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An employer may require an employee to provide a certification and recertification from a healthcare provider to support the need for leave under the Family And Medical Leave Act (FMLA) because of a serious health condition.

If an employer wants medical certification, it must request certification when the employee requests leave or within 5 days of the beginning of unforeseeable leave.  New medical certification may be requested in each subsequent leave year. 

Certification must come from an acceptable healthcare provider and contain a minimum amount of information. An employer may request clarification. The questions an employer can ask are limited as is an employer's right to contact the healthcare provider directly.

A second opinion may be requested. If it conflicts with the first opinion, a third opinion may be requested. A third opinion is binding on both employer and employee.

Failure to provide certification may result in no protection under the FMLA.

For additional information, see:

Who Can Provide Medical Certification

An employer may require that certification come from a medical professional whose scope of practice includes the reason for the medical necessity. For example:

  • An employer may reject a certification from a chiropractor who diagnoses depression.
  • An employer may reject a certification from a dentist who diagnoses a sinus infection.

An employer may not require an employee to provide a certificate from a specialist.

A whole batch of people can certify the need for time off under the FMLA, including the following:

  • Physicians
  • Podiatrists 
  • Dentists
  • Clinical psychologists 
  • Optometrists
  • Chiropractors
  • Nurses
  • Nurse Practitioners
  • Midwives
  • Christian Science Practitioners
  • Any health care practitioner recognized by the employer or the employer’s group health plans’ benefit manager 

What Must Be In A Healthcare Provider Certification

A healthcare provider must identify:

  • The date the serious health condition began
  • The probable duration of the health condition
  • Functions the employee cannot perform
  • Facts which establish the medical necessity the leave.  For intermittent or reduced schedule leave, the certification must include an estimate of the frequency and duration of episodes of incapacity. 
If the certification does not include any of the above, the employer can ask for more information.

An employer may request additional information in the following circumstances. Such additional information may be considered in determining FMLA entitlement.
  • If the situation involves Workers' Compensation, and state law allows additional information from an employee's Workers' Compensation healthcare provider, the FMLA allows the employer to ask for it.
  • If paid leave or short term disability benefits are involved, an employer may request additional information in connection with the leave or benefits.
If the certification is in a language other than English

An employee must provide an English translation if requested by the employer.

Foreign certifications

An employer must accept a certification from a foreign health care provider if the employee is visiting another country. 

Incomplete Healthcare Provider Certifications

A Healthcare Provider Certification is incomplete and does not have to be accepted by an employer if:
  • One or more applicable entries are not completed.
  • Information which is provided is vague, ambiguous or non-responsive.
An employer must tell an employee in writing why a certification is considered to be incomplete or not sufficient.
Employees are given 7 calendar days to cure an incomplete Healthcare Provider Certification.

If the certification is not cured within the alloted time, leave may be denied.

What Questions Can An Employer Ask To A Professional Who Certifies FMLA Need?

  • Name, address, and phone number of a health care provider.
  • The provider's type of practice (if the person is an oncologist, it discloses that the patient has cancer)
  • The health condition
    • What it is with sufficient detail to support the need for FMLA leave
    • Approximate date the health condition began
    • Esimtate about how long the condition will last

Limited Employer Contact With The Healthcare Provider

In general

An employee may allow an employer to contact a healthcare provider rather than speak with the provider him or herself.

An employer may contact a healthcare provider directly for authentication or clarification of a document after it has provided the employee an opportunity to cure any missing, incomplete or ambiguous entries.

An employer's contact may come from Human Resources, a leave administrator, or a management official. A direct supervisor may not contact the healthcare provider.

If an employee fails or refuses to cure deficiencies or does not grant permission to contact a healthcare provider, an employer may deny leave.


An employer is permitted to provide a healthcare provider with a copy of a certification and request verification that information in the document was completed by or authorized by the healthcare provider. Permission is not required to contact a healthcare provider just for authentication of the document and signature.


An employer must obtain permission from the employee before asking a healthcare provider for clarification of "individually-identifiable" health information. (This is because of HIPAA, not the FMLA. For information about HIPAA, see the document in "To Learn More").

When contacting a healthcare provider about a certification, the employer can only ask about information that is contained in the certification. For example, if a certification says an employee may not lift heavy objects, and the employee must regularly lift 25 pound objects, the employer can ask the healthcare provider to state whether the employee can lift 25 pounds.

Second Opinions

If an employer disputes a certification, the employer may request a second opinion.

The employer may not request a second opinion from a health care provider that the employer regularly uses.

An employer may deny leave to an employee who refuses to release relevant records to a health care provider who has been requested to provide a second or a third opinion.

If an employee requests a copy of a second or third opinion, the employer has 5 days to provide the requested opinion.

NOTE: Going to a doctor to get a second or third opinion is not time for which the employee has to be compensated. However, the employer must pay out-of-pocket expenses such as transportation.


Third Opinions

If the initial opinion and a second opinion conflict, either the employer or employee may request a third opinion.

Both employer and employee have to agree to the identity of the healthcare provider to issue the third opinion. 

The third opinion is final and binding on both parties.

NOTE: Both parties must act in good faith in choosing the provider for the third opinion. If either party does not act in good faith, that party is bound by the other party's certification.

Failure To Provide Certification

Forseeable Leave

An employer may deny FMLA leave until a certification is provided.

Unforeseeable Leave

An employer may deny FMLA leave after expiration of a 15 day period. For example, certification is not provided to an employer until the 21st day. The first 15 days are counted as FMLA leave. Days 16 - 20 are not protected and may be counted against the employer's attendance policy.

Confidentiality Of Certifications

Certifications are considered to be confidential medical records that must be maintained in files separate from an employee's personnel file.