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FMLA Applications

At Evolve Psychiatry, we understand the importance of the Family and Medical Leave Act (FMLA) in ensuring individuals have the support they need during challenging times. Our psychiatry practice can assess your condition and provide necessary documentation, and guide you through the FMLA application process. Our goal is to empower you to navigate FMLA leave confidently and successfully.

What is FMLA?

The Family and Medical Leave Act (FMLA) is a federal law that allows eligible employees to take up to 12 weeks of unpaid, job-protected leave per year for certain family and medical reasons. This federal law is crucial for individuals facing serious health conditions, including mental health challenges, ensuring they can take necessary time off without risking their employment.

Who is eligible to receive FMLA benefits?

Depending on an individual’s company policy, eligible employees typically include those who have worked for their employer for at least 12 months and have worked at least 1,250 hours over the previous 12 months. It’s best to consult with your company’s Human Resources department for more information.

How can I determine if I qualify for FMLA due to a mental health condition?

FMLA may apply if you have a serious health condition, including mental health conditions like depression, anxiety, PTSD, or bipolar disorder, that significantly impact your ability to perform essential job functions.

Can I use FMLA intermittently for mental health reasons?

Yes, FMLA can be used intermittently for mental health conditions, depending on the severity and nature of the condition as well as the terms of your specific insurance employer leave policy. Intermittent leave for mental health conditions may involve taking time off work on certain days or for specific periods when symptoms are particularly challenging or when medical appointments are scheduled.

Can I use FMLA to take care of a loved one?

Patients may apply to seek FMLA leave for themselves or while they are assisting a loved one. Individuals who are not established patients may not request an evaluation without being a patient first.

Can I request completion of an FMLA application after I have already taken time off?

Yes, you can apply for FMLA after taking time off, even if you have not seen your doctor initially. However, it's important to note that most FMLA policies require medical documentation to support your claim. You must see us promptly, within 7 days after taking time off to ensure you have the necessary documentation and medical support for your application.

What type of expertise does Evolve Psychiatry offer to assist with my FMLA application?

Navigating the FMLA process can be complex, especially when dealing with mental health conditions. Our experienced team specializes in evaluating and documenting mental health conditions for FMLA applications.  We support patients every step of the way to ensure their application accurately reflects their needs and conditions.

Will Evolve Psychiatry automatically send all my medical records to my employer or the short-term disability insurance provider?

Evolve Psychiatry can only provide necessary medical information to employers if a patient has signed consent forms allowing us to release that information.

What will Evolve Psychiatry provide to support my application?

  • Signed employer-specific form for employees to request FMLA leave as well as the reason for the leave (e.g., for the employee's own serious health condition or to care for a family member)

  • Diagnosis and severity of the mental health condition

  • Description of symptoms and their duration

  • Information about the treatment plan prescribed by your healthcare provider, including medications, therapies, or other interventions

  • Recommended duration of treatment and any modifications to work activities

  • Estimated duration and frequency of FMLA leave needed

  • Relevant medical records supporting your diagnosis and treatment history, which may include psychiatric evaluations, therapy notes, medication history, and hospitalization records, if specifically requested

How long after becoming a patient can I apply for an FMLA condition?

Our practice adheres to professional standards and guidelines that recommend a period of established care before providing documentation for legal or employment purposes like FMLA. This ensures that our assessments are thorough, reliable, and ethically sound. We require at least 3 to 5 visits before a patient is eligible to request support for an FMLA application.

How many weeks can I get approved for FMLA?

FMLA is limited for up to to up to 8 weeks. Patients whose primary reason is their own mental health must be seen every two weeks while they are on FMLA to monitor their progress and so that we may provide sufficient documentation to their employer or insurance company, if requested.

Do I have to pay for an extension every 8 weeks?

No, each leave may be extended up to two additional times without any additional fees. After the second extension (6 months total), patients must pay a new form fee, even if it is the same form as the original.

How long does it take to complete an FMLA application with your practice?

The time to complete an FMLA  application varies based on individual circumstances and the completeness of documentation provided. Most documents are prepared in 5 to 14 days. Patients have the option to request expedited processing in which case their request will be prioritized and completed in 48 hours. 

Is there a fee for FMLA documentation from your practice?

Pricing varies depending on the complexity of the case which is determined at the patient's consultation.  The general range of fees for straightforward FMLA applications are between $150-$200.  For more complex forms, the fees range from $300-$500. Insurance does not cover FMLA applications so fees are out-of-pocket and paid for privately by the patient.

Do any additional forms also require another payment?

Patients do not need to pay again for any forms associated with their application or any extensions for up to 6 months.  However, any additional forms that are unrelated to the application or any forms after the 6 months are completed will incur separate fees.

Can I set up a payment plan?

We do not offer payment plans for private pay services.  All fees must be paid up front and in full prior to our office completing a patient’s application.

How long after becoming a patient can I apply for a short-term disability condition?

Our practice adheres to professional standards and guidelines that recommend a period of established care before providing documentation for legal or employment purposes like FMLA applications. This ensures that our assessments are thorough, reliable, and ethically sound. We require at minimum 3 to 5 visits before a patient is eligible to request support for a FMLA application.

What if I have a previous FMLA application that has been denied?

If your FMLA application has been denied, our practice can assist you with an appeal. We will review the denial reason, gather additional supporting documentation if necessary, and help you navigate the appeal process to seek approval for your FMLA leave.

What supporting documentation do I need to submit to my provider along with my request?

Patients should review their Human Resources FMLA application to determine what documentation they need to submit with their formal request to help our team complete their forms as thoroughly as possible.

How can I get started?

For new patients, complete your PAQ and specify "FMLA application" as your primary reason for inquiry . If you are an established patient, obtain the necessary documentation requirements for your FMLA from your employer or insurance company, discuss with your provider at your next visit, and then complete a form request.

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