Got back pain questions? Our Back Wellness Coaches have answers. Text Us Now at 412.419.2225. It's FREE!

Login Signup

What is FMLA and How Do You Use It?

Published October 6, 2020
| Written By SpineNation Editorial Staff  
The Family Medical Leave Act (FMLA) serves as part of the labor rights movement. FMLA protects employees from unfair retribution or employment termination by employers when they or a family member becomes critically ill or injured. Individuals living with chronic pain and back, neck, and spine conditions often don't realize that they have intermittent or continual FMLA rights. Patients may put off necessary treatment or surgery because they are afraid to lose their job.

This article serves to educate patients on their rights under the Family Medical Leave Act and the legislation's history. 

A Brief History of the Family Medical Leave Act

President Bill Clinton passed signed FMLA into law in January of 1993. Legislators first began presenting the Act in Congress in 1984, but the bill was repeatedly stuck down and blocked. The Family Medical Leave Act was the first piece of legislation that President Clinton passed upon entering the Presidential office.

The Act was born out of necessity as women often lost their jobs when taking time off to give birth and recover. Parents might have their employment terminated, for instance, if a child were fighting cancer and the employee took too much time off to be at the hospital or attending doctors' appointments and medical tests.

You may recall a made-for-TV movie entitled, "A Child's Wish," starring John Ritter. Released in 1997, the film told the real-life tale of two families. Both families were impacted by childhood cancer, and both fathers lost their jobs due to the amount of leave they took from work to be with their children. Ritter portrayed father Ed, who testified in front of Congress and contributed to the Act's passing.

What does FMLA do?

The Family Medical Leave Act guarantees employees (under certain conditions) 12 weeks of unpaid time off in 12 months to tend to their own medical needs or that of a family member. It is important to note that the 12 months do not have to be a calendar year or a fiscal year. Instead, it is any 12 month period and begins whenever the employee first takes time off.

Note that FMLA leave is not paid leave. The employee has protection from losing their employment under the Act, but they will not receive a salary for time off unless they have sick leave or vacation days banked with their employer. There are three kinds of FMLA leave an employee can use: Intermittent, Continuous, and Reduced Schedule FMLA. 

Intermittent FMLA protects those living with chronic conditions from being punished or fired for taking time off. Employees may take leave for periodic flares of pain or other symptoms, regular doctors' appointments, or procedures. Time off may be taken in hourly, daily, or weekly increments, depending on the medical condition(s) and treatment(s).

When an employee misses work for three consecutive days or more and is seen by a doctor, Continuous FMLA is applied. Reduced Schedule FMLA leave is utilized when an employee needs to regularly reduce the number of hours they work per day or per week, to care for a family member or tend to their own medical needs. Medical needs apply to both physical and mental health treatments and conditions.

Who is eligible for FMLA leave protection?

Specific criteria must be met for an employer and employee to qualify for protection under the Family Medical Leave Act. A few of the conditions for covered employers are as follows:

  • Private-sector employers must have 50 or more employees.
  • Eligible employers are public agencies, like local, state, or federal government offices. They may also be private-sector corporations or non-profit organizations
  • All public and private schools are covered employers under the Act, no matter the size of staff.

Conditions for eligible employees include:

  • Any employee who works for a covered employer;
  • Any employee who has worked for a covered employer for a minimum of 12 months; and
  • Any employee who has worked at least 1,250 hours of service for an eligible employer.

Reasons one may utilize FMLA leave include, but are not limited to:

  • A child's birth: Parents may take twelve weeks off to bond with their newborn in the first year of the child's life;
  • An employee is caring for a spouse, child, or parent with a severe or chronic health condition;
  • An employee requiring surgery or intermittent medical treatment or medical treatments that are continuous for some time;
  • A health condition that impacts an employee's ability to perform essential job functions; or
  • The spouse, child, or parent of the employee is a military member called to active duty.

How to Use FMLA Leave

You will want to consult your organization's policies and procedures or consult the Department of Labor for the most accurate information. Still, in general, an employee seeking coverage under the Family Medical Leave Act will approach their human resources department. The law states that employers must provide the necessary documentation to employees seeking FMLA leave.

There are two forms the employee must complete and submit to their employer. The first is the FMLA Certification form, with sections completed by the employer, employee, and the employee's doctor. The second is the FMLA Notification form, which must be provided by the employer to the employee within two days of a leave request. Most companies have a custom version of this form, but you can find examples of all relevant documentation on the Department of Labor website.

It is common for doctors to require that patients schedule a medical appointment in the office just as they would for a regular check-up or treatment, and fill out the FMLA forms together. This procedure ensures that the doctor and patient are on the same page regarding treatment expectations and time needed off from work. It also provides that the physician is completing forms correctly. 

For intermittent FMLA, an employer may require an ADA: Accommodation Medical Certification form. (ADA stands for Americans with Disabilities Act.) The employee and their physician fill out the ADA form. The ADA form also provides space for listing special accommodations needed in the workplace for an employee's specific disabilities.


According to the Center for Disease Control (CDC), 26% of the U.S. adult population lives with some form of disability. No one should have to choose between their livelihood and their family's well-being or that of themselves. Employees must know their rights when it comes to medical disabilities and chronic illnesses and conditions. 

If you live with chronic disease or disabilities, whether they pertain to your physical or mental health, know your rights. Don't let supervisors or administrators make you feel like you must neglect your health and well-being to keep your job. Speak to your HR representative, if you have one, or visit or contact your human resources office if you have questions about workplace accommodations or FMLA leave eligibility.
Updated: October 6, 2020

Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.

You might also like...

  • Across the state of Florida, operating owners of multiple rehabs are being investigated for possible fraudulent allegations. It's not just a headline though — this is real life for some — for most, these days. "It looked fine. They were saying all the right things to me. I could not help my child so I trusted them to help," Holley recalled...