COUNTY OF SAN MATEO
HUMAN RESOURCES DEPARTMENT
Inter-Departmental Correspondence
DATE: April 21, 2014
TO: All Management Employees
FROM: Nicole McKay, Employee & Labor Relations Manager
SUBJECT: Employee Relations Bulletin 21 Medical Statements
Note: The information in this bulletin does not apply to sick leave used in conjunction with Workers Compensation cases, nor does it apply to medical statements required in conjunction with Medical or Family & Medical Leaves of Absence.
In recent negotiations, there was considerable discussion regarding the requirement for a medical statement to support an employee’s use of sick leave. One of the most discussed issues was some supervisor’s and manager’s refusal or objection to accepting statements (usually from Kaiser) that state that the employee “states that they are ill” and that do not certify that the employee was seen by a physician or health care practitioner. This bulletin will provide guidance on when it is appropriate to require the submission of medical statements and also clarifies that, under most circumstances, statements from Kaiser and other providers that simply state that the employee states that he/she is ill and unable to work are acceptable.
Requiring Medical Statements
Normally, the requirement to provide a medical statement to support the use of sick leave falls under one of the following categories:
- Some departments have a policy requiring employees to provide a medical statement if they are absent three or more days.
- Individual employees whose absenteeism is excessive are normally issued leave restriction letters that require them to provide medical statements any time they use sick leave as long as they are under the provisions of the leave restriction letter. These letters are issued if verbal counseling is not effective in correcting excessive absenteeism. Normally such letters, and the restrictions in them, are rescinded after six months to one year if the employee improves his/her attendance to an acceptable level.
- Individual employees who are not under leave restriction may be required to present a medical statement to support their use of sick leave if the circumstances of such use warrant substantiation. For example, if an employee’s request for vacation on a particular day is denied and the employee then calls in sick, it would be appropriate to require that the employee submit a medical statement upon their return to work. The employee must be advised of this requirement before they return to work, ideally at the time they call in.
- Employees who request Medical Leaves of Absence or Family and Medical Leaves of Absence are required to submit medical statements along with the leave application forms. The information below regarding acceptance of Medical Statements does not apply to requests for Leaves of Absence. Medical statements to support such requests must demonstrate that the treating health care professional has examined the individual (or their family member for FMLA leaves) and has determined that a leave of absence is required.
- Any time an employee uses sick leave in conjunction with a Workers Compensation claim, they are required to submit a statement from the treating health care professional. The information below regarding acceptance of Medical Statements does not apply to Workers Compensation cases.
Acceptance of Medical Statements
Often, when an employee is required to present a medical statement to support the use of sick leave, they return to work with a note that says “employee states he/she is ill and unable to work.” Usually, this occurs when the employee is in the Kaiser Health Plan. In most circumstances, such medical statements are acceptable to support the use of sick leave and should not be questioned by the supervisor/manager.
There are many minor or common illnesses and conditions for which health providers and insurors, and Kaiser in particular, will not routinely see a patient in person. This policy is due to medical priorities, cost containment, and the high probability that a phone assessment and advice will resolve the problem. Kaiser premium rates, and those of other HMO’s are driven, to a large degree, by utilization. Thus, when we force an employee to go into the office to be seen by a health care professional rather than following the guidance of the advice nurse, we are contributing to increased health insurance premiums for all employees. A department’s refusal to accept the form or letter supplied by the provider means another trip for the employee (more lost time from work) and may not result in any change in the statement provided.
Please feel free to call Employee Relations for guidance on this matter.