The Eighth Circuit Court of Appeals recently ruled that a disease in its earliest stage did not rise to the level of “serious health condition” that would qualify the employee for the protections of the Family and Medical Leave Act (“FMLA”).
Employee’s Kidney Issues Lead to Multiple Absences
In Dalton v. ManorCare of West Des Moine, IA, LLC, No. 13-3743 (8th Cir. April 7, 2015), employee Lucinda Dalton began experiencing significant weight gain and fluid retention. After multiple doctor visits, Dalton sought the opinion of kidney specialist, Dr. Robert Leisy, who diagnosed her with Stage One Chronic Kidney Disease (“CKD”) and Secondary Obesity. Dr. Leisy later testified that Stage One CKD is not truly a disease because kidney function “is actually normal to above normal at that point.” Instead, the kidneys simply must work harder than normal, which might eventually wear out the kidneys. Still, with proper care, such as weight loss, a Stage One patient may avoid advancing to higher stages of CKD.
During all this time, Dalton received a series of disciplinary actions, including one for 10 attendance infractions in the space of one month, and another based on complaints from her direct reports. Dalton raised the issue of FMLA leave but was informed that she was not eligible. A few days after receiving her latest warning, Dalton was directed to complete several unfinished tasks as soon as possible. She immediately left work, claiming to be ill.
Shortly thereafter, Dalton was admitted to the emergency room with complaints of “atypical chest pains.” She was released that same day without a diagnosis but with a note excusing her from work for three days. Upon her return, she was issued a written warning for failure to perform her job duties prior to her emergency room visit. Consistent with ManorCare’s progressive discipline policy, this resulted in Dalton’s termination.
Employee Did Not Suffer from a Serious Health Condition
When Dalton sued for interference with her FMLA rights, ManorCare responded that Dalton was not eligible for FMLA leave because she did not suffer from the required “serious health condition.” The lower court sided with ManorCare and dismissed the claim. On appeal, the Eighth Circuit affirmed, explaining that while kidney disease most certainly can be a serious health condition, Dalton’s diagnosis – Stage One Chronic Kidney Disease – did not amount to an “advanced disease.”
The appeals court relied on Dr. Leisy’s testimony that Stage One CKD is simply a warning that the kidneys are working too hard. They also pointed to the results of medical testing confirming that Dalton’s CKD had not reached an advanced stage. The court explained that while FMLA does cover medical treatment for symptoms which are later diagnosed as a serious health condition, Dalton’s CKD never progressed past Stage One. In other words, Dalton did not really suffer from a disease but rather demonstrated the signs that a disease might be forthcoming.
In dismissing the case, the Eighth Circuit also emphasized that the employer never interfered Dalton’s ability to take time off due to her medical issues or her need for testing. This made it difficult for the court to accept that any actual interference took place.
Bottom Line
This was an unusual case since the employee was absent for more than three days due to medical reasons yet was not eligible for FMLA leave because the medical reasons did not add up to a “serious health condition.” Employers should watch for such situations in evaluating medical certifications. Remember, however, that if the medical issue becomes more serious and progresses to a serious health condition, the employee’s absences at the early stages would be viewed as protected under FMLA. This sort of distinction is one of many that continues to vex employers in evaluating their rights and obligations under FMLA.