Sometimes during a medical or caregiver leave, you may need to request updated medical information from an employee to confirm their continued need for time off. This process is called recertification (for ongoing leaves) or annual certification (for leaves extending beyond 12 months). Cocoon's software automatically identifies when these are needed and guides both you and your employees through the process.
Medical certification verifies that an employee’s leave remains medically necessary during their approved time off. Annual certification does the same thing when a leave extends beyond 12 months. Cocoon automatically triggers most recertifications and all annual certifications, then guides employees to submit updated medical forms through their Task List. This ensures compliance while keeping everyone informed without the manual tracking typically required.
When you can request recertification
Under federal FMLA (with some state law exceptions), employers may request medical recertification when:
An employee seeks leave beyond the approved duration in the prior certification.
It has been more than six months since the prior certification.
The circumstances of the employee’s need for leave as described in the previous certification have changed significantly (e.g., the frequency and duration of absences).
The employer receives information that casts doubt upon the stated reason for the employee’s leave or absence or the continuing validity of the previous certification.
Note: California has different rules—you cannot request recertification due to doubt about the stated reason for leave.
When annual certification is required
Annual certification is needed when an employee seeks leave beyond a single year (12 months after their first day of leave for that qualifying reason). If approved, this establishes a new single leave year for determining the timing of any future annual certification.
Why this matters for your team
Medical recertification and annual certification help employers:
Ensure medical and caregiver leaves remain medically necessary or appropriate.
Employees and family members may recover from serious health conditions and no longer need leave or care at the same level they initially needed when their leave began.
Allowing employees to take more leave than is medically necessary or appropriate may negatively impact the work experience of co-workers, customers, or an employer’s business operations.
Establish consistent, reliable, and legally compliant processes for seeking updated medical information during leave. Employers must follow rules similar to those required when they seek supporting medical certification at the beginning of a medical or caregiver leave. These include:
Giving employees notice of the need to provide recertification and annual certification.
Providing at least 15 calendar days to return recertifications or annual certification.
Providing written notice of deficiencies in recertifications or annual certifications and at least seven calendar days to cure those deficiencies.
Verify whether employees meet eligibility criteria based on hours of service or other criteria at appropriate times during a leave.
Employers can conduct new eligibility determinations during annual certifications but not recertifications.
Cocoon’s recertification and annual certification process simplifies leave management, ensuring compliance while keeping both employers and employees informed.
How the process works in Cocoon
In most cases, Cocoon helps with the recertification and annual certification process by automatically determining when recertification and annual certification are needed for employees on intermittent medical and caregiver leaves. Once the recertification Cocoon handles and/or annual certifications are triggered, Cocoon notifies and guides the employee to provide the required documentation through their Task List and email reminders.
For example, when employees remain on intermittent leave beyond their expected return to work date without extending their leaves, employers can initiate recertification requests. Although not currently supported, later this year, Cocoon will also allow employers to initiate recertifications when employees remain on continuous leave beyond their expected return to work date.
If employers seek recertification based on doubt about the stated reason for the leave or absences, or the validity of the prior certification, Cocoon’s software also allows employers to initiate a recertification request when they review additional absences that employees report.
Step 1: Cocoon or the employer initiates a recertification or annual certification request
Cocoon automatically creates a task for employees on intermittent medical and caregiver leaves for:
Recertification:
The employee seeks additional intermittent leave, but the prior SHC form doesn't support the new leave duration.
Six months have passed since the prior certification, if permitted by state law
The employee has three or more overages when reporting absences for an intermittent leave, if permitted by state law.
Annual certification:
The employee seeks leave beyond a single leave year
An employer can also initiate a recertification if they receive information that casts doubt on the employee’s stated reason for the absence or the continuing validity of the previous certification. For example, if an employee is on FMLA leave for four weeks due to the employee's knee surgery, including recuperation, and the employee plays in company softball league games during the third week of FMLA leave, this information might cast doubt on the continuing validity of the certification currently supporting the FMLA leave, allowing the employer to request a recertification. Because these recertifications are triggered by information employers (not Cocoon) possess, employers must initiate them in Cocoon’s platform.
Step 2: Employee receives a task in Cocoon
Once you’ve submitted the request, the employee will receive an email notification to complete a medical recertification and they will see a task on their Task List that prompts them to:
Download the new SHC form
Work with their healthcare provider complete the form within 15 days
Upload the completed form back to Cocoon
If an employee does not submit the new medical certification on time, the requested days will be automatically denied. An email notification will be sent out to both the employee and the Admin team to confirm the denied dates.
Step 3: Employer reviews the updated Information
After the employee submits the SHC form, we’ll notify Employer Admins via their Task List and through email notification. If you need a refresher on how to find the duration request on a SHC form, check out this article.
Under the ‘Leave details’ section of the employee’s leave, admins can see a new banner at the top of an employee’s leave ‘Intermittent medical leave request’ To view the medical recertification form admins will need to click on ‘Review’
Admins can download the new certification form to review any changes the medical provider has outlined in the SHC, and then fill out in Cocoon the leave’s 'Serious Health Condition Form' details based on the certification the employee has uploaded.
Examples of updates you might see:
Condition improved: If the condition has improved and the leave needs to be shortened, the updated form should reflect the new, shorter duration of time off based on the medical provider’s assessment. This can be adjusted to align with the improvement and the employee's ability to return to work sooner.
Condition worsened: If the condition has worsened and the leave needs to be extended past the originally approved dates, the updated form will need to indicate the new leave period, reflecting the extended time off based on the medical provider’s recommendations for continued care or treatment.
Changed frequency / duration: If the leave episode’s frequency and duration need to be updated to align with the medical provider's recommendations, the form should include the revised schedule. For example, if the provider now recommends more or fewer episodes of incapacity, or if the length of time per episode has changed, this should be clearly reflected in the updated details.
How to update the Serious Health Condition details in Cocoon
Step 1: Under the ‘Leave details’ tab, there is a section to ‘Review’ the recently submitted document for a leave of absence. Click on ‘Review’
Step 2: Download the new ‘Medical Recertification' form. Take a moment to review the updated Serious Health Condition form and note any new details, such as (but not limited to):
Updated leave dates that align with the new or current leave request from the employee.
Revised frequency and duration of episodes of incapacity.
Updated details on the reduced work schedule.
Step 3: Fill out the Serious Health Condition form details section with the updated SHC information
Step 4: Indicate the validity period of the medical certification.
Is the certification valid for a specific date or a certain length of time?
Please note the "valid through" date as listed on the certification form.
If the certification indicates a lifetime or indefinite duration, please select "Medical certification supports a leave for a lifetime or indefinite duration."
Step 5: Once you've reviewed the form and made any necessary updates, go ahead and submit the updated leave details.
Once the new SHC form details have been completed, you can click on ‘Submit’. This will save the updated certification information on file for when the employee reports another absence.
FAQ:
What happens if the SHC form that is provided does not include updated leave information?
If an employee submits a recertification or annual certification form that doesn't include updated information, such as leave updated or new leave dates, frequency and duration of episodes, or a revised reduced work schedule, the employer may need to issue a Deficiency Notice. This notice will send an email to the employee, letting them know that the form they provided is not sufficient enough to support their current or new leave request. The employee will then be asked to submit a new recertification or annual certification form. Once received, this will prompt the employer to review the updated SHC.
If the employee does not return the updated recertification and annual certification, the following may occur:
All pending time will be denied and the leave’s status will be ‘partially approved’. This means any already approved dates will remain approved, and any new dates requested will reflect as denied, resulting in the total leave plan reflecting partially approved.
What is an ‘Overage’?
Cocoon uses the term 'overage' to describe the situation when an employee exceeds the estimated leave parameters in Cocoon. Parameters may include:
Being absent more frequently than estimated.
Being absent longer than estimated.
In Cocoon’s system, if there are four ‘overages’ within the last 4 weeks, Cocoon will request a recertification. Employers must then review the employee’s upload for the recertification, review the pending time, or send a deficiency notice for recertification. The system's request for a recertification is based on overages to determine whether adjustments or further documentation are required.
We’re here to support you
Managing medical recertifications and annual certifications can feel complex, but Cocoon's automated triggers and guided processes help ensure you stay compliant while reducing manual tracking. Remember, we're here to support you every step of the way.
Have questions? We're here to help.
Email us at [email protected]