Title: Certification of Medical Necessity (UPG 10.04)
1Certification of Medical Necessity (UPG 10.04)
Information about Changes to the Unclassified
Leave Statements
- UW-Madison
- Sick Leave Policy for Academic Staff, Faculty,
and Limited Appointees
2Certification of Medical Necessity Requirement
for Faculty, Limited Appointees, and Academic
Staff use of Sick LeaveBoard of Regent
Resolution 9068Effective October 7, 2005
- UPG10.04(c) UW institutions shall require
written certification from a health care provider
of the medical necessity for use of sick leave
for absences of more than 5 consecutive full
working days, except where the use of sick leave
is authorized in advance, pursuant to the
Wisconsin or Federal Family and Medical Leave
Acts. -
- Where an institution is aware of an emergency
that prevents communicating with or obtaining
information about the condition of the employee,
such written certification shall not be required
until such time as communication is possible and
appropriate, given the condition of the employee. - In cases of suspected abuse of the sick leave
privilege, the institution shall be authorized to
require written certification from a health care
provider to verify the medical necessity for the
employee's absence regardless of the length of
absence.
3Why did the Regents add this requirement?
- To respond to public concern that was raised
regarding the potential for sick leave abuse. - To insure compliance with sick leave polices.
- To protect a valuable component of our benefit
package. - To provide UW supervisors and managers with a
specific process for monitoring sick leave to
prevent possible misuse. - The 5-day trigger option was chosen because it is
a common practice in the private sector and,
based on feedback, had institutional support.
4Requesting Medical Certification
- Employee should be notified by his/her supervisor
of the need to provide medical certification.
The Request for Medical Certification for
Academic Staff, Faculty, and Limited Appointees
form should be used. - Employees must be provided at least 15 days, from
the day of their return to work, to secure their
health care providers medical certification. - The request for medical certification is separate
from requests related to "confidential medical
information." Only Divisional Disability
Representatives (DDRs) are authorized to request,
receive and maintain medical information related
to disability or medical condition under the ADA
and/or WFMLA/FMLA.
5Requesting Medical Certification
- For leaves of absence of 5 consecutive days or
more for care of an immediate family member, the
Request for Medical Certification for Academic
Staff, Faculty, and Limited Appointees form must
be used. - Please refer to UPG 10 for the definition of
immediate family member.
6Requesting Medical Certification
- Employees should submit the Request for Medical
Certification for Academic Staff, Faculty, and
Limited Appointees form to their Supervisor or
the Divisional Disability Representatives (DDR),
as determined by the divisional Human Resources
Office. - To determine who the DDR is for the
school/college, please refer to EDRCs website
http//www.wisc.edu/edrc/disability/dlrdiv.html
7What does the Request for Medical Certification
form include and not include?
- The request form includes a Health Care Provider
statement that absence from work is justified
based on medical necessity. - It includes a statement of the specific time
period for which an absence is medically
necessary. - If the employee has the form completed prior to
his/her return to work, the physician/practitioner
should provide a best guess return to work
date. - It should not include any confidential medical
information
8Requesting Medical Certification
- When an institution is aware of an emergency that
prevents communicating with or obtaining
information about the condition of an employee,
such written medical certification shall not be
required until such time as communication is
possible and appropriate given the condition of
the employee. - Managers, Supervisors or Department Chairs are
authorized to request medical certification for
use of sick leave if they suspect the request for
sick leave is inappropriate, regardless of the
length of the absence. The department must
consult with the divisional Human Resources
Representative prior to making a request to the
employee. - Such requests should be presented in writing to
the employee, who must be provided at least 15
days to secure the medical certification. The
requested information should be provided to the
Divisional Disability Representative.
9Does the new requirement affect the leave
provisions provided by FMLA?
- If the use of sick leave is authorized in
advance, pursuant to the Wisconsin or Federal
Family and Medical Leave Acts, additional medical
certification is not required. - Departments should follow their normal process
for documenting leave under FMLA. In the case of
WFMLA for family leave following the
birth/adoption of a child, medical certification
is not required (since no person is ill) as long
as the leave has been pre-approved. -
- Information about the Family Medical Leave Acts
can be found in the UPG 10.11 and Balancing
Family and Work.
10Failure to Return Medical Certification
- If the faculty, academic staff, or limited
appointee does not provide the requested medical
certification within the required timeframe,
he/she cannot use sick leave to cover the
absence. - The employee will have to use other paid leave
options, or will be required to take a leave
without pay.
11Other changes to UW-Madison Sick Leave Policies
- The leave statement now includes a statement
certifying that the leave accounting is accurate,
and states that misrepresentation can lead to
disciplinary action. - The employees immediate supervisor (the
department chair for faculty) is responsible for
signing the monthly leave statements. - Effective with the 2007-08 year, unclassified
employees who do not turn in all leave statements
for a given fiscal year will have their sick
leave reduced. For more information, refer to
http//www.bussvc.wisc.edu/ecbs/ucla-changes-imple
mentation-msn.pdf
12Why is it important for academic staff, faculty,
and limited appointees to turn in monthly leave
statements?
- At retirement sick leave accrued is converted
to credits to pay health insurance premiums. - State law caps the annual sick leave accrual at
6.4 days per year for 9 month staff and 8.5 days
for 12 month staff. - The sick leave cap has been waived for
UW-Madison based on our agreement to meet certain
conditions, such as monthly reporting of sick
leave usage. - Compliance with UW sick leave policies will
help to insure the continued availability of the
waiver on the sick leave cap.
13Role of Supervisor/Manager
- Please encourage the faculty, academic staff and
limited appointees you supervise to turn in leave
statements in a timely fashion. - Stress the importance of the sick leave cap
waiver, and the potential loss of its benefits to
all employees. - Remind unclassified employees that missing leave
statements may be printed from their My UW
account and completed prior to the end of the
fiscal year (to avoid having a sick leave
reduction).
14Examples
- To assist in the administration of this policy
the following examples are provided.
15What is meant by more than 5 Consecutive Full
Working Days?
- Example 1
- Staff members work schedule is Monday through
Friday from 8 am to 5 pm. Staff member is out
ill and uses sick leave for the entire 1st week,
returning the following Wednesday. - For this individual, 8 am to 5 pm is a full work
day. A full work day represents the period of
time an individual is scheduled to work for that
day. Thus the employee was out a total of 7 days.
-
- A written Medical Certification would be required
as of Monday, the 6th day of absence.
16What about Part-Time or Variable Work Schedules?
- Example 2
-
- Staff members work schedule is Monday through
Friday from 8 am to Noon, 4 hours per day. Staff
member is out ill an entire 1st week, returning
the Wednesday of the following week. Thus the
employee was out a total of 7 days. - A full work day represents the period of time an
individual is scheduled to work for that day.
For this individual, 8 am to noon is a full work
day. -
- A written Medical Certification would be required
as of Monday, the 6th day of absence.
17What about Part-Time or Variable Work Schedules?
(cont.)
- Example 3
-
- Staff members work schedule is 8 am to 5 pm on
Monday, Wednesday and Friday. -
- This individual would not have more than 5
consecutive full working days until the end of a
two week period. - Day 1 Monday Day 4 Monday
- Day 2 Wednesday Day 5 Wednesday
- Day 3 Friday Day 6
Friday - A medical certification is required when the
individual uses sick leave for more than 5
consecutive full working days. - Remember The requirement states 5 consecutive
full working days, not consecutive calendar days.
18References
- Unclassified Personnel Guideline Chapter 10
http//www.uwsa.edu/hr/upgs/upg10rev_oct7_2005.pdf
- Balancing Family and Work UW-Madison Leave
Related Policies for Faculty, Academic Staff, and
Limited Appointees http//www.ohr.wisc.edu/polpr
oced/FamilyLeaveBrochure_10-05.doc - Information on Sick Leave Reduction for Failure
to Turn in Leave Statements http//www.bussvc.wi
sc.edu/ecbs/ucla-changes-implementation-msn.pdf
19Questions?
- Managers, Supervisors, and Department Chairs
should contact their divisional Human Resources
Representative if they have any questions or
compliance issues. - For questions about UPG 10, contact Catharine
DeRubeis at cderubeis_at_ohr.wisc.edu - Updated 7/2008