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Disability Employment Policy Resources by Topic

Employment Laws: Medical and Disability-Related Leave

When employees are injured or disabled or become ill on the job, they may be entitled to medical and/or disability-related leave under two federal laws: the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). In addition, state Workers' Compensation laws have leave provisions that may apply. Depending on the situation, one or more of these laws can apply to the same employee. To help employers understand their responsibilities related to medical and disability-related leave, an overview of each is provided below, including information about where the laws intersect and overlap.

Workers' Compensation laws apply to almost all employers. Workers' Compensation is a form of insurance that provides financial assistance, medical care and other benefits for employees who are injured or disabled on the job. Except for federal government employees and certain other groups of employees, Workers' Compensation laws are administered at the state level.

  • Covered employers: Because each state has its own system, coverage varies. As a general rule, Workers' Compensation laws apply to all employers with one or more employees.
  • Covered employees: In most states, all employees are covered. An on-the-job injury triggers coverage.
  • Medical and disability-related leave rules : Injured employees receive varying amounts of paid leave, depending on the state and the nature of the injury.
  • Additional information: Each state has an agency that administers its Workers' Compensation laws. For information about Workers' Compensation for federal government employees and certain other groups of employees, contact the U.S. Department of Labor (DOL) Office of Workers' Compensation Programs.

The Americans with Disabilities Act (ADA) is a federal law that protects the rights of people with disabilities by eliminating barriers to their participation in many aspects of working and living in America. In particular, Title I of the ADA prohibits covered employers from discriminating against people with disabilities in the full range of employment-related activities, from recruitment to advancement to pay and benefits.

  • Covered employers: Title I of the ADA applies to employers (including state or local governments) with 15 or more employees and to employment agencies, labor organizations and joint labor-management committees with any number of employees.
  • Covered individuals: The ADA protects individuals with a disability who are qualified for the job, meaning they have the skills and qualifications to carry out the essential functions of the job, with or without accommodations. An individual with a disability is defined as a person who: (1) has a physical or mental impairment that substantially limits one or more major life activities; (2) has a record of such an impairment; or (3) is regarded as having such an impairment.
  • Medical and disability-related leave rules: The ADA does not specifically require employers to provide medical or disability-related leave. However, it does require employers to make reasonable accommodations for qualified employees with disabilities if necessary to perform essential job functions or to benefit from the same opportunities and rights afforded employees without disabilities. Accommodations can include modifications to work schedules, such as leave. There is no set leave period mandated because accommodations depend on individual circumstances and should generally be granted unless doing so would result in "undue hardship" to the employer.
  • Additional information: The U.S. Equal Employment Opportunity Commission (EEOC) enforces the ADA's employment provisions. The EEOC Web site offers related information and resources, including specific guidance about accommodations for small businesses.

The Job Accommodation Network (JAN) is a free service sponsored by DOL's Office of Disability Employment Policy that provides information on specific job accommodations, including leave. JAN can be contacted by calling 1-800-526-7234 or 1-800-ADA-WORK (1-800-232-9675) (V/TTY).

The U.S. Department of Justice's ADA Home page provides extensive ADA information and resources, including publications for businesses and links to the various agencies responsible for enforcing its different provisions.

The Family and Medical Leave Act (FMLA) is a federal law designed to help workers balance job and family responsibilities by giving employees up to 12 weeks of unpaid leave per year for specific reasons, including a serious health condition or to care for an immediate family member who has a serious health condition. During FMLA leave, employers must continue employee health insurance benefits and, upon completion of the leave, restore employees to the same or equivalent positions.

  • Covered employers: The FMLA applies to private employers with 50 or more employees working within 75 miles of the employee's worksite. Employers with fewer than 50 employees can also choose to provide benefits similar to those required by the FMLA, and many find it beneficial to do so. The FMLA also applies to all public agencies and private and public elementary and secondary schools, regardless of the number of employees.
  • Covered individuals: Employees are eligible to take FMLA leave if they have worked for their employer for at least 12 months, and have worked for at least 1,250 hours over the 12 months immediately prior to the leave, if there are at least 50 employees working within 75 miles of the employee's worksite.
  • Medical and disability-related leave rules: Eligible employees can take up to 12 weeks of leave for treatment of or recovery from serious health conditions. The FMLA's definition of a serious health condition is broader than the definition of a disability, encompassing pregnancy and many illnesses, injuries, impairments, or physical or mental conditions that require multiple treatments and intermittent absences. Generally, things like cosmetic surgery, colds, headaches, and routine medical and dental care are not included. FMLA leave is unpaid, but employers may require employees to concurrently take paid leave, such as accrued vacation or sick leave, or employees may elect to do so.
  • Additional information: DOL's Wage and Hour Division enforces the FMLA and has online compliance assistance resources for employers. In addition, DOL has an interactive FMLA Advisor for employers and employees.

When Medical and Disability-Related Leave Laws Intersect

When employees need time off because of a medical or disability-related issue, it is important to remember that they may have rights under all of these laws at the same time. In certain circumstances, provisions of the ADA, the FMLA and Workers' Compensation laws can apply to the same employee, and employers may find understanding their responsibilities a challenge. For example, a Workers' Compensation injury that requires hospitalization or incapacitates an employee for more than three days and requires continuing treatment by a healthcare provider generally qualifies as a serious health condition under the FMLA. If the injury causes a permanent mental or physical impairment that substantially limits a major life activity, that same employee could be entitled to additional leave as a reasonable accommodation under the ADA.

In addition, several states have enacted their own family and medical leave laws, some of which provide greater amounts of leave and benefits than those provided by the FMLA, and/or provide benefits to employees who are not eligible for FMLA. When employees are covered by both federal and state family and medical leave laws, they are entitled to the greater benefit or more generous rights provided under the different parts of each law. DOL has additional information about state-specific family and medical leave laws online.

Below are the basic steps employers can follow to determine their responsibilities regarding medical and disability-related leave requests:

  1. Determine which laws apply to employees as a group. For example, the ADA applies to employers with 15 or more employees. The FMLA applies to private employers with 50 or more employees. Thus, for both laws to apply, a private employer must have 50 employees.
  2. Determine which laws cover the particular employee's situation. For example, a short-term or temporary condition does not usually meet the ADA's definition of disability. Below is a quick checklist:
  • Is the injury work related? (Workers' Compensation)
  • Does the employee have a serious health condition? (FMLA)
  • Does the employee's condition meet the definition of disability? ( ADA)

In some situations, employers may need to decide if a medical certification or consultation is necessary to ensure that a requested accommodation is necessary and reasonable. Also, the FMLA allows employers to request a medical certification of the serious health condition.

  1. Determine the employee's benefits and/or entitlements under the relevant laws. As described above, when more than one law applies, employers must provide leave under whichever law provides the greater rights and benefits to employees.
  2. Evaluate whether the employee is entitled to reinstatement once able to return to work. If so, consider whether there are obligations to provide any accommodations, an altered work schedule, and/or a light duty assignment.
  3. Evaluate whether the return to work poses a direct threat to the health or safety of the employee or others in the workplace.

The EEOC Web site has further information about the interaction between the ADA and FMLA and guidance about the relationship between the ADA and state Workers' Compensation laws.