Family medical leave act written on chalkboard

Navigating Life’s Uncertainties: FMLA vs Disability Insurance

Life is unpredictable. Having a safety net becomes essential when circumstances beyond our control can impact our health and financial stability. Both disability insurance and the Family and Medical Leave Act (FMLA) offer support to employees facing medical issues that need to take time from work, but they do so in different ways.

Overview: Difference between FMLA and disability insurance

FMLA protects job security by providing unpaid leave for specific qualifying events, while disability insurance offers income replacement during periods of temporary or permanent disability. Combining both provisions can provide comprehensive coverage, ensuring employees have the support they need during challenging times.

What is the Family and Medical Leave Act (FMLA)?

The Family and Medical Leave Act (FMLA)1 provides eligible employees with up to 12 workweeks of unpaid leave a year and requires group health benefits to be maintained during the leave as if employees continued to work instead of taking leave. Employees are also entitled to return to their same or an equivalent job at the end of their FMLA leave.

Disability Income Insurance

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What types of employers does the FMLA apply to?

The FMLA applies to covered employers, including:

  • Private-sector employers who employ 50 or more employees in 20 or more workweeks in either the current calendar year or the previous calendar year,
  • Public agencies (including Federal, State, and local government employers, regardless of the number of employees), and
  • Local educational agencies (including public school boards, public elementary and secondary schools, and private elementary and secondary schools, regardless of the number of employees).

All employers covered by the FMLA are required to post a notice explaining the FMLA’s provisions and providing information concerning the procedures for filing complaints of violations of the FMLA.

FMLA eligibility requirements for employees

For an employee to be eligible to take leave under the FMLA, they must:

  • work for a covered employer;
  • have worked 1,250 hours during the 12 months prior to the start of leave;
  • work at a location where the employer has 50 or more employees within 75 miles; and
  • have worked for the employer for 12 months. The 12 months of employment are not required to be consecutive in order for the employee to qualify for FMLA leave.

What conditions qualify for FMLA?

A covered employer must grant an eligible employee unpaid, job-protected leave for one or more of the following reasons:

  • for the birth of a son or daughter and to bond with the newborn child;
  • for the placement with the employee of a child for adoption or foster care, and to bond with that child;
  • to care for an immediate family member (spouse, child, or parent – but not a parent “in-law”) with a serious health condition;
  • to take medical leave when the employee is unable to work because of a serious health condition; or
  • for qualifying exigencies arising out of the fact that the employee’s spouse, son, daughter, or parent is on covered active duty or call to covered active duty status as a member of the National Guard, Reserves, or Regular Armed Forces.

How long does FMLA last?

An FMLA leave for eligible employees can last up to 12 workweeks in a 12-month period for one or more of the reasons mentioned above.

The FMLA also allows eligible employees to take up to 26 workweeks of unpaid, job-protected leave in a “single 12-month period” to care for a covered servicemember with a serious injury or illness.

Common health conditions that qualify for FMLA leave

Some of the most common health conditions that qualify for FMLA leave include:

  • conditions requiring an overnight stay in a hospital or other medical care facility;
  • conditions that incapacitate you or your family member (for example, unable to work or attend school) for more than three consecutive days and have ongoing medical treatment (either multiple appointments with a health care provider, or a single appointment and follow-up care such as prescription medication);
  • chronic conditions that cause occasional periods when you or your family member are incapacitated and require treatment by a health care provider at least twice a year; and
  • pregnancy (including prenatal medical appointments, incapacity due to morning sickness, and medically required bed rest).

Does an employee have to provide proof if they are requesting FMLA leave for a health condition?

If an employee wants to use FMLA because of a serious health condition, the employer may require proof or certification by a healthcare provider. The employer must allow the employee at least 15 calendar days to obtain the medical certification.

How to notify employer of FMLA leave

Employees seeking to use FMLA leave are required to provide 30-day advance notice of the need to take FMLA leave when the need is foreseeable, and such notice is practicable. If leave is foreseeable less than 30 days in advance, the employee must provide notice as soon as practicable – generally, the same day or the next business day.

FMLA requirements

It’s important to note that FMLA requirements may differ by state. The FMLA allows states to set their own standards, and many have chosen to do so.

Does FMLA pay weekly?

Unfortunately, FMLA doesn’t pay anything. It is job-protected, unpaid leave. Employees may be able to use their employer-provided PTO (paid time off) while they take FMLA leave as long as the employer’s paid leave policy covers why they are using it. An employer may also require employees to use available PTO during FMLA leave.

Is FMLA paid leave?

FMLA is not paid leave – which is why you should consider investing in disability insurance.

What happens if an employee is not eligible for FMLA?

When an employee isn’t eligible for FMLA, employers are not obligated to grant leave, even if it is unpaid. That means if you do have to take time off, you may be at risk of losing your job.

What is disability insurance?

Disability insurance, often referred to as income protection, is a financial safety net that provides individuals with a regular income in case they become unable to work due to a covered illness, injury, or disability. It’s like a shield against the unexpected, offering peace of mind by ensuring that you’ll have a portion of your income even if you can’t work.

How does disability insurance work?

Here’s how disability insurance works: when you purchase a disability insurance policy, you agree to pay regular premiums. In return, if you experience a covered event that prevents you from working, such as a heart attack, stroke, or cancer, the insurance company provides you with a portion of your lost income

To make a claim, you’ll need to provide medical documentation that confirms your inability to work. The insurance company then reviews your claim and, if approved, starts providing you with regular payments to help replace your lost income. Disability insurance offers peace of mind, ensuring that you can focus on recovery without worrying about your financial stability during challenging times.

How much does disability insurance cost?

The cost of disability insurance can vary widely depending on several factors. These include your age, occupation, health status, the amount of coverage you need, and the specific terms of the policy. On average, you can expect to pay around 1-3% of your annual income for disability insurance coverage.

It’s important to note that while disability insurance premiums are an additional expense, they can offer immense financial protection in times of need. Weighing the potential cost against the security it provides during unexpected situations when you’re unable to work can help you make an informed decision about whether disability insurance is a worthwhile investment for your financial well-being.

Woligo Disability Insurance

Woligo offers flexible, customized disability insurance policies designed to meet your individual needs. We understand the importance of maintaining an income stream in the event of illness or injury and make getting protection simple and fast.