Did you know that FMLA fraud costs employers more than
$4.8 billion each year? And FMLA abuses are up more than 150%.
So how can you protect your firm?
The best way to keep employees from gaming FMLA leave is to
use the law's medical certification process. Keep reading
and you'll learn 10 Steps to Fight FMLA Fraud.
The Challenge: Employees are becoming increasingly sophisticated
about the ways they beat the Family Medical Leave Act (FMLA).
To protect your business, you need to become just as sophisticated
about managing requests for leave.
The 60 Second Solution: 10 Steps to Fight FMLA Fraud
FMLA stands for the Family Medical Leave Act. The law's intention
is to give people more medical recovery time or time to care for
a loved one.
But, the law is sometimes referred to as the "Far More Leave than
Anyone Intended Act" and the "Slacker's Protection Act."
Officials at the Society for Human Resource Management in
Alexandria, VA, said many companies grant FMLA requests even
if they do not believe the reasons are legitimate because they
are worried about compliance.
If you're concerned about FMLA fraud, follow these 10 steps:
- Obtain a medical certification for each request for leave due
to a serious health condition. It's important that your sick leave
or attendance policy requires a doctor's certification for all
absences of three or more days for the leave to be excused.
If there's no such requirement and you intend to require paid
leave to run concurrent with FMLA leave, you might not be able
to require a medical certification, which is the first step in
an anti-fraud program.
- Enforce a policy denying the leave request if an employee
fails to submit certification within 15 days. In each instance,
assess any appropriate penalties for failure to be at work.
- Examine the certification closely to ensure it's been properly
and fully completed. If the medical certification is incomplete,
specify in writing what information is lacking and allow the
employee at least seven days to cure the deficiency. If the
employee fails to do so, deny the leave request. If the medical
certification doesn't support the existence of a serious health
condition, obviously you should deny the request.
- Require a second opinion if the circumstances are even
- Once the certification is approved, make a limited inquiry
each time the employee requests more leave, particularly in the
case of intermittent FMLA leave. Is this leave related to the
original qualifying reason?
- Watch the schedule of absences closely in cases of intermittent
leave to determine whether a suspicious pattern develops
(e.g. immediately before and after weekends or days off) or whether
there's a change in the frequency or timing. Such actions could
suggest a change in condition that enables you to request a
- Request recertification as often as the law allows. The frequency
of recertification permitted will differ depending on the type
of leave and the type of serious health condition.
- Require accrued leave to run concurrently with FMLA leave
when allowed by law. When an employee realizes that taking
leave today will affect future vacation time, he or she is
more likely to take FMLA only when the need is legitimate.
- Ask the physician to verify that the medical certification
is exactly as he or she signed it and has not been altered.
- Aggressively pursue potential fraud, and if concrete
evidence of fraud is discovered, take appropriate disciplinary
action. Always follow up on tips from fellow employees or
other sources that the employee does not, in fact, need leave.
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