Connecticut Administrative Code › Title 31 - Labor › 51qq - The Family and Medical Leave Act › Section 31-51qq-31 - How much information may be required in a medical certification for an employee's own serious health condition or the serious health condition of a family member?

Current through July 10, 2024
(a) Required
			 information. When an employee requests leave because of the employee's own
			 serious health condition or the serious health condition of a family member, an
			 employer may require an employee to obtain a medical certification from a
			 health care provider that, in addition to identifying the health care provider
			 and type of medical practice (including pertinent specialization), sets forth
			 the following information;
(1) A
			 certification as to which part of the definition of "serious health condition,"
			 if any, applies to the patient's condition, and the medical facts which support
			 the certification, including a brief statement as to how the medical facts meet
			 the criteria of the definition.
(2) The approximate date the serious health
			 condition commenced, and its probable duration, including the probable duration
			 of the patient's present incapacity, if different.
(3) Whether it shall be necessary for the
			 employee to take leave intermittently or to work a reduced schedule as a result
			 of the serious health condition, and if so, the probable duration of such
			 schedule.
(4) If the condition is
			 pregnancy or a chronic condition, whether the patient is presently
			 incapacitated and the likely duration and frequency of episodes of
			 incapacity.
(5) If additional
			 treatments shall be required for the condition, an estimate of the probable
			 number of such treatments. If the patient's incapacity shall be intermittent,
			 or shall require a reduced schedule, an estimate of the probable number and
			 interval between such treatments, actual or estimated dates of treatment if
			 known, and period required for recovery if any.
(6) If any of the treatments referred to in
			 subdivision (5) of this subsection shall be provided by another provider of
			 health services, such as a physical therapist, the nature of the
			 treatments.
(7) If a regimen of
			 continuing treatment by the patient is required under the supervision of the
			 health care provider, a general description of the regimen.
(8) If medical leave is required for the
			 employee's absence from work because of the employee's own condition, including
			 absences due to pregnancy or a chronic condition, whether the employee:
(A) Is unable to perform work of any kind;
			 or
(B) shall be absent from work
			 for treatment.
(9) If
			 leave is required to care for an employee's family member with a serious health
			 condition, whether the patient requires assistance for basic medical or
			 personal needs or safety, or for transportation; or if not, whether the
			 employee's presence to provide psychological comfort would be beneficial to the
			 patient or assist in the patient's recovery. The employee shall indicate on the
			 form the care he or she will provide and an estimate of the time
			 period.
(10) If the employee's
			 family member will need care only intermittently or on a reduced schedule
			 basis, the probable duration of the need.