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September 27, 2012

Not all doctor visits constitute “medical treatment” for the purposes of the FMLA

 Not all doctor visits constitute “medical treatment” for the purposes of the FMLA
Jones v. C & D Technologies, Inc., USCA, 7th Circuit, Docket No. 11-3400. 

Copyright © 2012. All rights reserved by Carl C. Bosland, Esq. Reproduced with permission. Mr. Bosland is the author of A Federal Sector Guide to the Family and Medical Leave Act & Related Litigation.

Jones had an approved FMLA-covered serious health condition requiring periodic treatment by his physician.  He asked for and was approved FMLA leave for an afternoon appointment to receive medical treatment by one of his physicians.  Although he was scheduled to work the morning, Jones did not show up to work.  Whether Jones timely called in his morning absence was in dispute.  Instead of working, Jones visited another of his physicians.  During the unscheduled morning visit, Jones ensured that his physician forwarded his medical records for his afternoon medical appointment.  As a result of a short conversation in the lobby, Jones also secured a prescription refill note from his doctor during his impromptu morning visit.  Jones was never examined or evaluated during the morning visit with his doctor.  Because he missed working his morning shift, Jones was terminated pursuant to the Company's attendance policy.

Jones sued alleging that his termination interfered with his FMLA rights.  Specifically, Jones argued that he received FMLA-covered "medical treatment" during his morning doctor visit, as evidenced by the prescription refill note.  The Company argued that Jones' morning visit was not "medical treatment" within the meaning of the FMLA. 

An employee is entitled to FMLA leave if she suffers from a "serious health condition" that renders the employee unable to perform the functions of the employee's position.  29 USC 2612(a)(1)(D).  Under the FMLA, an employee who must be absent from work to receive medical treatment for a serious health condition is considered "unable to perform the functions of the employee's position."  29 CFR 825.123(a)(emphasis added).  The parties do not dispute that Jones had an FMLA-covered serious health condition.  Instead, the case focused on whether Jones' impromptu morning visit with his physician constituted "necessary medical treatment."  
After initially noting that the statute does not define "treatment," the Court looked to the DOL regulatory definitions of "treatment" in sections 825.113(c) and 825.115 for guidance on the meaning of "treatment" in 825.123(a).  The Court concluded that 825.115 was not helpful in understanding the meaning of "treatment" in 825.123(a) because, while it refers to "continuing treatment," it fails to address the circumstances where a person actually receives medical treatment that prevents them from performing the functions of their position.  Similarly, while acknowledging the reference to a course of prescription medication as evidence of a "regimen of continuing treatment," the Court ultimately concluded that, while relevant to determining the existence of an FMLA-covered serious health condition, it was not helpful to determine whether an employee actually receives "treatment" that prevents him from performing his job.  According to the Court:

Many chronic conditions require a course of prescription medication, but the FMLA requires something more for an employee to become entitled to leave -- inability to perform her job functions.  A course of prescription medication and an inability to perform a job are not mutually exclusive.

Relying on its previous decision in Darst v. Interstate Brands Corp., 512 F.3d 903, 911-12 (7th Cir. 2008), the Court determined that treatment "includes examinations to determine if a serious health condition exists and evaluation of the condition," but not actions such as calling to make an appointment or scheduling substance-abuse rehabilitation."  Applying that standard, the Court concluded that Jones did not receive treatment preventing him from working that morning by visiting his doctor to ensure his referral to another lab was in order.  The Court also found that merely picking up a prescription refill note did not, under the circumstances, constitute FMLA-protected treatment.  The Court observed:

Although we can envision a scenario where obtaining a prescription note in connection with a physician's examination might constitute treatment, this case does not approach that hypothetical.  Here, Dr. Lubak never evaluated or examined Jones, and Jones even conceded in a deposition that he was never "physically examined" that morning.  Jones arrived at Dr. Lubak's clinic unannounced and appeared only to briefly speak with his physician in the office lobby. The entirety of Jones's interaction with Dr. Lubak consisted of the physician's acquiescence to refill a prescription.  There is simply no evidence that Jones was examined, and therefore treated, that morning.

Mr. Bosland Comments:  The decision of the Seventh Circuit is well reasoned.  To be covered by the FMLA, an absence to receive "medical treatment" under 825.123(a) requires, for the Seventh Circuit, the visit be "necessary" and a physical examination, which the Court equates with "treatment."  Jones' unscheduled, non-emergent morning doctor visit was not medically required.  Moreover, checking to ensure that medical paperwork was forwarded to a second doctor and securing a prescription refill after a brief lobby conversation with his physician, did not impress the Court as rising to the level of an "examination" and, therefore, treatment for purposes of the protections of the FMLA.  It will be interesting to see if other courts following the lead of the Seventh Circuit. 

The decision is posted on the Internet at:

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