WA State and FMLA

[Sushirolls]

So WA state recently passed a law stating that FMLA forms brought to doctors offices must be filled out in 7 days or less.

Are people interpreting this as declaration/mandate dictating care that all forms will lead to time off? If so why not remove the doctor from this and let patients fill it out themselves? Are physicians now simply a mandated paper monkey?

Or is the work around to this, filling the form out in a way that reflects time off shouldn't be granted. Technically a doctor has completed the law by filling out the paperwork. Doesn't state the patient must have time off.

i.e. patients who have "anxiety" or "depression" and want time off, essentially a paid vacation of work stress/burnout/boss conflicts; but have no interest in doing things like IOP/PHP which is more constructive in returning to work.

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[PsyDr]

FMLA is not paid.

 

[clausewitz2]

FMLA is not paid.

modulo the individual policies of some particularly generous employers, but yes, it just keeps them from firing you, it doesn't keep the money coming in.

 

[Sushirolls]

Wrong. In WA state they have paid FMLA, funded by payroll taxes (a withholding from employees paychecks), a program started by the state government.

Home - Washington State's Paid Family and Medical Leave

Paid Family and Medical Leave is a new benefit for Washington workers, and lets you take up to 12 weeks of paid time off when you need it most. Learn more and apply.

paidleave.wa.gov

Other states FMLA is likely the same as we all know.

 

[comp1]

FMLA can very much be paid, it just isn't guaranteed. The rules around sick leave are as varied as workplaces. FMLA is simply a federal minimum guarantee for sick leave. Sometimes, sick leave is paid as an employee benefit. This particular law doesn't appear to be for FMLA, however. It's for a weird Washington state program that is always paid. The form is...amazingly short. I don't know how the law applies if you don't agree that the patient should get it. I guess you just write a letter saying they don't qualify (within 7 days)? That would probably cover your obligation. It would be nice if this form was yes/no instead of just yes.

 

[LucidStupor]

Are people interpreting this as declaration/mandate dictating care that all forms will lead to time off? If so why not remove the doctor from this and let patients fill it out themselves? Are physicians now simply a mandated paper monkey?

I don't think the law requires you to say "yes" to all patient requests. It specifically says "Nothing in this section requires a provider to complete a certification for a serious health condition for which the provider does not have the necessary patient information". So if you don't think the patient has a "serious health condition" as defined under RCW 50A.05.010, then you don't have to certify "yes" on the form.

The main impact of the law is that healthcare providers can no longer have an office policy of not doing FMLA paperwork. If you find that the patient has a "serious health condition", and the patient asks you to complete the form, then you have to complete it (and cannot charge extra).

 

[Stagg737]

I don't think the law requires you to say "yes" to all patient requests. It specifically says "Nothing in this section requires a provider to complete a certification for a serious health condition for which the provider does not have the necessary patient information". So if you don't think the patient has a "serious health condition" as defined under RCW 50A.05.010, then you don't have to certify "yes" on the form.

The main impact of the law is that healthcare providers can no longer have an office policy of not doing FMLA paperwork. If you find that the patient has a "serious health condition", and the patient asks you to complete the form, then you have to complete it (and cannot charge extra).

So basically mandating physicians to fill out government forms without receiving pay for it. Do you have to say “no” if you don’t certify? If you must fill something out it seems like a pretty egregious violation of private practice rights.

 

[LucidStupor]

So basically mandating physicians to fill out government forms without receiving pay for it. Do you have to say “no” if you don’t certify? If you must fill something out it seems like a pretty egregious violation of private practice rights.

The government probably thinks doctors are used to doing extra admin for free. Prior authorizations, anyone?

At least you get to charge the patient for the consultation necessary to complete the form, and the form itself is not very long. Just 3 pages. The law only says you have to complete the form required for FMLA under state law. Not the 30+ page form required for private STD / LTD that some patients may want you to do.

I don't know what you mean by "Do you have to say “no” if you don’t certify?", and to the extent that "private practice rights" is a thing, I don't think this new mandate conflicts with it. State governments have wide latitude to regulate what constitutes your professional responsibility, and WA State has decided that filling out FMLA form is now one of them in WA. (As long as the patient qualifies for it, in your professional opinion.)

 

[comp1]

Getting a license to do anything is always a trade off in freedoms. The right to decline evaluation for a particular form is now one of those in Washington for healthcare providers. From a practical perspective, you can indeed charge for the consultation needed to (re)evaluate the patient, but the 7 day thing might be challenging. If you wanted to exercise that ability to charge, you better have some immediate availability in your schedule. The form itself is DEAD simple, though. It's not even 3 pages. It's one with 2 pages of (dumb) instruction in massive 30 point font. The state can at least get credit for that. Beats any other sort of disability form I have ever seen. I'd still much prefer it was a yes/no situation instead of just yes.

 

[VA Hopeful Dr]

OK so I finally went and looked into this.

In Section 1 of the new law:

"Nothing in this section requires a provider to complete a certification for a serious health condition for which the provider does not have the necessary patient information"

So you tell the patient they need an appointment so you can get all the information you need to fill out (or not) the form and the 7 day rule doesn't apply. You also can't charge a form fee, but you can get an office visit out of it.

 

[comp1]

OK so I finally went and looked into this.

In Section 1 of the new law:

"Nothing in this section requires a provider to complete a certification for a serious health condition for which the provider does not have the necessary patient information"

So you tell the patient they need an appointment so you can get all the information you need to fill out (or not) the form and the 7 day rule doesn't apply. You also can't charge a form fee, but you can get an office visit out of it.

That's one interpretation, but probably not the one patients will make. I anticipate they will interpret the law as expecting you to get the necessary information within 7 days when asked for the form to be completed if you already have an established relationship with them. Otherwise, the 7 day thing doesn't have much meaning at all, right? I mean otherwise you could NEVER get the necessary patient information and just have that as your office policy. I get that there would be reasonable exceptions to this, but I'm not sure my schedule is full will be one of them.

 

[VA Hopeful Dr]

That's one interpretation, but probably not the one patients will make. I anticipate they will interpret the law as expecting you to get the necessary information within 7 days when asked for the form to be completed if you already have an established relationship with them. Otherwise, the 7 day thing doesn't have much meaning at all, right? I mean otherwise you could NEVER get the necessary patient information and just have that as your office policy. I get that there would be reasonable exceptions to this, but I'm not sure my schedule is full will be one of them.

The interpretation the patients make doesn't matter, its the one that either the medical board or judge (not sure which) decides.

I suspect this is trying to solve the problem of doctors who get surprise FMLA forms and just throw them out. Heck, I do that frequently.

It looks to my non-lawyer eyes that this is basically saying "if you receive FMLA forms you have to take action within 7 days". It has a specific phrase that says the time limit flat out doesn't apply if you don't have the information you need to accurately fill out the form. The wording doesn't appear all that vague.

 

[clausewitz2]

The interpretation the patients make doesn't matter, its the one that either the medical board or judge (not sure which) decides.

I suspect this is trying to solve the problem of doctors who get surprise FMLA forms and just throw them out. Heck, I do that frequently.

It looks to my non-lawyer eyes that this is basically saying "if you receive FMLA forms you have to take action within 7 days". It has a specific phrase that says the time limit flat out doesn't apply if you don't have the information you need to accurately fill out the form. The wording doesn't appear all that vague.

And this is sort of how it would have to work. Imagine receiving a faxed FMLA form for a patient you haven't seen or been in communication with in 18 months. I am confident the legislature in question did not intend for the result of this law to be that you have to opine on their disability without any update on their situation. I think you're right about the plain language of the statute being pretty clear but courts do actually consider legislative intent.

 

[comp1]

These are often patients heavily involved with litigation to begin with. A judge will decide this eventually.

 

[VA Hopeful Dr]

And this is sort of how it would have to work. Imagine receiving a faxed FMLA form for a patient you haven't seen or been in communication with in 18 months. I am confident the legislature in question did not intend for the result of this law to be that you have to opine on their disability without any update on their situation. I think you're right about the plain language of the statute being pretty clear but courts do actually consider legislative intent.

And if not, you can just write all over the form "haven't examined patient in X months". Hey, you completed the form in 7 days!

 

[nexus73]

You'd hope this would be reasonably interpreted, but this is Washington state. Land of the excellent Volk v Demeerleer duty to warn case in which psychiatrists were determined to have a duty to warn if their patient could possibly be violent to someone, whether or not the patient was making actual homicidal statements or even if there was an actual victim named.

 

[calvnandhobbs68]

You'd hope this would be reasonably interpreted, but this is Washington state. Land of the excellent Volk v Demeerleer duty to warn case in which psychiatrists were determined to have a duty to warn if their patient could possibly be violent to someone, whether or not the patient was making actual homicidal statements or even if there was an actual victim named.

Yeah between Volk and this FMLA stuff I think I've checked Washington off my list of places to get a license.....