Is Your Disability a Serious Health Condition Under the FMLA?

The Family and Medical Leave Act (FMLA) allows many 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 that qualifies for FMLA leave. But that's incorrect.

Even though the acts seem similar, they aren't the same. So, not every disability counts as a serious health condition under the FMLA, and not every chronic health condition is an ADA-protected disability. Below, we explain how the Family Medical Leave Act defines a serious health condition and discuss what conditions qualify for FMLA leave.

What Counts as a Serious Health Condition Under the FMLA?

There are six specific categories of serious health conditions under the FMLA (described below). Each involves 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're capable of doing your job and taking care of daily tasks, you won't need time off work because of your disability.

FMLA and Permanent or Long-Term Conditions

If you're 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're not in treatment for your condition, you can use the FMLA to take time off work as you need it.

Chronic Health Conditions

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 of time and must require periodic medical visits for treatment (at least twice a year).

FMLA Leave for Conditions Requiring Multiple Treatments

You have a serious health condition under the FMLA if you need time off for multiple treatments for:

• restorative surgery following an injury or accident, or
• a condition that would require you to miss more than three days of work if not treated, like
  
  • kidney disease, or
  • cancer requiring chemotherapy.

Incapacity for More Than Three Days With Continuing Treatment

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 serious case of flu
• a severe case of COVID-19
• pneumonia
• mononucleosis
• a severe infection, or
• chickenpox.

FMLA Covers Health Conditions Requiring Inpatient Care

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 all of the following times when:

• you're in the health care facility (like a hospital or rehab center)
• you're receiving treatment in connection with your stay, or
• you're incapacitated in connection with your stay.

FMLA Leave for Pregnancy and Prenatal Care

If you're unable to work or perform your other regular activities because of your pregnancy, you have a serious health condition that qualifies for FMLA leave. For example, if you have morning sickness or need to spend a week in bed before giving birth, you can take time off under the FMLA.

You can also take intermittent FMLA leave for regular doctor visits during your pregnancy, even if you're not incapacitated. Learn more about when you can take FMLA leave for pregnancy and prenatal care.

What's on the FMLA Serious Health Conditions List?

Any medical condition that requires inpatient care or continuing treatment is considered a serious health condition under the FMLA. The following conditions all fit the FMLA definition of a serious health condition:

• cancer
• heart attack
• diabetes
• Alzheimer's disease
• organ donation
• pregnancy and complications of pregnancy
• chronic back conditions (like degenerative disc disease or spondylitis)
• severe anxiety or PTSD
• severe depression or bipolar disorder
• treatment for substance abuse
• anorexia nervosa (and other severe eating disorders)
• multiple sclerosis
• emphysema
• rheumatoid arthritis
• pneumonia
• broken bones and other severe injuries, and
• inpatient surgeries.

What's Not on the FMLA Conditions List?

Some medical conditions are typically not severe enough to qualify you for FMLA leave. Those include:

• colds and mild flu
• sinusitis
• earaches
• nausea (other than morning sickness)
• minor ulcers
• headaches (other than migraines)
• routine dental problems or periodontal disease, and
• outpatient cosmetic treatments (other than restorative procedures).

But any medical condition, including those above, is considered serious under FMLA standards if it:

• causes you to be hospitalized
• incapacitates you, or
• requires continuous treatment.

And seemingly mild symptoms can be indicators of very serious conditions—like the stomach ache that turns out to be pancreatic cancer. This is why there are no conditions that are automatically disqualified for leave under the FMLA. Each employee's situation must be considered individually.

What Is a Disability Under the ADA?

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.

Major life activities also include the proper functioning of bodily systems, including the:

• reproductive system
• respiratory system
• digestive system
• neurological system, and
• immune system.

Under the ADA, 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.

If you have a disability under the ADA, you have the right to "reasonable accommodation" at work, including time off when appropriate. Learn more about your right to workplace accommodations under the ADA.

Not All Serious Health Conditions Are Disabilities Covered Under the ADA

As you can see from the definitions above, there are serious health conditions that aren't considered disabilities. Temporary conditions—like a broken bone that heals fully—would qualify for FMLA leave but not as a disability under the ADA. (Learn more about the ADA and temporary conditions.)

The same is true of a normal pregnancy. You might qualify for time off under the FMLA if you can't work for a few days or weeks due to pregnancy. But you wouldn't be considered disabled under the ADA—unless you developed a serious complication, such as gestational diabetes.

Thus, there aren't any protections for a normal pregnancy under the ADA. But pregnant workers do get some protection under the Pregnancy Discrimination Act (PDA).

Not All Disabilities Are Serious Health Conditions Under the FMLA

And not every disability is a serious health condition, as defined by the FMLA. And that makes sense since 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. So, disabilities like deafness aren't covered by FMLA.

Whether a condition is covered by the FMLA always depends on the facts of a situation. For instance, if you need surgery to stop the progression of your hearing loss, that might qualify as a serious health condition under the FMLA. But as long as you're able to do your job and aren't otherwise incapacitated, your condition isn't covered by the FMLA.

Social Security's Definition vs. the FMLA and ADA

And of course, Social Security's definition of disability is different from the FMLA's and ADA's. Social Security defines disability as having a medical condition that makes you unable to work enough to earn a living, which lasts (or is expected to last) at least a year. And whether your health condition qualifies for FMLA leave or ADA protection has no bearing on whether Social Security will approve you for disability benefits and vice versa.

Learn more about what it takes to qualify for Social Security disability benefits.

_{Updated February 24, 2023}