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Reviewing an intermittent medical or caregiver leave

Step-by-step guidance on reviewing leave requests and supporting medical documentation

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Written by Cocoon Support
Updated over a week ago

When an employee submits an intermittent medical or caregiver leave, Cocoon empowers you to easily review those submissions and automates any associated communications between you and the employee. Because intermittent leaves typically happen during unique, personal situations for employees, we believe People teams have the best context for assessing leave requests and should ultimately control these decisions—with Cocoon here to guide you and your employees through each step of the process.

30 second summary: When employees submit intermittent medical or caregiver leave requests with required documentation, you’ll receive a notification and have five days to take action: approve, deny, or send a deficiency notice. Cocoon guides you through reviewing serious health condition (SHC) forms and automates required communications to ensure compliance with FMLA and state leave laws.

Employee submission

First, when an employee plans an intermittent medical or caregiver leave, Cocoon automatically determines their eligibility under FMLA, applicable state laws, and any company medical or caregiver leave policies you’ve authorized in Cocoon.

Next, if they meet eligibility criteria, we prompt employees to submit a serious health condition (SHC) form to support their request. If an employee doesn’t upload the required documents by the 15-day deadline, Cocoon automatically takes the next steps to keep the leave process moving. This may include following up with the employee or, if necessary, denying the leave request.

Reviewing the leave submission

When an employee uploads their SHC form, certified by their medical provider, into Cocoon, Workspace Admins will get the following email with the subject, “[Action Required]: {Employee} turned in their documents in support of their leave of absence”.

Email from Cocoon sent to employer to review supporting document for leave.

Workspace Admins will also see this task in their Admin dashboard.

Employer task list item in Cocoon dashboard to review supporting documents.

To align with FMLA requirements, you’ll have five days to take an action on the leave in Cocoon: approve, deny, or send a deficiency notice.

💡What is a deficiency notice? A deficiency notice tells employees they have failed to satisfy their legal obligation to submit complete and sufficient SHC forms to support the medical or caregiver leave request. FMLA requires employers to send employees a deficiency notice before they deny the leave. It gives employees a second chance to submit the legally required information. A written deficiency notice tells employees their SHC form failed to satisfy their legal obligation, explains the additional required information or detail to cure the deficiency, the deadline for doing so (at least seven calendar days), and the consequences for failing to do so. If you find an employee's SHC is incomplete or insufficient, you can identify and request the additional information you need through Cocoon and this will send the employee the required written notice explaining what additional information or detail is required to inform your decision.

If Cocoon doesn’t see any action taken after two days, you’ll get another email with the subject, “[Action Required]: 3 days to review and act on {Employee}’s leave of absence” to remind you to take action.

To determine what action is appropriate, guided by Cocoon’s software, you’ll need to review the details of SHC forms employees have uploaded into Cocoon. When you click “View documents” you’ll be taken to the employee’s leave details, where you can download the SHC and review the leave request.

Admin view of an employee leave details where they can review supporting documents.

Employer flow to enter medical certification details.

As a Workspace Admin, you’ll need to confirm whether the SHC supports the leave the employee has requested. After comparing the leave request with what’s in the medical certification you may decide:

  1. You have enough to approve or deny the full leave duration.

  2. You have enough to partially approve some portions of the leave, but need more info before approving or denying other portions of the leave

  3. You don’t have enough information to approve or deny any portion of the leave and need more information before making a decision

In situation 1, you will approve or deny the leave as applicable, and the system will automatically send the appropriate designation notice. In situations 2 and 3, you’ll request more information, identify the information you need, and the system will automatically send the required deficiency notice seeking that information. In situations 2 and 3, the system will not send a designation notice because you are still awaiting information.

Regardless of what decision you make after reviewing the SHC form, Cocoon’s software will ask you to enter certain details about the leave request that you should be able to find in the SHC form. These details will allow Cocoon to further administer the leave based on the SHC details, including, if necessary, seeking recertification or annual certifications.

Identifying serious health condition duration

Follow the steps outlined below to determine the duration for which the leave is valid based on the information provided in the SHC form. This process ensures consistency and accuracy in validating leaves and managing recertification timelines.

Does the SHC form specify a period during which the employee will be unable to work or require leave? ​Example: 40 days or a specific end date.

  • If yes: Enter the certified dates from SHC form. The system will use this date to determine if recertification is needed in the event of a leave extension.

If no, does the SHC form state that the medical condition or need for leave is indefinite or lifetime?

  • If yes: Select the corresponding box. The form will be tracked with a 12-month duration as a default, and this date will act as the operative end date.

Employer flow to enter medical certification details.

If you’re unsure of the duration, please check out this helpful guide on how to review a serious health condition form.

Understanding overages and recertification triggers

Under FMLA, one reason employers can request recertification for intermittent leave is if there are “changed circumstances.” A recertification for “changed circumstances” is typically triggered when employees take intermittent leave more frequently or for longer durations than their health care providers estimated in their most recent SHC form. Because health care providers estimate the frequency and duration of intermittent leave absences, employers usually only seek these recertifications after the estimate is exceeded enough times to raise a reasonable question about the continuing validity of the earlier certification.

Cocoon counts every instance when an employee’s absence is longer or more frequent than what’s estimated in their certification as an “overage.” If an employee has 4 overages within a 4-week period, Cocoon’s software will trigger a recertification request.

To enable Cocoon to request these recertifications automatically through its software, as a Workspace Admin, you must input in Cocoon the frequency and duration of absences identified in the SHC form. Below is an example of how the medical certification details would be completed for the frequency and duration for an employee who needs to be absent for two appointments per week, with each appointment lasting a total of three hours.

Screen for employer to enter planned medical treatment/appointment details from the Serious Health Condition (SHC)

Below is an example showing an employee who has taken more than the allowed two episodes per week, with each episode totaling three hours. This highlights how an overage appears in an employee’s leave plan—specifically, it shows that the employee incurred an overage starting with the fourth absence, which goes beyond what was outlined in the medical certification details.

Employer view of employee's reported absences.

In short, overages help track when absence goes beyond what was approved, but there are exceptions built in for flexible, occasional absences.

Approve a leave fully

To fully approve the leave, follow the steps below:

  1. Under “Leave details” you can see a section to review an employee’s work schedule and leave forms that were uploaded into Cocoon

  2. Click on “Review” next to the submitted documents for the employee’s leave of absence

Admin view of an employee leave details where they can review supporting documents.

  1. Put any relevant information from the health certification to document what the employee is anticipated to need. E.g., planned medical treatment dates (appointments) and any expected duration, incapacity (illness) estimated frequency and duration, or reduce work schedule expectations

  2. Click “Next”

  3. Keep the radio button selected on “Approve leave”

  4. Click “Next”

  5. Double check that the dates requested are what you want to approve, and then confirm your action

Approve a leave partially and send a deficiency notice

If the SHC only supports part of the leave request (e.g. the first half of the requested dates), update the date range to what you are ready to approve, and then confirm your approval.

Cocoon will then automatically ask you to give instructions to the employee to address the deficiency in their support for the remaining time. With that information, Cocoon will email the employee and give them seven days to upload new proof to address the deficiency. The dates you approve will be marked “Approved” and the remaining dates will stay “Pending”.

Employees will get an email with the subject, “[Action required] Provide an updated serious health condition form.”

Keep the whole leave pending and send a deficiency notice

If the SHC doesn’t support any part of the leave, you can select “Send deficiency notice” and skip any approval.

If you learn there is no serious health condition or there’s no longer need to go on leave, you may select all the rows, click “Action”, and “Deny leave”.

FAQs

What happens if I don't take action within five days?

You'll receive reminder emails, but it's important to act within the FMLA-required timeframe to ensure compliance.

Can I approve part of a leave request and deny another part?

Yes, you can partially approve dates that are supported by the SHC form while requesting additional documentation for unsupported portions.

How does Cocoon determine when to trigger a recertification request?

Cocoon automatically tracks overages (instances when absences exceed what's certified) and triggers recertification requests when an employee has four overages within a four-week period.

We hope this guide has been helpful. Remember, we're here to support you every step of the way. If you have any questions or need further assistance, please don't hesitate to reach out.

Have questions? We're here to help.

Email us at [email protected].

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