Although the legal requirements of the Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA) are similar in some regards, at times an employer may find that the requirements of one law contradict the other. In these cases, it is important to know which law takes precedence, or “trumps,” the other.

Here, we present a workplace scenario related to the benefits coverage of an employee who has been out on extended unpaid leave. Then we provide relevant information about the ADA and FMLA and the proper course of action for the employer.

Facts

Note: If you have read our previous 'FMLA and ADA interplay quiz' articles related to reinstatement and medical exams, the scenario regarding the employee's FMLA leave is the same. You can skip down to "Entitled to benefits while on extended unpaid leave?" section for new details (or reread the Facts section to refresh your memory).

"Joe" is an employee of Good Fellows Industries, Inc., a large industrial employer. Joe has been out of work on FMLA leave for 10 weeks due to a serious back injury suffered in a skiing accident. Joe’s injury is partially permanent and will substantially limit his ability to bend and lift. Before taking leave, Joe worked on the loading dock, lifting and carrying heavy cartons on a regular basis.

Today Joe appears at work with a fitness-for-duty medical certification from his doctor stating his ability to return to work, but that he is unable to do heavy lifting (an essential function of the job). Joe acknowledges that this is true. However, he wants to start working immediately.

Joe’s position could not be held open for 10 weeks, so it has been filled. Currently, there are no other vacancies for positions equivalent to the dock loader’s position, but there is a vacancy for which Joe is qualified—an assistant to the dock loaders that requires only light lifting.

Entitled to benefits while on extended unpaid leave?

While on FMLA leave for his back injury, Joe was not paid (having exhausted all other paid leave at the beginning of the ski season). It is Good Fellows Industries’ established policy to discontinue benefit coverage for employees who take an extended unpaid leave of absence, regardless of the reason.

Joe wants to know if he is still covered under the company’s dental plan, which is a component of the company’s IRS-qualified group health plan. While recuperating from his back injury, he developed a cavity that needs to be filled immediately. Must Good Fellows continue Joe’s medical benefit coverage during his extended unpaid leave?

The law

The ADA does not require the continuation of benefits during leave unless the employer ordinarily continues benefit coverage for other types of unpaid leave. In this case, it is the employer’s policy to discontinue benefit coverage for employees who take an extended unpaid leave of absence, regardless of the reason for taking leave.

The FMLA requires that for health/medical insurance, the employer is required to maintain coverage under any IRS-qualified group health plan for employees during leave at the same level and conditions of coverage that would have been provided if the employee had not taken leave. Since he was on FMLA leave, Good Fellows (and Joe) should have continued to pay premiums as though Joe had continued working.

Advice for employer

While Joe is on unpaid FMLA leave, Good Fellows must continue to provide group health benefits at the same level (under the FMLA), regardless of whether the employer ordinarily continues benefits coverage for other types of unpaid leave. This would include dental benefits if these benefits were offered as a part of the group health plan. In this case, FMLA benefit continuation requirements “trump” the ADA.