825.306 - How much information may be required in medical certifications of a serious health condition?


(a) DOL has developed an optional form for employees' use in obtaining medical certification from health care providers that meets FMLA's certification requirements. (See Appendix B to these regulations.) This optional form reflects certification requirements so as to permit the health care provider to furnish appropriate medical information within his or her knowledge. This form, or another form containing the same basic information, may be used by the employer; however, no additional information may be required. The form identifies the practitioner and type of medical practice (including pertinent specialization, if any), makes maximum use of checklist entries for ease in completing the form, and contains required entries for:
(1) The date the serious health condition commenced and the health care provider's best medical judgment concerning the probable duration of the condition;
(2) Diagnosis of the serious health condition;
(3) A brief statement of the regimen of treatment prescribed for the condition by the health care provider (including estimated number of visits, nature, frequency and duration of treatment, including treatment by another provider of health services on referral by or order of the health care provider); and
(4) Indication of whether inpatient hospitalization is required.
(b) For medical leave because of the employee's own serious health condition, the health care provider's certification must also include either a statement that the employee is unable to perform work of any kind, or a statement that the employee is unable to perform the essential functions of the employee's position, based on either information provided via a statement from the employer of the essential functions of the employee's position, or, if not provided, discussion with the employee about the employee's job functions. (See 825.115.)
(c) For family leave to care for a seriously-ill family member, the health care provider's certification must also include a statement that the patient requires assistance for basic medical, hygiene, nutritional needs, safety or transportation, or that the employee's presence would be beneficial or desirable for the care of the family member, which may include psychological comfort. The employee is required to indicate on the form the care he/she will provide and an estimate of the time period. (See 825.116.)
(d) The treatment regimen and other information in the certification should satisfy the requirement that_if leave must be taken intermittently or on a reduced leave schedule because of the employee's own serious health condition or a seriously-ill family member_the certification include:
(1) A statement of the medical necessity for such leave (see 825.117); or,
(2) That the leave is necessary to care for the child, parent, or spouse who has a serious health condition, or will assist in the family member's recovery, and (3) The expected duration and schedule of the intermittent or reduced leave schedule. (See 825.116.)