Medical Leave in California
Examining the Intersection of Workers' Compensation and State and Federal Medical Leave
An on-the-job injury or illness may require taking time off work to recover and receive the necessary medical treatment, which can place an undue burden on workers and their families. Each state has its own set of Workers' Compensation laws to protect those who are hurt at work. In addition, California has the California Family Rights Act (CFRA), which is very similar to the federal government's Family and Medical Leave Act (FMLA). All of these are designed to benefit people who are dealing with serious health issues.
When an injury or illness requires a worker to take time off, FMLA, CFRA and Workers' Compensation benefits may intersect. However, it is important to understand that they are very different. FMLA and CFRA provide job protection only, whereas Workers' Compensation benefits can help ease an injured worker's financial burdens.
Workers' Compensation Fundamentals
In California, if you are hurt at work, you are eligible for the following benefits:
Medical Care—Treatment needed to cure or relieve the effects of a work-related injury or illness. This can include doctors, hospitals, chiropractors, nurses, medicine, braces, canes, hearing aids, as well as treatment found to be necessary and reasonable care ordered by a doctor.
Temporary Disability—Generally, two-thirds of a worker's average weekly income for up to two years (depending on the date of the injury and up to statutory maximums) to compensate the worker while he or she is unable to work and under active medical treatment due to an on-the-job injury. The first payment is to be paid no later than 14 days after your employer is made aware of the injury. Additional payments must be made at least twice a month. These benefits are tax free.
Permanent Disability—Compensates an injured worker based on the percentage (between 1 percent and 99 percent) of loss of body function. Employees must disclose previous disabilities upon request, and employers are liable only for the portion of permanent disability caused by the workplace injury.
Supplemental Job Displacement Voucher—This is available if you're not offered a job by your employer when you're ready to return to work. It may be used for such things as training, computer equipment, payment of licensing, certification or testing fees. The amount of the voucher will vary depending on your date of injury and, in some cases, your level of permanent disability.
Return to Work Fund—Restrictions apply, including date of injury. May be used to pay past-due bills, repaying loans, etc. It is for injured workers whose permanent disability ratings are disproportionately low in comparison to their wage loss.
Death Benefits—May be payable to dependents of a worker who dies on the job or from a work-related injury or from a heart attack, cancer, stroke or other disease found to be caused or aggravated by work.
Returning to work after an on-the-job injury is dependent on the date of your injury, your level of recovery and your employer's ability to accommodate any work restrictions you may have.
Whether you are unable to work because of your own serious health condition, or because you need to care for your parent, spouse, or child with a serious health condition, the FMLA provides unpaid, job-protected leave. Leave may be taken all at once, or may be taken intermittently as the medical condition requires.
FMLA applies to all public employers and private businesses with 50 or more employees, and was designed only for job protection. FMLA allows "eligible" employees up to 12 work weeks of unpaid leave in any 12-month period for a variety of reasons, including the following:
- An employee's own serious health condition.
- The birth of a child, or care of a newborn, newly adopted child or a new foster care placement.
- The care of a child, spouse or parent with a serious health condition.
- When it comes to FMLA, the Department of Labor mandates that:
- An employer cannot force an injured worker to take time off under FMLA.
- In instances where both FMLA and Workers' Compensation benefits apply, the employer must provide leave under whichever best benefits the employee.
In some situations, FMLA and Workers' Compensation benefits run concurrently. This can be advantageous for the worker because:
- The employer is required to keep the injured worker's job open upon his or her return. The worker cannot be forced to return to "light duty." In the Workers' Compensation system, there are stipulations regarding returning to work with restrictions as well as accommodation protocol required of the employer.
- The employer is required to continue a worker's healthcare coverage during this period.
The most common serious health conditions that qualify for FMLA leave are:
- Conditions requiring an overnight stay in a hospital or other medical care facility.
- Conditions that incapacitate you or your family member (for example, inability to work or attend school) for more than three consecutive days and require ongoing medical treatment (either multiple appointments with a healthcare provider, or a single appointment and follow-up care, such as prescription medication).
- Chronic conditions that cause occasional periods when you or your family member are incapacitated and require treatment by a healthcare provider at least twice a year.
- Pregnancy (including prenatal medical appointments, incapacity due to morning sickness, and medically required bedrest).
How Does FMLA Work in California?
CFRA, which is family medical leave in California, provides the same coverages as FMLA. There are, however, specific criteria for eligibility, including:
- An employee must have worked for an employer for at least 12 months.
- An employee must have worked 1,250 hours in the 12 months prior to the start of the leave.
CFRA authorizes eligible employees to take up a total of 12 weeks of paid or unpaid job-protected leave during a 12-month period. While on leave, employees keep the same employer-paid health benefits they had while working. Eligible employees can take the leave for one or more of the following reasons:
- The birth of a child or adoption or foster care placement of a child.
- To care for an immediate family member (spouse, child, or parent) with a serious health condition.
- When the employee is unable to work because of a serious health condition (criteria must be met).
Paid Medical Leave in California
The CFRA amended the 1991 California law to essentially mirror the FMLA. Although FMLA and CFRA contain similar provisions and can run concurrently, there are some situations in which the leave would be FMLA only or CFRA only.
Workers' Compensation, FMLA and CFRA are complicated, and it is wise for those who are injured to have experienced legal counsel guide them so that they receive the full range of benefits to which they are entitled.