1. Family Medical Leave Administration Services

2. CareWorks Absence Management partnered
Leave of Absence
CareWorks Absence Management partnered
with Butler University to provide administration services for their leave of absence program.
On the following slides, we will review
What is FMLA?
Review the Leave of Absence Process
When to refer an employee to CareWorks Absence Management
Protected Health Information
Questions
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What is FMLA?
The Family Medical Leave Act, also known as FMLA, is a federal law allowing eligible employees to take unpaid leave that protects their job and benefits for up to a total of 12 weeks in a 12 months period for:
Birth of child
Adoption and/or foster care
Care of a spouse, child or parent with a serious health condition
An employee’s own serious health condition
Care of a spouse, child, parent or next of kin with a serious injury or illness incurred or exacerbated within 5 years of active duty in the Armed Forces (up to 26 weeks)
Qualifying exigency due to a spouse, child or parent on active or reserve duty in the Armed Forces being deployed to a foreign country
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4. FMLA Eligibility Requirements
Employed for 12 months, AND
does not have to be consecutive time
1,250 actual hours worked in the 12-month period preceding the date of the requested leave, AND
Employed at a worksite where 50 or more employees are employed within 75 miles of that worksite, AND
Available FMLA hours, AND
Qualifying condition certified by a health care provider or meeting the military family leave eligibility
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5. What is a Serious Health Condition?
A medical condition that renders an employee unable to perform the essential functions of his or her job, such as:
Incapacity of more than three days with treatment
Incapacity is defined as an inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment therefore, or recovery therefrom. ( (b))
In patient Hospital care
Pregnancy
Chronic conditions requiring treatment (e.g., asthma, diabetes, epilepsy, etc.)
Permanent or long term conditions (e.g., Alzheimer’s , severe stroke, terminal states of a disease, etc.)
Multiple treatments (e.g., dialysis, chemotherapy, physical therapy, etc.)
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6. FMLA 12-Month Calculation
Butler University is currently using the 12 Month Rolling Backward Calendar Calculation
CareWorks Absence Management will add up the employee’s FMLA usage over the 12 months preceding the date leave is to begin and subtract that amount of time from the 12 week total allowed to determine the employee’s available FMLA time.
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Types of FMLA Leave
An eligible employee is entitled to up to 12 weeks of leave under FMLA in a 12 month period for a qualifying reason. Leave under FMLA may be taken in the following ways:
Continuous leave: a block of days taken continuously
eg., Surgery or birth of a baby
Intermittent leave: hours or days taken in separate blocks of time due to a single qualifying reason.
eg., Physical Therapy one time per week for 6 weeks
Reduced schedule: the employee works a reduced number of hours per workweek or per day
eg., Released to return to work for only 6 hours per day
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8. How will the FMLA process work?
For new FMLA Leave Cases:
Employees will continue to report absences following their normal reporting procedures.
The employee will then call CareWorks Absence Management to report an absence/file a new claim that may qualify for leave.
CareWorks Absence Management will verify FMLA eligibility, send applicable paperwork, review medical certification, designate the FMLA and notify the HR Representative & Supervisor.
CareWorks Absence Management will send an notification to the HR Representative & Supervisor each time work is missed for a claim.
For intermittent leaves, employees must call their supervisor and CareWorks Absence Management to report every intermittent absence as indicated per policy.
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9. Employee’s Responsibilities
Report FMLA absences to their supervisor/manager.
For new FMLA claims, call CareWorks Absence Management to report an absence after missing 3+ days for an FMLA qualifying reason.
For FMLA, an employee must provide 30 days advance notice, unless the leave is unforeseeable. In this case, notice must be provided as soon as practical. At all times, employees must follow the employer’s call-in procedures.
For FMLA leave taken on an intermittent basis, employees must attempt to schedule leave so that employer’s operations are not disrupted.
Provide medical certification from their healthcare provider to CareWorks Absence Management within required timeframe.
Per the employer’s policy, employees must continue to follow call-in procedures for reporting absences and remain in contact with the employer during the period of leave.
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10. Manager’s Responsibilities
Refer employees to CareWorks if they are absent for any of the below reasons.
Absence of more than three (3) days for a medical reason and/or family care.
Absences that appear to relate to chronic conditions or multiple absences for the same reason and/or condition.
Multiple doctor visits and/or treatments.
Absence related to a previously protected medical related issue.
Anything you suspect that may be a qualifying reason for leave
Establish, communicate, and enforce the department’s policies and procedures consistently between FMLA and non-FMLA absences.
Review time to make sure that any time reported to you has also been reported to CareWorks.
Ensure employees on approved FMLA leave do not resume any work activities until CareWorks receives a Return to Work (RTW) Medical Release.
RTW releases may be obtained for a continuous FMLA absence
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11. What to expect from CareWorks
Dedicated specialist will handle leave requests, gather required documents and communicate with the employee the HR representative & the supervisor throughout the leave duration.
CareWorks will verify the employee’s eligibility for FMLA and any applicable state leave laws.
Medical certifications will be reviewed by an Absence Specialist to ensure consistency and accuracy of requests. The Absence Specialist will contact the healthcare provider if there is a medical release on file and there are questions or if more information is needed.
CareWorks will report leave hours to HR & the supervisor and notify them of any approved leaves and any need to know changes in leave status.
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12. Example of an email notification
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Employee Portal
Our Employee Portal provides a convenient and secure site for employees to view leave and absence information.
You can visit or call our customer service team to create your secure account
Real Time claim status
View all Documentation
Displays hours available for your leaves
Interactive Messaging with representative
FAQ Support
Intermittent Time Reporting
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14. Additional helpful materials
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15. Protected Health Information
An employee’s PHI is protected information by HIPAA and should not be discussed in the workplace.
A supervisor/manager may need to discuss an employee’s leave with him/her, however, may only ask questions relating to the workplace:
OK to ask….
How long do you expect to be absent?
Will your absence require intermittent time away from work or a continuous time period?
Have you contacted CareWorks Absence Management?
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16. Protected Health Information
The supervisor/manager should not ask any questions related to the medical diagnosis of the employee or his/her family member:
Do not ask:
What condition do you or your family member have?
What have you been diagnosed with?
What are you or your family member seeing the doctor for?
If the employee does share their information with you please do not share it with anyone else, as this information should be kept confidential due to HIPAA
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17. Please contact CareWorks Absence Management at
CareWorks Contact Information
Please contact CareWorks Absence Management at
with any questions or concerns regarding FMLA. Please note that all calls are recorded for quality assurance.
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