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What guidelines must employers follow when an employee submits an FMLA certification that is vague or incomplete?

When an employee submits a certification for Family and Medical Leave Act (FMLA) leave that is vague or incomplete, FMLA regulation 825.305 applies. A certification is considered incomplete if one or more of the applicable entries have not been completed. A certification is insufficient if the entries on the form are complete but the information provided is vague, ambiguous or nonresponsive. In such cases, the employer must inform the employee in writing about specific additional information necessary to make the certification complete and sufficient. Employers must give the employee seven calendar days to correct the deficiencies in the certification. If the deficiencies cited by the employer are not corrected in a resubmitted certification, the employer may deny the taking of FMLA leave. A certification that is not returned to the employer is not considered incomplete or insufficient but constitutes a failure to provide certification.

Direct contact with the health care provider by an employer may only take place after the employee has had an opportunity to correct any deficiencies with the certification as noted above. Employers may make direct contact with the health care provider by using another provider, an HR professional, a leave administrator or a management official. Under no circumstances can an employee's direct supervisor contact the health care provider. In the case of a vague or incomplete certification, direct contact with the health care provider would be limited to requesting clarification. Clarification is defined as "contacting the health care provider to understand the handwriting on the medical certification or to understand the meaning of a response on the certification." Employers are prohibited from requesting information beyond that required by the certification form.

Health Insurance Portability and Accountability Act (HIPAA) privacy rules will require an employer to have authorization from the employee before talking to his or her health care provider. An employee may decline to provide such an authorization and the employer cannot require it. In such a situation where the employee refuses to cooperate, the employer may deny the FMLA leave because the medical certification remains incomplete or insufficient and is considered as a failure to provide required certification. 


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