How Does the Medical Leave of Absence Work in the U.S.?

30 of June, 2022

The issue of medical leave has been a hot-button topic in the U.S. since its inception in 1993. Neither employer nor employee, has a good word to say about the Family and Medical Leave of Absence program (FMLA). Most of America’s population simply has no coverage at all. Coverage for the few, 20 million a year, is provided for a very narrow range of reasons. The application process is so tortuous that it has become a specialty of lawyers. Then, if matters were not bad enough, FMLA offers only unpaid medical leave. And little benefit to lower-income caregivers who have most need of it for family and medical reasons. 

Medical Leave in the U.S. vs Sick Leave in Europe

What is called medical leave of absence in the U.S is very different from Europe’s version, called sick leave. Though, both have in common the right to be absent from work during sickness and later return to the job. Sick pay in the EU involves the continuing payment of wages, whether in part or in full. It is part of a complete health care protection system, or Medicare. There is no European Union (EU) Member State without some form of sick leave or sickness benefit.

When the U.S. Medical Leave passed in 1993, the legislation was never tied to the administration of health. It instituted labor law administered by employers to monitor claims under which they provide job protection for employees for medical reasons.

If granted, the FMLA provides up to twelve weeks of unpaid leave for very specific reasons. For example, the birth of a baby, the need to care for a family member with “serious” health condition. Or because of the employee’s own “serious” health condition. That emphasis on “serious” conditions for medical leave has led to all manner of misunderstandings and litigation. That’s because the employer is the one who monitors the process of healing and the time of return to work. 

How does the FMLA work in the U.S.?

US companies with 50 or more employees must provide FMLA coverage. Also, it is a requirement to have worked at least one year and provide a medical certification certifying the need to leave.

There is more than one catch to the smooth functioning of the U.S. medical leave program. For instance, while as a benefit, the employer has to maintain the leave-taker’s benefits including medical insurance. The employer has the right to require that the employee pay his portion of the health insurance while on leave. The employer is to restore the employee to the “equivalent employment benefits”. Any equivalent position must in theory have the same duties and responsibilities as the one that was left. Then again, some employers have their own short-term disability policy with a short-term income replacement feature, of say 6 weeks duration. That time is taken from the FMLA’s 12 week coverage.

The truth behind FMLA

At the end of the day, almost a quarter of U.S. adults have been fired or threatened with dismissal for taking time off to recover from illness or to care for a sick relative. The public health agency NSF conducted a survey in 2014 that found a quarter of the workforce in the U.S. goes to work sick fearing the loss of salary and job. To understate matters, this is a medical leave of absence system in need of improvement.

Did this information help you? We hope so. At Sesame, we know how important is to keep our employees happy and healthy. Avoid the overlapping of your employees’ leaves with a simple and visual absence management software. Learn more about our human resources software at Sesame HR.