The U.S. Department of Labor reported 349 FMLA compliance actions in 2024, affecting 344 employees and resulting in over $1.4 million in back wages. These violations included 115 instances of denied leave and 112 cases of discrimination, such as disciplinary actions.
Having a medical leave claim denied is frustrating, especially if you’re sick. A denial can jeopardize your job and health, whether your request was under the FMLA, California’s PFL, or another employment policy. Thanks to legal aid, things can improve.
According to a Los Angeles medical leave claim attorney, it’s normal to feel unsure when you have to ask for medical leave, but you have the right to expect your employer to handle your request in good faith. If they don’t follow the contract, a lawyer can help you hold them accountable and protect your rights.
Continue reading to find out how to handle a denied medical leave claim and how legal representation can protect your job, income, and health.
Understanding Your Rights Under the Law
The Family and Medical Leave Act protects eligible employees by allowing them to take unpaid leave for specified medical reasons without apprehension of losing their jobs.
It is advantageous to have an understanding of all the company policies and legalities affecting leaves. When denied, you should otherwise apply for an appeal, adding any necessary documentation that could support the claim.
Keep records of all communications with the employer, as they may be important later in proving your case and may turn the law to your side.
ADA attorney Natalia Asbill just like FMLA, under the Americans with Disabilities Act (ADA), employers need to make exceptions to their policies, including leave policies, to provide a reasonable accommodation for people with disabilities.
If your medical leave is being denied, it is wise to consult a lawyer.
Common Reasons for Denied Medical Leave Claims
Understanding the common reasons for denied medical leave claims will better prepare you for trials. A very common problem is inadequate documentation of medical conditions. Should your doctor not adequately specify the nature of your medical condition, the claim may well get rejected.
Another reason for claim rejection is that claims may be submitted by individuals who do not meet the eligibility criteria outlined in the company’s regulations or the federal Family and Medical Leave Act (FMLA).
There may be additional reasons why employers reject a claim; for example, they might deny a request if you fail to meet submission deadlines, if there are inconsistencies in your application, or if the paperwork is not completed correctly.
If the employer has already begun to doubt the validity of your claim, they are likely to deny it without conducting any further inquiry.
Steps to Take After Your Claim Is Denied
If your medical leave claim is denied, you can do a few things to counter this.
- Look through the denial letter. Understand the reasons it was denied, as it will inform your course of further action.
- Gather all documentation, including medical records and all correspondence with your employer or insurance.
- Speak with your HR department or claims administrator to discuss the denial and seek clarification.
- If required, and based on the information you gathered, proceed to an appeal. Make sure that you do adhere to the appeal deadlines; otherwise, you stand to lose your rights.
- Keep a detailed log of all communications pertaining to your claim so you can obtain it later on if the matter leads to a disputed issue.
The Benefits of Seeking Legal Assistance
An experienced attorney understands employment law, spotting any violations that may have resulted in your claim being denied. He or she can review your case and gather all the relevant documentation so you’ll have a strong stance to present.
A lawyer will then advise you on your rights and strategies to pursue in an appeal. In addition to this support, carrying your case with a lawyer removes the burden of fighting by yourself so that you can focus on recovery. An attorney will increase the chances of a positive result where you get the medical leave you deserve.
Preparing for Your Appeal Process
As you get ready for your appeal process, always gather all the documentation relevant to your case that may strengthen it. Look through your medical records, including notes from doctors and whatever test results that can substantiate your need to take time off.
Be sure to include the letter denying your claim, all correspondence with your employer, and anything related to it. After this, review the leave policies of your particular workplace to determine what rights you may have.
If there are witnesses to your case or coworker statements relevant to your claim, it may be helpful to get them. An attorney will be able to offer good advice on what to document.
Prepare everything so that it looks neat and professional when you file the appeal. This preparation maximizes your chances of a positive determination. You need to communicate with your lawyer and monitor the progress of your appeal.
