The Family and Medical Leave Act (FMLA) allows eligible employees to take time off work for a "serious health condition" as defined in the act. If you have a disability under the Americans with Disabilities Act (ADA), you might assume that it automatically counts as a serious health condition for which you can take FMLA leave.
But even though the terms seem pretty similar, they are not identical. Not every disability counts as a serious health condition under the FMLA, and not every serious health condition is a disability. Below, we explain how the Family Medical Leave Act defines a serious health condition. (Learn about the basics of FMLA leave and whether you're eligible in our article Your Right to FMLA Leave.)
There are six specific categories of serious health conditions under the Family and Medical Leave Act (described below), mostly involving some form of incapacity (the inability to work or perform other daily activities). Unless your disability is incapacitating in some way, it won’t qualify you for FMLA leave. And that makes sense. If you are capable of doing your job and taking care of daily tasks, you won’t need time off work because of your disability.
If you are under the supervision of a health care provider for a condition that makes you unable to work for a long time, or permanently, you have a serious health condition under the FMLA. This category can include cancer, Alzheimer’s disease, terminal illnesses, and advanced amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease). Even if you are not in treatment for your condition, you may use the FMLA to take time off work as you need it.
You may take FMLA leave for a chronic serious health condition, like epilepsy, diabetes, depression, or asthma. This category is intended to include conditions that are long term and may wax and wane, causing episodes of incapacity or disability. To fit into this category, your condition must continue for an extended period and must require periodic medical visits for treatment (at least twice a year).
You have a serious health condition under the FMLA if you need time off for multiple treatments for:
You can take FMLA leave for a condition that leaves you unable to work for more than three days and requires continuing treatment from a health care provider. Continuing treatment means either two treatments that take place within 30 days of your first day of incapacity (with the first treatment happening within a week), or one treatment (again, within the first week of your illness) that results in a continuing regimen of care (such as antibiotics). This is kind of a catch-all category, intended to include conditions that aren’t permanent or ongoing but might wipe you out for a while, like a bad flu, pneumonia, infection, or chicken pox.
You have a serious health condition under the FMLA if you need to stay overnight at a hospital, residential care facility, or hospice. You can take time off under the FMLA for the time you spend in the facility and for periods of time when you need treatment or are incapacitated in connection with your stay.
If you are unable to work or perform your other regular activities because of your pregnancy, you have a serious health condition for which you may take FMLA leave. For example, if you have morning sickness or need to spend a week in bed before giving birth, you may take time off under the FMLA. You may also take FMLA leave for regular doctor visits during your pregnancy, even if you are not incapacitated.
The Americans with Disabilities Act defines a disability as a physical or mental condition or impairment that "substantially limits" a major life activity. Major life activities include not only working but also things that are basic to daily life, such as seeing, hearing, walking, sleeping, learning, and caring for yourself. They also include the proper functioning of bodily systems, such as the reproductive, neurological, and immune systems.
Whether or not a condition is substantially limiting is decided without considering what your condition is like with medication or assistive devices. For example, if you have diabetes, you have a disability under the ADA because the proper functioning of your endocrine system is substantially limited—even if your condition is controlled by monitoring and medication. (For more on how the ADA defines disability and what conditions are included, see our article on how the ADA defines disability.)
As you can see from the definitions above, there are serious health conditions that are not disabilities. Temporary conditions, such as a broken bone that heals fully, would qualify for FMLA leave but not as a disability under the ADA. (See our article on the ADA and temporary conditions.) The same is true of normal pregnancy: Even though you may qualify for time off under the FMLA if you are briefly unable to work due to pregnancy, you would not have a disability under the ADA unless you developed a serious complication, such as gestational diabetes.
By the same token, not every disability is a serious health condition as defined by the FMLA. And that makes sense: The purpose of the FMLA is to allow employees to take time off work when they need it, while the purpose of the ADA is to allow employees with disabilities to continue to work. Even conditions that limit major life activities, such as deafness (which would be covered under the ADA), might never be incapacitating and might never require time off work (and thus not be covered by FMLA). But whether a condition is covered by FMLA always depends on the facts of a situation. If you need surgery to, for example, stop the progression of your hearing loss, that might qualify as a serious health condition under the FMLA. However, as long as you are able to do your job and not otherwise incapacitated, you aren’t covered by the FMLA.
And of course, Social Security's definition of disability is different from the ADA's: it's the inability to do a substantial amount of work for at least a year. Whether someone's health condition qualifies for FMLA leave or ADA protection has no bearing on whether Social Security will approve someone for disability benefits, and vice versa.