Family Medical Leave Act (FMLA) for Drug and Alcohol Rehab
Have you ever wondered if you could take excused time off from your job to attend drug and alcohol rehab? Thanks to the Family Medical Leave Act (FMLA), this employment benefit may be available to you if you meet specific requirements. Learn what FMLA is, what it covers, and how to see if you qualify below.
What Is the FMLA?
The Family Medical Leave Act (FMLA) is a labor law that allows employees to take a leave of absence from their job for up to 12 weeks for illness or important family matters.1 This act also mandates that the employee’s health benefits continue during this time frame without the risk of losing coverage.1 Although employees can maintain their benefits, they are not entitled to pay during this time.1
The FMLA is the minimum guideline the federal government sets, and individual states can expand upon this policy if they wish.1 In fact, many already have, including California, Connecticut, Hawaii, Maine, Minnesota, New Jersey, Oregon, Rhode Island, Vermont, Washington, and Washington, D.C.2
Does the FMLA Cover Drug and Alcohol Rehab?
Yes, treatment for substance use is considered a serious health condition under the FMLA so long as the conditions for inpatient care or continuing treatment are met.3 For substance use to be covered, the treatment must be prescribed by a medical doctor or provider of healthcare services.3 The FMLA does not cover an employee’s absence due to the use of a substance, only treatment for it.3
The FMLA can be utilized by the person’s family members as well.3 If the family member can document that they are the primary caregiver for the person, they are given the same amount of time as the person receiving substance use treatment.3
Are Substance Misuse and Addiction Considered Serious Conditions?
Substance misuse and addiction can be classified as serious health conditions if the conditions related to inpatient care and continuing treatment are met.3 Substance misuse and addiction are often accompanied by a co-occurring medical and/or mental health condition.4 All of these should be identified during initial treatment referrals and assessments.4
Does the FMLA Cover Mental Health Treatment?
Yes, the FMLA can cover mental health treatment, although there are limitations.5 For the FMLA to include mental health treatment, a person must have a serious mental health condition that requires inpatient care.5 This may consist of an overnight stay in a hospital or other medical care facility to qualify.5 FMLA can also be taken for the continuation of mental health care, which may include things like therapy appointments or receiving psychiatry services.5
What Length of Rehab Treatment Will the FMLA Cover?
The FMLA will cover up to 12 weeks of unpaid leave in a 12-month period.1 If a person needs longer than 12 weeks of time off, an employer may be obliged under the Americans with Disabilities Act (ADA) to grant additional unpaid leave as a reasonable accommodation.6 This is decided on a case-by-case basis.6
The ADA has no specific time limit, unlike FMLA.6 There are stipulations that the employer must hold the employee’s position during the duration of the accommodations. Still, if it’s deemed to cause undue hardship, the employer can reassign the employee to a different position.6
Do I Qualify for the FMLA?
There are specific requirements a person must meet to qualify for the FMLA.1 If a person just started a job, their employer is not obligated to allot FMLA to them until they meet the outlined requirements under the act.1
FMLA qualifications include:1
- Working for a qualified employer.
- Having worked 1,250 hours during the 12 months preceding the start of the leave. (Note: Different rules apply to airline workers).
- Working at a location where the employer has 50 or more employees within 75 miles.
- Working for at least 12 months. The 12 months do not have to be worked consecutively. Employment for 12 months is counted within the past 7 years, except for military members called to duty or a separate written agreement regarding rules.
Do All Employers Have To Honor the FMLA?
In short, no. The FMLA only applies to employers in the private sector that engage in commerce or any industry or activity affecting commerce and that have 50 or more employees per working day.7 The employees must work at least 20 calendar weeks in the current or preceding year.7 The law also covers all public agencies (state and local) and local education agencies (public or private schools).7
How to Check if the FMLA Applies to My Employer
All covered employers are required to display a poster explaining the provisions of FMLA.7 This poster should include information for employees on filing a complaint with the Wage and Hour Division of violations of the act.7 An employer is also obligated to provide general notice to any eligible employees by including the notice in the employee handbook or other written guidance administered to employees concerning benefits or leave rights.7 Employees can also check by consulting the human resources department at their place of work.
Will I Still Be Paid if I Use FMLA to Go to Rehab?
Under the act, an employer is not required to provide pay to anyone who utilizes the FMLA benefit.5 The act does allow the employer to require that the employee use all of their vacation and sick time for some or all of the term of leave.5 If the employer does this, the employee would still receive any benefits with their vacation and sick time, including pay.5 When FMLA protocol is followed, federal law also protects paid leave.5
All FMLA leave is protected against retaliation from employers.3 However, if an employer’s terms and conditions of remaining employed involve refraining from substance use, the employer may be able to terminate the person’s employment.3 These policies are typically outlined in an employee handbook.
What Proof Does My Employer Require for My FMLA Request?
An employer may require that the request for leave regarding a serious health condition be supported by a certification issued by a healthcare provider.1 Employees are not required to provide medical records; the certificate should suffice.1
By law, the employer should allow 5 days for the person to obtain the certification upon request.1 If an employer finds an employee’s documentation incomplete, they must provide a list in writing about what is missing and allow the employee 7 business days to fix the deficiency.1 An employer can request that the employee receive a second opinion from another medical doctor if they believe that the documentation is insufficient or they have reason to doubt the employee’s claims, but this would be done at the employer’s expense.1
Upon return to work, the employer may require the employee to obtain a fitness for duty certification to ensure that their health is sufficient to proceed with their day-to-day duties.1 This would be done if the employer had safety concerns regarding the person’s health during work.1
Type of Rehab Treatment Available
Many different treatment and treatment settings are available for those struggling with substance misuse, including:8
- Detox: Detox treatment is a medically monitored setting for a person to withdraw more comfortably and safely from a substance. Detox can help a person prepare for ongoing treatment.
- Inpatient treatment: Inpatient programs provide 24-hour intensive, structured care that usually includes medical attention and safe housing.
- Outpatient treatment: These programs involve individual or group-based therapies and do not include live-in options.
- Intensive outpatient program (IOP): Patients may have multiple appointments a week in a program that treats substance misuse.
- Partial hospitalization: People entering this type of treatment program will continue to live at home but may attend a program that meets every day for several hours a week, typically in a hospital-like setting.
- Aftercare: There are many different options for aftercare. This generally refers to a program that offers support and resources to help a person maintain their sobriety and continue to address any mental health concerns.
Check Your Insurance Coverage for Drug and Alcohol Rehab
If you’re considering treatment for drug or alcohol use, knowing in advance what your insurance will cover can give you peace of mind and allow you to focus on recovery. In addition to contacting your primary care physician for a referral, you can learn about your specific coverage at a rehab near you or out of state, by:
- Calling an American Addiction Centers at . An admissions navigator will provide information on treatment options, verify your insurance, and help you start the admissions process if you’re ready.
- Fill out the form below to check what your insurance covers.