify unless they become more serious. Cosmetic treatments usually don't qualify unless complications arise.
However, seemingly minor conditions can qualify if they cause significant incapacity or require substantial treatment. Don't assume your condition doesn't qualify—review the specific criteria.
Medical Certification
Employers can require medical certification confirming your serious health condition. The certification must include the date the condition began, expected duration, appropriate medical facts, and a statement that you cannot work or need leave.
Employers cannot ask for your specific diagnosis—only enough information to confirm a serious health condition exists and necessitates leave.
Intermittent Leave
Serious health conditions often require intermittent leave—taking leave in separate blocks rather than all at once. Intermittent leave is available when medically necessary. Chronic conditions with unpredictable flares particularly benefit from this flexibility.
For example, an employee with Crohn's disease might need occasional days off during flares rather than extended continuous leave.
Caring for Family Members
FMLA leave is also available to care for a spouse, child, or parent with a serious health condition. The same definitions apply—your family member's condition must meet the serious health condition requirements.
When Employers Disagree
If your employer denies that your condition qualifies, they can request a second opinion at their expense. If opinions conflict, a third opinion is binding. Don't accept an employer's informal denial—the certification process exists to resolve disputes.
Getting Legal Help
If your employer denies FMLA leave for a condition you believe qualifies, consult an employment attorney. They can review your situation, advise on whether your condition meets the definition, and help you assert your rights or pursue claims if your leave was wrongly denied.