In a 2010 BLR webinar, “Solving PTO Problems: How to Reduce Unscheduled Absences Without Alienating Employees or Violating the Law,” attorney Catherine Moreton Gray listed the items addressed on the Family and Medical Leave Act Medical Certification Form used in connection with a paid time off program.
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- Health care provider’s information and type of practice
- Approximate beginning date of the condition
- Probable duration
- Medical facts sufficient to support the need for leave
- Sufficient information on the employee’s inability to perform job duties
And, if intermittent or reduced-schedule leave is required for planned treatment or unforeseeable episodes of incapacity, the form states the medical necessity and gives estimated dates and duration of treatment/recovery/incapacity periods.
Catherine Moreton Gray is an associate attorney in the Labor and Employment section of Robinson & Cole LLP in Hartford, Conn. She has more than 20 years of experience in human resources and employment law. Contact her at cgray@rc.com.