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Can You Use FMLA for Rehab? What You Need to Know Before Taking Leave

Losing a job is one of the most common fears that people have when considering rehab for their addiction. The thought of reaching out to your employer for an extended leave of absence to obtain treatment can be overwhelming, which is why many people often wait much longer than they should to get the care they need.

Many people do not realize that federal law provides eligible employees up to 12 weeks of unpaid leave for qualifying medical reasons each calendar year. In many cases, treatment of addiction falls under this.

Understanding how FMLA applies to rehab can be the piece of information that finally makes it possible for someone to say yes to treatment.

What Is the Family and Medical Leave Act?

The Family and Medical Leave Act is a federal law that was passed by Congress in 1993 and is enforced by the U.S. Department of Labor. The FMLA provides employees with job-protected leave for serious medical conditions (for them or to a qualifying family member) for up to twelve weeks per 12-month period without risking loss of their job or their benefits.[1]

In order to be eligible for the Family and Medical Leave Act (FMLA), the following conditions must be satisfied:

The employee works for a covered employer, including most private businesses that have 50 or more employees within a 75-mile radius, federal, state, or local government agencies, or a public agency or school
The employee has worked for their employer for a minimum of 12 months.
The employee has completed at least 1,250 hours of service during their 12-month period immediately prior to their leave.

If all three of these conditions are met, employees then have access to an employer’s job-protected leave. This means that employers must return employees to either the same or a substantially equivalent position upon their return.

Does FMLA Cover Rehab and Substance Abuse Treatment?

This is where there are many misconceptions, and there is nuance to be aware of. The FMLA does cover substance abuse treatment, but only under specific conditions.

Under the FMLA, substance use disorder can qualify as a serious health condition when the leave is taken for inpatient care or for continuing treatment by a healthcare provider. This means if you enter an inpatient treatment program or participate in a structured outpatient program under medical supervision, you can qualify for protected FMLA leave.

However, FMLA does not protect your job or benefits if an employee is absent due to being too intoxicated to work or for active substance abuse. It is taking leave for treatment that the law protects, not substance abuse-related behavior.[2]

This is an important distinction: an employer is not required to excuse absences caused by drug or alcohol use itself; however, in cases where an employee seeks a leave of absence to obtain medical treatment for that drug or alcohol-related problem, the law requires the employer to protect that leave.

A healthcare provider must certify that your condition qualifies as a serious health condition under FMLA. Your treatment center or doctor can provide the medical certification you need, and your employer is entitled to request it.

Physical Dependence vs. Addiction

People often use physical dependence and addiction interchangeably, but it is important to understand that they are not the same thing.[5]

Physical dependence is when the brain and the body adapt to the presence of a substance. If the person stops using or reduces the use of that substance, it produces uncomfortable withdrawal symptoms. This can happen with any type of substance: illegal drugs, prescription drugs, or painkillers, even when used as directed by a doctor.

Addiction, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), goes further than physical dependence. Someone addicted to a substance will use it compulsively, lose control, and continue to use it despite any negative consequences. They may feel that they will not be able to cope with their daily routine without that substance.

Someone can be physically dependent on a substance without being addicted to it, but most people with addiction also have a physical dependence on the substance they are using. Both dependence and addiction should be addressed to achieve effective treatment results.

What Types of Rehab Does FMLA Cover?

FMLA can apply to several types of addiction treatment, including:

Inpatient treatment: An inpatient program provides care at facility-based sites where residents live on-site, such as residential treatment centers or hospitals.
Partial hospitalization programs (PHP): These are structured programs that provide care during the day, but do not require the client to live on-site. Clients typically spend their days in treatment and then return home or to a sober environment in the evening.
Intensive outpatient programs (IOP): IOP consists of an outpatient setting where the patient attends multiple sessions each week under the supervision of a qualified provider.
Medically supervised detox: When detoxification happens as part of a formal treatment program, and the process is supervised by a qualified provider.

Standard outpatient therapy sessions, like weekly individual therapy, are less likely to qualify unless the treatment meets the “continuing care” criteria established by the healthcare provider.

If you are uncertain whether you qualify for a leave of absence, you should contact your employer’s HR department and your treatment provider before you move forward with any proposed treatment plan

Can FMLA Be Used for Alcoholism?

The Family and Medical Leave Act (FMLA) specifically states that alcohol use disorder is a serious health condition, and employees are protected when leave is taken for treatment.[3] In this way, FMLA and alcoholism, and FMLA and other substance abuse disorders are treated the same. As in, the law will protect employee leave for treatment, not for absences caused by drinking, such as being too hungover to come to work or failing to report to a scheduled shift due to alcohol use.

Employees should also note that alcoholism may also be regarded as a disability under the Americans with Disabilities Act (ADA).[4] The ADA prohibits any employer from discriminating against any qualified person with a disability, including people who are in recovery from an alcohol use disorder.

The ADA and FMLA can work together to provide employees with protections during their treatment, as well as protections from discrimination upon returning to work.

How to Request FMLA Leave for Rehab

If you are considering requesting FMLA leave for treatment of your substance use disorder, here are the steps involved:

Notify your employer as soon as possible. Typically, the FMLA requires at least 30 days’ notice for leave. If the leave is urgent, notify your employer as early as you can that you will be taking a medical leave.
Complete the employer-required paperwork. Employers may request that employees submit an FMLA request form prior to taking leave.
Obtain a medical certification. The physician or treatment center will need to complete and submit a medical certification form verifying that your condition is a “serious health condition” under the FMLA.
Understand the employer’s policies. Some policies require employees to use accrued paid time off (such as sick or vacation days) concurrently with FMLA leave. Review your employee handbook or contact HR to see how these policies apply.
Know your rights after returning. Upon completion of the FMLA leave, you are entitled to return to either the same job or a job that is comparable in compensation, benefits, and terms of employment.

Will My Employer Know Why I Am Taking Leave?

A common concern employees have when contemplating taking leave for a substance use disorder is whether their employer will know the reason for the leave. This is very understandable. Employees never have to tell their employers that they are going to rehab. They only need to give the employer notice that they will be taking medical leave and provide a medical certification from their healthcare provider stating that a serious health condition exists. The medical certification does not have to specify that the condition is a substance abuse disorder.[5]

Your medical records are also protected by HIPAA.[6] This means your treatment provider cannot disclose information about the treatment to the employer without your consent. The process provides you with a great deal of privacy protection, which can be facilitated with assistance from your company’s HR department or your treatment team.

Don’t Let Fear of Losing Your Job Stop You From Getting Help

The fear of losing your job is one of the main reasons that people might not reach out for help. That is why FMLA exists — specifically to remove this fear. FMLA recognizes that serious health conditions, including substance use disorders, need medical treatment and that you should not have to make a choice between health and your livelihood.

If you or someone you love is ready to pursue treatment for substance abuse, Meridian Recovery wants to offer assistance. Our admissions team can answer questions about the treatment process, assist with insurance verification, and help identify your options so you have the confidence to take the next step toward recovery.

Verify Your Insurance

Frequently Asked Questions About FMLA and Rehab

Can I get FMLA to go to rehab?

Yes. In many cases, you are eligible for FMLA coverage if you are seeking rehabilitation as a formal medically supervised treatment program (inpatient or structured outpatient). You must meet the eligibility requirements (working for a covered employer for 12 months with 1,250 hours) and provide medical support documentation.

Can I go to rehab and not lose my job?

Yes. FMLA supports job protection from qualifying illnesses and allows eligible people to take job-protected time away for a maximum of twelve weeks. Please confirm with your HR department regarding your specific company’s policy before leaving.

Will my employer know if I go to rehab?

No, you do not have to inform your employer that you will be in rehab. You only need to notify them that you are taking an FMLA medical leave for a “serious health condition” and provide the appropriate medical certificate. This medical certificate does not need to specify what the condition is.

Can FMLA be used for detox?

Detoxification can qualify for FMLA coverage as long as you participate in a structured program and the detox is documented as part of your serious health condition by your health care provider.

Is alcoholism a protected disability?

Alcoholism is considered a disability under the Americans with Disabilities Act (ADA). Covered employers cannot discriminate against employees due to a history of addiction. While a person currently consuming alcohol and unable to perform their job is not protected, someone in recovery is protected under both FMLA and ADA.

Sources

[1] [2] [5] U.S. Department of Labor, Wage and Hour Division. (n.d.). Fact sheet #28: The Family and Medical Leave Act. https://www.dol.gov/agencies/whd/fact-sheets/28-fmla

[3] U.S. Department of Labor. (n.d.). Family and Medical Leave Act. https://www.dol.gov/agencies/whd/fmla

[4] U.S. Equal Employment Opportunity Commission. (n.d.). The Americans with Disabilities Act and addiction. https://www.eeoc.gov/laws/guidance/applying-performance-and-conduct-standards-employees-disabilities

[6] U.S. Department of Health and Human Services. (n.d.). Health information privacy. https://www.hhs.gov/hipaa/index.html