The Family and Medical Leave Act of 1993 makes it possible for employees to keep their jobs secure while undergoing addiction treatment. What does one need to know about FMLA, and how does it apply to rehabilitation? Read to know more.
One of the major concerns of people thinking about addiction treatment is job security. If they’re deciding to go through inpatient rehabilitation, this means that they need to take a hiatus from their jobs. However, this thought leaves many hesitant because they don’t have a guarantee of employment once they resume their routines. Thankfully, the FMLA leave for rehab was created to cover employee rights.
What Is FMLA?
The Family and Medical Leave Act provides employees with eligible status to have unpaid leave without losing their jobs. The FMLA covers absences that are related to medical and family issues, which is usually in conjunction with and continuation of health insurance coverage if it was provided initially by the employer.
What is the eligibility for FMLA?
For an employee to claim benefits under the FMLA, he or she must meet the following requirements:
- The employee should have completed work of at least 12 months, of which 12 weeks of unpaid leave will be provided.
- The employee must have completed at least 1,250 work hours in those 12 months.
- He or she must have a valid family or medical-related reason to take the leave.
Additionally, the FMLA is in effect for organizations with at least 50 employees. Some smaller companies do not need to comply with this act. However, there are also differences in each state regarding leave benefits and insurance continuity for employees.
If you are considering addiction treatment while claiming the Family and Medical Leave Act, here are some things you need to know about FMLA in relation to rehab.
FMLA For Rehabilitation
To better understand FMLA for rehabilitation, we should also consider the other government laws and rights related to it. The Mental Health Parity and Addiction Equity Act requires many insurance companies to treat mental health and substance abuse conditions of clients to the same degree as physical health conditions.
This means that substance use disorders such as alcohol and drug addiction will be given treatment and the patient will have the same medical benefits if he or she were to have other chronic diseases such as heart disease or diabetes. If you have comprehensive health insurance coverage for these chronic diseases, it is likely that you can claim the same benefits for addiction treatment.
How does MHPAEA relate to FMLA?
As MHPAEA deals with the insurance side of addiction treatment for employees, the FMLA covers the rights of the same people who need to take a medical leave. Thus, if you have a diagnosed substance abuse problem and meet eligibility requirements, it is possible that you will be granted health insurance coverage along with 12 weeks of unpaid leave.
According to U.S. Department of Labor, below are some of the major valid reasons for employees to take a job leave under FMLA:
- Caring for a newborn child of the employee in the first 12 weeks (also known as maternity leave)
- For adjustment reasons as an employee takes in a child through adoption or foster care
- To provide assistance for an immediate family member who has a serious health condition
- To undergo treatment if an employee has a serious health condition interfering with their ability to perform their job
The third and fourth point stated is relevant to addiction treatment, for the following reasons:
- MHPAEA states that substance use disorders are a serious health condition requiring equal treatment and insurance coverage.
- FMLA inpatient rehab often lasts for 30-90 days. This means that clients can maximize their leave by completing the span of addiction treatment.
Does FMLA cover rehab?
The simple answer is yes. Substance use disorders are considered a medical condition that can disrupt your ability to work. It is helpful to know that you can claim FMLA for drug rehab or FMLA for alcohol rehab, as long as you fit the eligibility requirements and your company fits the 50-employee threshold.
In summary, here are the FMLA guidelines in relation to rehab if you do plan to file a claim:
FMLA Guidelines For Rehab
For the Employee:
- You must have worked at least 12 months in the company.
- Your total work hours within those 12 months must be 1,250 or more.
- You must be diagnosed with a substance use disorder.
- If you plan to care for an immediate family member, you must meet the first two requirements and your loved one must meet the third requirement.
For the Employer:
- You are required to comply if your company has 50 or more employees within a 75-mile radius.
- Generally, you must provide a maximum of 12 weeks leave within a 12 month period if your employee meets the eligibility requirements.
- Unless stated in your state or company guidelines, the leave is unpaid but still under health insurance coverage, if initially provided.
Types Of FMLA Leave For Rehab
There are two types of FMLA leave for rehab:
- FMLA Inpatient Rehab: Once diagnosed with a substance use disorder, the patient is required to stay within the rehabilitation facility for 30-90 days. The length of time needed depends on the severity of the condition, recommendations of health professionals and personal preference. This is the common route employees take to file a leave under FMLA.
- FMLA Outpatient Rehab: Substance use disorders do not always get treated in inpatient rehab facilities. In some instances, addiction can be mild but disruptive in work performance. FMLA for outpatient rehab is available in this scenario as the patient stays in his or her home but attends programs and activities related to addiction treatment.
Although different, these two types of FMLA leaves are granted in the same manner. Once an employee meets the eligibility requirements, the employer must provide a maximum of 12 weeks of unpaid leave for addiction treatment along with health insurance coverage when initially provided.
Deciding to undergo addiction treatment under FMLA? Here are some steps that can help you successfully file a leave.
FMLA Employee Guide: Steps To Take
Step 1: Consider getting an official diagnosis
An official diagnosis can strengthen your case of having a serious health condition. The first step is noticing the signs of addiction, which will be further discussed below. You may seek help from an addiction or rehabilitation specialist or contact a primary care physician to discuss your symptoms and get a formal diagnosis. Even if you won’t be using FMLA for addiction treatment, this can be a helpful step in your road to recovery.
Step 2: Calculate your work hours and days of employment
If you plan to use FMLA, it is essential to make sure that you have completed 1,250 work hours in 12 months of employment within the company. Additionally, you must not have claimed FMLA on other instances within those 12 months.
Step 3: Read on company guidelines
Before filing for FMLA, you must also find out if your company is required by law to comply. As previously mentioned, FMLA is for companies that have at least 50 employees within a 75-mile radius and other state and company-specific sanctions.
Step 4: Provide a notice
Most FMLA drug rehabilitation claims are non-emergency. This means that as an employee, you are required to provide a 30-day notice about your treatment leave. This also depends on the company guidelines you have agreed upon signing up for the company. Some companies can be lenient about this, as long as you provided your reasons for not providing notice. However, it is best to provide a notice to help your employers prepare for your absence and transfer of responsibilities.
Following these steps increases the chance that you can seek addiction treatment at your target date along with the health insurance coverage if provided by your employer.
To ensure that you take the first step of the FMLA claim confidently, here are some vital things to note about addiction and its signs. Talk to a Intake Coordinator
Take The First Step Towards Recovery
Talk to a Intake Coordinator
Signs of Addiction
Unlike many diseases which symptoms appear within the short timeframe, addiction is quite different. There are stages in how addiction develops, which starts with substance tolerance and escalates into dependence and full-blown addiction disorder.
If you suspect a substance use problem in yourself or a loved one, it helps to get specific with the following signs:
- Hazardous use of substances: You have used substances in a way that brought you and others in danger. Examples of this included driving under the influence of alcohol, overdosing on drugs or committing risky behaviors related to substance use.
- Relationship or interpersonal issues: Substance use has caused you to have problematic relationships with family, friends, co-workers, and others.
- Inability to perform roles and responsibilities: Using drugs or alcohol has caused you to neglect work, school, or other home duties that you were performing before.
- Experiencing withdrawal: You may also suffer from withdrawal symptoms, which range from uncomfortable to life-threatening when attempting to stop substance use.
- Tolerance in use: You find yourself taking in larger amounts of the substance in order to achieve the same effect.
- Several attempts to stop or minimize use, but unsuccessful: You have recognized your frequent use of the substance, and have attempted to quit. However, withdrawal symptoms or intense cravings may have stopped you from quitting altogether.
- Increased time spent on substance use: You find yourself spending more time taking drugs or drinking alcohol than you previously did.
- Physical and mental affectations: You also suffer from complications related to substance use such as depression and anxiety. Physical problems may also be apparent such as liver damage, memory loss, or nutrition deficiency related to substance use.
- Experiencing cravings: You feel an overwhelming sense to use to a drug to either for recreation or finding relief.
If you or a loved one has any of these signs, it is possible that they may be suffering from a substance use disorder. It is best to seek professional help to get the best form of treatment possible. Undergoing substance abuse rehabilitation is one of the best options you can take to improve your chances of recovery.
What To Expect During FMLA Drug Rehabilitation
After getting approved on FMLA leave and verifying your insurance on your rehab facility of choice, you may have questions about what to expect in addiction treatment. Here is a concise overview of the three stages of rehabilitation:
The first stage of addiction treatment is called a medical detox. During medical detox, patients are provided with comfortable lodging, nutritious meals, and 24/7 monitoring. This is done to safely manage complications of substance withdrawal. It is typical to feel some level of discomfort, as the goal of the medical detox is for the body to get used to functioning again without drugs or alcohol.
Inpatient rehabilitation usually requires a medical detox, but in some cases, it may not be needed. Outpatient rehabilitation may or may not undergo drug detox, all of which depend on the severity of the addiction as well.
After being stable following the medical detox, patients now proceed with the treatment options which fit their specific needs. In Sunshine Behavioral Health centers, there are several types of treatment available, such as:
- 12 Step Treatment
- Dual Diagnosis
- Faith Treatment
- Holistic Treatment
- IOP Program
- Non-12 Step Treatment
- SMART Recovery
- Luxury Rehab
Patients have the option of combining treatments or activities depending on their needs and recommendation of medical experts. This is the longest stage of addiction treatment within the facility.
Substance abuse treatment doesn’t end during intensive care. It is important to have some form of maintenance routines to help ensure the success of recovery. Following the intensive 30-90 day treatment, an aftercare program is provided to help reduce the chances of relapse.
Common recommendations for aftercare include the following:
- Continued one-on-one or group counseling
- Continued psychotherapy treatments
- Plugging to local substance abuse support groups
- Nutrition and fitness plans
- Lifestyle changes (new hobbies, recreation, time management)
- Relapse prevention protocols
Aftercare is just as important in addiction treatment success. Although relapse is typical and may even be expected in many cases, having an aftercare program in mind helps minimize these occurrences and keeps the client accountable.
Paying For Rehab
Aside from health insurance coverage, there are several routes you can take in paying for rehab.
- Health Insurance: As an employed or self-employed individual, you can use your health insurance to cover assessment and management costs for substance abuse.
- Sponsors: Government agencies or private companies that support causes related to sobriety may able to provide sponsorship for people seeking addiction treatment.
- Family and friends: You can ask family and friends for financial support in your rehabilitation. This is one way they can show support in your desire for recovery.
- Fundraising: You can create events, sell products, or set up a crowdfunding account to help partially or fully cover costs of treatment.
- Savings: See addiction treatment as an investment in your health. You may have some savings in your bank account that you can use to partially cover your rehabilitation.
Securing Your Employment and Sobriety Is Possible
Going through rehab doesn’t have to cost you your job. The FMLA is created to provide the rights you need to seek addiction treatment. By following the guidelines and checking your eligibility, you can successfully secure your employment while recovering from substance abuse.
- dol.gov – US Department of Labor. Family and Medical Leave Act.
- nami.org – National Alliance on Mental Illness. Understanding Health Insurance.
- ncbi.nlm.nih.gov – National Center for Biotechnology Information. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health.
- verywellmind.com – VeryWell Mind. The 11 Official Criteria of Addiction.
Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.
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