The Family Medical Leave Act (FMLA) created the need for employers to evaluate, track and monitor employee's requests for time off work, due to their own or a relative's serious health condition as defined by the Act. FMLA gives employers the right to certain specific information about the condition and the right to clarify this information with the Health Care Provider who provides it. The employer must determine whether the employee's request qualifies for time off under the Act, communicate with supervisors in regard to what to expect for frequency and length of absences, account for time taken under the FMLA, and monitor for abuse and fraud. If not managed effectively, FMLA absences can have an impact on the morale of co-workers and supervisors, as well as disrupt schedules and negatively impact productivity. While an important benefit for those really in need, FMLA time off can be abused by a small minority, as seems to frequently be the case with all well- intended benefit programs.

Consider some of these facts regarding the costs to manage FMLA cases for American companies. A random sample of 54 FMLA second and third opinion cases out of 775 consecutively managed by The OMS, Ltd. over the previous three years showed the following:

	18% of the second opinion cases and 10% of the third opinion cases in the random sample were determined to be NOT “Serious Health Conditions” as defined by FMLA.
	An additional 42% of both second and third opinion cases were determined to have a frequency and duration of absences excessive for the Serious Health Condition.
	In the cases of excessive frequency and duration of absences, the average reduction in frequency and duration time compared to what was granted by the Health Care Provider was 69%.

Reductions in FMLA leave time can be translated directly into dollars:

	Twelve weeks of FMLA leave each year equates to 480 hours (12 weeks x 5 days/week x 8 hours/day).
	69% of 480 hours equals a 331-hour reduction in necessary FMLA leave.
	331 hours multiplied by an average labor rate of $20/hour equals $6,620.00.

Even if employees are not paid during their time off on FMLA leave, someone has to do their work. That means overtime (time and one half), a temporary worker or extra staffing.

The OMS, LTD (Occupational Medicine Specialists), a 30 year old, Chicago-based, woman-owned business, has developed a service product to assist its corporate clients in managing their FMLA requests. Our physicians have performed thousands of clarifications of requests for FMLA time off for a variety of clients in both union and non-union environments. We are pleased to present the following description of our service.

FMLA CLARIFICATION SYSTEM

Each request for FMLA clarification we receive is assigned a unique number and logged into a database. Name and social security number are also used as unique identifiers but since an individual frequently generates more than one clarification request, the unique number is used to avoid confusion. The data base is used to track and monitor turn-around time, physician=s work load, and billing. We can accept faxed or e-mail requests but since the original request which is filled out by the health care provider is frequently needed, hard copy in some form is usually desirable. OMS files hard copies of all documents received and generated during the process.

Each physician periodically receives an updated list of pending cases assigned to them and verifies the status of the cases for the project coordinator who keeps the client apprised. After the physicians have contacted the health care provider, they generate their own reports and give them to the project coordinator who sends them to the client. The database tracks each step of the process from initial receipt to physician assignment, report generation and delivery to the client. Invoices are generated monthly based on work completed

The project coordinator is available to the client=s authorized personnel by phone, fax or e-mail to answer any questions. All material is kept in a confidential manner in a clinic environment. All staff handling requests are certified medical assistants.

PROFESSIONAL STAFF

The OMS, Ltd has assembled a multi-specialty team of physicians to perform FMLA clarifications. In addition to experience and board certification in occupational medicine, our staff holds certifications in pediatrics, psychiatry, family practice, internal medicine and surgery. They hold licenses in a combined total of more than 20 states. All are covered by OMS=s medical malpractice insurance policy when performing clarifications. All have provided testimony in depositions and court room and are available for hearings or depositions if needed.

Only physicians make calls to the health care provider and each personally types and signs each report sent to the client. Each has been trained by OMS to make the contacts in a consistent manner and within the parameters allowed by the client and the FMLA. Each physician has undergone an apprentice period starting with reading the reports of others and studying a procedure manual developed by OMS describing the clarification process. The manual contains suggested scripts to use in typical situations as well as questions and language to be avoided. Then, they listen to calls made by others and finally make calls under the supervision of seasoned physicians. For a period of time, all their reports are read by a second physician before they are sent to the client.

All physicians are available by phone to answer questions directly from the client=s staff if needed. OMS has conducted clarifications throughout the United States and can accommodate all time zones.

WORK PRODUCT

OMS can provide clients with forms to make clarification requests or can tailor forms to suit the client=s own FMLA Certification form. Several examples of Request for Clarification forms are attached.

OMS =s physicians can report in a narrative report or in a question and answer format. When using the narrative format, our reports will always contain certain information such as date of contact, contact name and credentials, employee name and identifiers and the name and credentials of the physician making the clarification. All of our reports under go a quality assurance check to make sure that each question asked has been addressed. An example of both a narrative and question and answer format are also attached. ARecommendation@ sections are optional depending on whether the client wants an opinion from the OMS physician or not.

Each physician keeps a written phone log of all attempts to reach the certifying medical provider. This log documents the date and who was contacted in case this becomes an issue. A copy is attached for illustration. Physician=s notes made during the call are also kept on file in case testimony might be needed.

OMS=s staff can assist clients in locating physicians to perform second opinion exams on contested FMLA cases and set up these exams all over the United States.