Determining What is Considered a Serious Medical Health Condition

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Determining What is Considered a Serious Medical Health Condition serious health condition fmla serious medical conditions

Many employers struggle with the question of whether an employee’s request for medical leave is covered under FMLA as a serious medical condition.

The term “serious” is intended to exclude minor ailments, like colds, earaches, flus, and headaches.

However, whether a health condition is serious depends on its origin or effects. For example, a cold is typically not a serious health condition, but it could become one if it leads to pneumonia. The health care provider will make the determination of whether a condition is serious; it is not at the discretion of the employer.

So what counts as a serious health condition—and how can you tell whether an employee qualifies for this type of leave?
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How to Determine Who is Covered Under FMLA

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who is covered under fmla

The Family and Medical Leave Act (FMLA) provides certain employees up to 12 workweeks of unpaid, job-protected leave a year. It is also required that health benefits be maintained while the employee is on leave.

However, how do you know if FMLA coverage is an option for your employee? Who is covered under FMLA? We spoke with ERC's HR Help Desk Advisors about the steps to take to decide if your employee would qualify for coverage under FMLA.

Determine if an employee is eligible for FMLA coverage

Here are some guidelines to follow to determine if an employee is eligible for FMLA coverage. And remember, all must apply.



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New Rulings and Regulations Impacting HR

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New Rulings and Regulations Impacting HR

From marriage equality to proposed changes to overtime exemptions (not to mention the Supreme Court ruling that again affirmed the ACA), HR professionals across the country are taking a collective breath after a week of landmark rulings and proposed new regulations that impact the employment landscape. Here is what employers need to know (and do) now.
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The 5 Most Common FLSA Exemptions

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The 5 Most Common FLSA Exemptions

The most common FLSA exemptions are white collar exemptions. They can be broken down into five main categories, including:

  1. Executive
  2. Administrative
  3. Professional
  4. Outside sales
  5. Computer

In order for an exemption to apply, an employee’s specific job duties and salary must meet all of the requirements of the Department of Labor’s regulations.

Here is how the FLSA defines exemptions for these various duties.

1. Executive

An employee is exempt from the FLSA as an executive if they regularly perform all of the following:

  1. The employee must be compensated on a salary basis (as defined in the regulations) at a rate not less than $455 per week;
  2. The employee’s primary duty must be managing the enterprise, or managing a customarily recognized department or subdivision of the enterprise;
  3. The employee must customarily and regularly direct the work of at least two or more other full-time employees or their equivalent; and
  4. The employee must have the authority to hire or fire other employees, or the employee’s suggestions and recommendations as to the hiring, firing, advancement, promotion or any other change of status of other employees must be given particular weight.

2. Administrative

This exemption is for employees whose main duties involve the support of the business, such as human resource staff, public relations, payroll and accounting. Generally, administrative employees do not directly produce what the company sells; however, they are at a much higher level than those employees performing clerical work.

The FLSA defines exempt administrative duties as follows:

  1. The employee must be compensated on a salary or fee basis (as defined in the regulations) at a rate not less than $455 per week;
  2. The employee’s primary duty must be the performance of office or non-manual work directly related to the management or general business operations of the employer or the employer’s customers; and
  3. The employee’s primary duty includes the exercise of discretion and independent judgment with respect to matters of significance.

3. Professional

Exempt professional employees include lawyers, physicians, teachers, architects, registered nurses, and other employees who perform work that requires advanced education or training. These typically are intellectual jobs, require specialized education and involve the use of discretion and judgment. 

This exemption also includes creative professionals such as writers, journalists, actors and musicians. In general, such jobs require imagination and some unique combination to the employer. 

  1. The employee must be compensated on a salary or fee basis (as defined in the regulations) at a rate not less than $455 per week;
  2. The employee’s primary duty must be the performance of work requiring advanced knowledge, defined as work which is predominantly intellectual in character and which includes work requiring the consistent exercise of discretion and judgment;
  3. The advanced knowledge must be in a field of science or learning; and
  4. The advanced knowledge must be customarily acquired by a prolonged course of specialized intellectual instruction.

4. Outside Sales

To qualify for the outside sales employee exemption, all of the following tests must be met:

  1. The employee's primary duty is to make sales or the employee's primary duty is to obtain orders or contracts for services or contracts for the use of facilities for which clients or customers pay
  1. The employee must be customarily and regularly engaged away from the employers place or places of business.

The salary requirements of the regulation do not apply to the outside sales exemption. An employee who does not satisfy the requirements of the outside sales exemption may still qualify as an exempt employee under one of the other exemptions allow

5. Computer

A computer professional can be paid on a salaried or hourly basis, but must receive compensation equal to or greater than:

  • $455 per week if paid on a salary basis (annual salary of $23,660); or,
  • $27.63 per hour, if paid for each hour worked.

Job titles do not determine the exemption status. In order for this exemption to apply, an employee’s specific job duties and compensation must meet all the requirements of the FLSAs regulations. However, the computer exemption does state that an employee must be employed as a:

  • Computer systems analyst, computer programmer, software engineer, or other similarly skilled worker in the computer field; and,
  • The employee’s primary duty must consist of:
    1. The application of systems analysis techniques and procedures, including consulting with users, to determine hardware, software or system functional specifications;
    2. The design, development, documentation, analysis, creation, testing or modification of computer systems or programs, including prototypes, based on and related to user or system design specifications;
    3. The design, documentation, testing, creation, or modification of computer programs related to machine operating systems; or
    4. A combination of the aforementioned duties, the performance of which requires the same level of skills.

If you have any additional questions regarding common FLSA exemptions, and are an ERC Member, contact our HR Help Desk or visit the U.S. Department of Labor (DOL) FLSA page at http://www.dol.gov/whd/flsa/.

By providing you with information that may be contained in this article, the Employers Resource Council (ERC) is not providing a qualified legal opinion concerning any particular human resource issue. As such, research information that ERC provides to its members should not be relied upon or considered a substitute for legal advice. The information that we provide is for general employer use and not necessarily for individual application. We also recommend that you consult your legal counsel regarding workplace matters when and if appropriate.

HR, compliance, termination, or compensation questions?

ERC has a team of HR Help Desk Advisors to provide timely and trusted answers.

Contact the Help Desk

What Are the Changes to the New FMLA Ruling?

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What Are the Changes to the New FMLA Ruling? recent fmla changes fmla updates

As of March 27, 2015,  another change to the Family Medical Leave Act (FMLA) will be followed by employers nationwide. There is now a revised definition of “spouse” and it includes same-sex married couples in all 50 states.

 The Department of Labor (DOL) has proposed a change to the FMLA’s definition of “spouse.” The recent FMLA changes are stated as:
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FMLA Expands to Include More Employees in Same-Sex Marriages

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FMLA Expands to Include More Employees in Same-Sex Marriages

In its 20 plus years on the books, administration of the Family and Medical Leave Act (FMLA) has long been viewed as a complicated and challenging task faced by employers of all shapes and sizes – or at least for those with 50 or more employees.

Despite seemingly countless revisions since its inception, FMLA has become an integral part of US employment law and, despite administrative challenges, has provided families and individuals with previously unimaginable opportunities to take time away from work to care for loved ones without fear of losing their jobs.
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Paid Parental Leave: Policy, Politics, and Parenting

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Paid Parental Leave: Policy, Politics, and Parenting

Although the chances of this Congress successfully passing a bill on paid parental leave are tepid at best (even among supporters of such a measure), one thing is clear, awareness is building on the topic—from the State of the Union address to its own twitter handle #LeadOnLeave.

A mention in the Statue of the Union is usually a sure-fire way to simultaneously be thrust into the national spotlight as well as get written off as political posturing. Even if Washington is a standstill, the media coverage around the U.S.’s lack of parental leave over the past year has placed this issue in a whole new framework—one that just might persuade the American public and business owners alike to take a second look.
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Free Community College: What's all the Buzz?

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Free-Community-College-Whats-all-the-Buzz

The average American is carrying around $27,000 in student-load debt in 2015. American's are either not going to school for the first time or not furthering their education because they can't afford it or don't want the debt.

In the January 2015 State of the Union Address, President Obama introduced many proposals, but one in particular stood out in the education field: Free community college tuition for everyone.
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What is the HIPAA Privacy Rule? An Overview

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What is the HIPAA Privacy Rule? An Overview

According to the U.S. Department of Health and Human Services, the HIPAA Privacy Rule "establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically."

HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. Title I of the Act protects health insurance coverage for workers and their families when they change or lose their jobs. Title II of the Act requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers.

Under Title II, the Privacy Rule, also known as The Standards for Privacy of Individually Identifiable Health Information, establishes a set of national standards for the protection of certain health information.
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What Employers Need to Know About the Hobby Lobby Decision

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What Employers Need to Know About the Hobby Lobby Decision

The U.S. Supreme Court closed out its 2014 term dramatic fashion as it handed down a 5-4 decision in favor of Hobby Lobby in the controversial Burwell v. Hobby Lobby Stores case.

The ruling set off a barrage of strongly worded articles, blog posts and comments, including the Court’s own majority and dissenting opinions. Given the politically and morally charged nature of the case that hit on topics including the Affordable Care Act (ACA), religious freedom, women’s health, contraception, and separation of church & state just to name a few, the resulting controversy was virtually inevitable.
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