Transcript FMLA Absence Management Program

Family Medical Leave
Administration Program
CareWorks USA
CareWorks USA will administer the Family
Medical Leave Benefit for Butler University
This change will take place on January
1, 2014
What to Expect When Partnering with CareWorks USA
Fair and consistent administration of FMLA
Compliance with FMLA regulations
Streamlined process and ease of administration
Simplified reporting through a 24/7 toll-free number
Accurate FMLA tracking
Employee satisfaction
What is FMLA?
The Family Medical Leave Act of 1993 known as
FMLA, is a federal law allowing eligible employees of a
covered employer to take job-protected leave, for up to a
total of 12 work weeks in any 12-month period for:
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Birth of a child.
Adoption and foster care.
Care of a spouse, child or parent with a serious health condition.
The 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 arising out of the fact that a spouse, child or
parent is on active duty in the Armed Forces or is deployed to a
foreign country.
Eligibility Requirements - FML
 Employed for 12 months (does not have to be
consecutive time).
 1,250 actual hours worked preceding the date of the
requested leave.
 Available FML hours.
 Qualifying condition certified by a health care provider
or meeting military family leave entitlement.
Serious Health Condition
A medical condition that renders an employee
unable to perform the essential functions of
his/her job:
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Incapacity of more than three days with treatment.
Hospital Care.
Pregnancy.
Chronic conditions requiring treatment.
Permanent or long term conditions.
Multiple treatments.
12 Month Calculation
 The Butler University uses a Rolling Calendar
Back Calculation
 This method looks back over the last 12 months from
the date of the request, adds all FMLA time the
employee has used during the previous 12 months and
subtracts that total from the employee’s 12-week leave
allotment.
12 Month Calculation
Example:
John has been employed by Butler University since October 15,
2007. He needs to have surgery and will need to take 12 weeks
of FMLA leave beginning on June 1, 2014.
Actions:
CareWorks USA reviews John’s record for the last 12 months
(May 31, 2013 – June 1, 2014). It shows that John has not taken
any FMLA leave in the last 12 months.
Since there is no FMLA leave to deduct from John’s 12-week
entitlement, John is entitled to the full 12 weeks of FMLA leave
for his surgery.
How Does The Program Work?
Customized program materials are available for all employees.
Existing Leaves of Absence
 Employees with current FMLA approvals will be
transitioned to CareWorks USA.
 Employees will not be required to complete new
certification paperwork.
 CareWorks USA will fully adopt the current FMLA
certifications.
 Employees who have approved intermittent leaves
must call their Supervisor and CareWorks USA to
report every intermittent absence.
New Leaves of Absence
1. Employee reports off of work to his/her Supervisor.
2. The employee must also call CareWorks USA to
report a new claim that may qualify for FMLA.
 CareWorks USA will send an email notification to the
Supervisor and Human Resources Department to
notify of the request for leave.
 Employee must call CareWorks USA and report
his/her absence to his/her Supervisor each time work
is missed for an Intermittent FML.
Claim Packet
 A claim packet will be mailed to the employee’s home
within 2 business days from the date of request for
leave.
 The packet will include:
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FMLA Rights and Responsibilities Letter
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FMLA Certification Forms
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Medical Release
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Return to Work Release
 Forms to be returned to CareWorks USA within 15
days of receipt.
Claim Packet-continued
 CareWorks USA will call the employee between days 8-10
of the 15 day timeframe if documentation is not returned.
 Health care provider will need to complete the medical
certification form.
 If completed forms are not received, leave request may be
denied and any absent time may be unexcused.
Determination Made
 Medical certification form is reviewed by Absence
Management Specialist and RN.
 Additional information will be obtained if necessary.
 Approval/Denial of claim determined.
 Employee is notified via letter of claim status.
 Supervisor and Human Resources Representative is
notified via e-mail of claim determination.
 Employee is contacted by CareWorks USA throughout
absence for claim updates and to ensure a smooth
transition back to work.
Employee’s Responsibilities
Notify your supervisor of your absence
Call CareWorks USA to report your absence and/or
make request for FMLA
For Intermittent FMLA, must notify supervisor and
CareWorks USA of any FMLA absence.
Once packet is received, submit required paperwork by
the due date provided in CareWorks USA
correspondence
For FMLA an employee must provide 30 days advance
notice, unless the leave is not foreseeable. In this case,
notice must be provided as soon as practical.
Employee’s Responsibilities
 Employee must attempt to schedule intermittent leave
so not to disrupt operations.
For employee’s own serious medical condition,
employee must submit completed Return to Work
Certification to CareWorks USA prior to returning to
work.
Supervisor’s Responsibilities
Refer and employee to CareWorks USA the
employee has:
 An absence of more than 3 days for medical reason
and/or family care
 Continued absences for the same reason and/or
condition
 Continued absences for a qualifying family member
 Multiple doctor visits and/or treatments
 Anything you suspect that may qualify for FMLA
Supervisor’s Responsibilities
 Know University’s Leave Policies and Procedures
 Review CareWorks USA’s emails and act on them
when necessary
 Work with CareWorks USA and internal resources
on the employee’s return to work
CareWorks USA’s Administrative Role
New FMLA initiation
Certification packet sent to employee
Employer notified of new FMLA request
Medical Review
Documentation review by CareWorks USA RN and
any needed clarification made with medical provider
Leave designation (Approval or Denial)
Documentation of FMLA time utilized by employee
Leave closure once employee returns to work or leave
expires
Answer questions for employees and supervisors
Coordination of Benefits
 FMLA WILL run concurrent with any Workers’
Compensation absence or Short Term Disability
Claim.
 Employees are required to use their available Paid
Time Off (PTO) while on leave.
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FMLA is an unpaid job protection and the employees’
paid time will provide compensation during the leave
of absence.
 Employees WILL BE responsible to pay their
Insurance Premium contribution while out on unpaid
FMLA.
Thank You!