Is this even LEGAL (RE FMLA)???

[heathenmom]

I e-mailed my company's Disability group this afternoon. They handle all the FMLA stuff. I explained that I remembered from my last pregnancy that a doctor's signature was required on the FMLA forms. I said that we would be using a midwife, not a doctor, and asked if that was a problem. The first answer was, no problem, just have her sign off on Form B. Great!

That person then forwarded my e-mail to 2 other people, one of whom responded, your nurse-midwife can sign off on Form B. I responded back, we're not using a CNM, is that a problem. She replied, FMLA only recognizes a certified licensed nurse midwife under the directions and license of a medical doctor as a health care provider.

So my reply was, even though I'm having a baby, you're telling me that I cannot qualify for FMLA/maternity leave unless I use a doctor or CNM? No response yet .....

Is that LEGAL? Can they require that I use a doctor or CNM or refuse me leave??? NOTE: lay midwifery is not legal in my state.

[BelgianSheepDog]

I think they can require that the professional be licensed by the state, yes. If your midwife is licensed in a neighboring state, I wonder if that would work.

[lovebug]

i will be taking notes!

[aisraeltax]

Health care provider means:
(1) A doctor of medicine or osteopathy who is authorized to practice
medicine or surgery by the State in which the doctor practices; or
(2) Podiatrists, dentists, clinical psychologists, optometrists, and
chiropractors (limited to treatment consisting of manual manipulation of
the spine to correct a subluxation as demonstrated by X-ray to exist)
authorized to practice in the State and performing
within the scope of their practice as defined under State law; and
(3) Nurse practitioners, nurse-midwives and clinical social workers
who are authorized to practice under State law and who are performing
within the scope of their practice as defined under State law; and
(4) Christian Science practitioners listed with the First Church of
Christ, Scientist in Boston, Massachusetts.
(5) Any health care provider from whom an employer or a group health
plan's benefits manager will accept certification of the existence of a
serious health condition to substantiate a claim for benefits.
(6) A health care provider as defined above who practices in a
country other than the United States, who is licensed to practice in
accordance with the laws and regulations of that country.

[DayDreamer]

I'm not sure in your case since lay midwifery is not legal.

Whenever I had my DS, it was OK for my CPM to put me ON leave, using the FMLA, but a DOCTOR had to release me back to work...stupid.

So I just went to my family doctor (whom I had a very good relationship with) and she spoke with my MW and release me. Do you have a family doc you see that would do this for you?

[khaoskat]

There are always ways to bend the rules. It does not have to be an OB or CNM who signs off on your FMLA. If you trust your family DR, have your family physician sign the forms, or even try to see if your child's pediatrician will sign off on them.

Also, your lay midwife may know a CNM/OB group that they associate with in case you have to do a transfer for various number of reasons who could sign off on the forms.

[Arwyn]

That's what I'm thinking - why does it have to be your Primary Pregnancy Care Provider who signs the forms? Aren't they just saying "yup, she's pregnant all right!"? Go see a backup OB, or a family doc, or a chiropractor, if they're legal in your state...

[heathenmom]

Well, it seems an easy fix to just get parallel care through an ob, but my dh has been staunchly opposed to that for ethical reasons (it's wrong to see an ob under false pretenses when we have no intention of birthing with him). I understand his point and agree with it, but feel like we're being pushed into a corner. He also thinks we're going to compromise and compromise and compromise until I'm right back at the hospital having the section I fought so hard to avoid with dd. And I do agree with him on that, too. I'm just so frustrated trying to make the best decisions for me and our baby in a system that is inherently designed to force us into the medical model. :

As for my regular doctor signing off, I'm *sure* he won't. He wouldn't see me for anything AT ALL related to reproductive health ... just told me to find an ob. We don't have the best relationship and I don't know how to go about finding a doctor in my area who would be more supportive. It's a decidedly uncrunchy area.

Chiropractors are recognized in my state & covered by my insurance, but she was so SPECIFIC. I suppose it can't hurt to ask mine if he would do it .....

[aisraeltax]

you dont have to see one for the duration of your preg. just make an appt. with any ol'e (s)OB and have him sign your FMLA papers at your first visit. then never go back.

the law is pretty clear though (i posted earlier), but if you look at this part:

5) Any health care provider from whom an employer or a group health plan's benefits manager will accept certification of the existence of a serious health condition to substantiate a claim for benefits.

all the benefits manager needs to do is to agree. i wouldnt spend too much time on it though. just show them the law. if they want you to go to a regular OB for certification of the claim, although its stupid, just go for the signature like i said above.

some fights are worth fighting for...this one i wouldnt lose any sleep over. and who cares if you dont go back? the employer/benefits manager is requiring this...it doesnt force you to give birht in the hospital.

[Electra375]

Or got to even your FP doc after the birth and state you need a doctor to sign this form that you had a baby. Of course it helps if your FP doc knows you and knows you are pregnant.

That is the angle I would take. I had to have a docs note to get a birth certificate. I took dc to our FP for the note to take to the HD -- no biggie. Of course, it probably helped that he is from Lancaster PA and hbs a dime a dozen, didn't even bat an eye.

[boscopup]

Originally Posted by heathenmom

Well, it seems an easy fix to just get parallel care through an ob, but my dh has been staunchly opposed to that for ethical reasons (it's wrong to see an ob under false pretenses when we have no intention of birthing with him).

For your DH's point... Seeing an OB doesn't always have to be under false pretenses. My OB has full knowledge that I plan to birth out-of-hospital (although I'm birthing across the state line where midwifery is legal and I'm using a licensed midwife in that state). Could be tricky if you aren't near the state line though. I personally couldn't see an ob under false pretenses either, so I understand your DH's point (and would agree with it for ME) if you don't have any options to actually tell the OB about your plans.

BUT... I don't think you need parallel care just for FMLA forms. Just go see your FP once and have them sign it. Not a big deal. They can do a pee-in-a-cup pregnancy test and say "Yep, she's pregnant". For postpartum, you can do the same thing - just go to the FP and they'll check you out and say "Yep, she can return to work". In your situation, I'd probably stay away from the OB unless you have a good *medical* reason to see one.

[Max'sMama]

We had a DEM and a CPM at dd's birth, neither are legally protected in my state, so we had our Chiro sign the forms for the FMLA.

[djinneyah]

hmm..

i didn't work this past pg., but dh filed for FMLA for paternity leave...i had a UP/UC, and at first they said he'd need a signature, but he just kept telling them that wouldn't be possible, etc...eventually they gave up and approved it without the sig.

i know with ds, the paperwork got screwed up...he was early, and the doctor put the wrong dates on the paperwork..anyways, it ended up getting figured out after he was born, at which time they approved it...

so, it's my understanding, at least from my experience, that if you have a baby, you're entitled to FMLA, whether it's filed before or after the birth, regardless of whether a professional signs off on it or not. i could be wrong, though, but those are my experiences with it...

[kalisis]

I have both a CNM and a an OB. My OB knows very clearly that I will never birth any babies in the hospital and that I need to see them for routine care that the midwife doesn't/is too flaky to provide. They're not really that crunchy at all, but they're pretty cool with it.

Does your OB have a PA? If so, that might be your best bet. Call in, say you just need an appt with the PA to confirm your pregnancy and then have them sign off on it. IME, PA's are a lot less 'routine obsessed' than the actual dr. and a lot more lenient.

Good luck - i hope you get it worked out.

[sapphire_chan]

It wouldn't be dishonest if you told the OB at that appointment that you just want him/her to confirm your pregnancy for FMLA.

[heathenmom]

With my first pregnancy, we went in to confirm it and told the ob we really wanted a homebirth. He told us flat-out to find another care provider -- that homebirth was inherently dangerous, that we were risking our child's life to do something "cool", and that if at any time he suspected we planned to homebirth while using him as parallel care, he would drop us as patients. So you can understand why I'd be hesitant to try that again. Here's how I'm afraid this will happen:

We go in to confirm the pregnancy at a 1st prenatal visit. With my insurance, the 1st prenatal is a $25 co-pay, then you don't pay another dime for the rest of the pregnancy. With my first ob/medwife experience, it took 2 months to get them to sign my FMLA forms. So, I drop off my forms the 1st visit and I have to go back 2 more times before they've signed the forms. That puts me at at least 18 weeks. No telling what kind of crap they'll have wanted to do to me & our baby between now and then. I know I can refuse anything, but it's just the stress of it. Okay, so I get the form, then I call them to tell them I'm "switching providers." Somebody on MDC told me that if you don't deliver with an ob, they can go back and bill you for all the stuff that would normally have been covered by insurance, and the insurance company may deny the claims. So, instead of the $25 co-pay, I'm afraid I'll get stuck with several hundred dollars worth of doctor's visits, on top of the midwife's fee that's already out of pocket. I'm just scared to even *start* a relationship with an ob that I might not be able to get out of easily.

The chiro is an interesting idea, though. I need to call mine next week anyway, to ask about his experience working on pregnant women. I'll see if he'd be willing to sign the forms.

Thanks for everybody's input!! I MDC!

[aisraeltax]

Originally Posted by heathenmom

We go in to confirm the pregnancy at a 1st prenatal visit. With my insurance, the 1st prenatal is a $25 co-pay, then you don't pay another dime for the rest of the pregnancy. With my first ob/medwife experience, it took 2 months to get them to sign my FMLA forms. So, I drop off my forms the 1st visit and I have to go back 2 more times before they've signed the forms. That puts me at at least 18 weeks. No telling what kind of crap they'll have wanted to do to me & our baby between now and then. I know I can refuse anything, but it's just the stress of it. Okay, so I get the form, then I call them to tell them I'm "switching providers." Somebody on MDC told me that if you don't deliver with an ob, they can go back and bill you for all the stuff that would normally have been covered by insurance, and the insurance company may deny the claims. So, instead of the $25 co-pay, I'm afraid I'll get stuck with several hundred dollars worth of doctor's visits, on top of the midwife's fee that's already out of pocket. I'm just scared to even *start* a relationship with an ob that I might not be able to get out of easily.

as far as the 2 month ordeal, all you have to do is tell them you need the forms by x date. when you go for your first visit, get it signed then. if for some reason they cant sign it then, ask what day that week you can come pick it up b/c you HAVE to have it ASAP.

and whoever told you that you would be charged with additional fees? thats ludicruous. at each visit, they bill you for services and submit claiims to the insurance co. you pay a copay at that time. they cant go back and bill you extra. its early so i cant think of what laws that woudl violate but there are several.

[wednesday]

You're entitled to FMLA after your child's birth in order to care for your newborn, not because you are medically unable to return to work. Seems to me a birth certificate should be documentation enough. This thing where employers require new moms to have a doctor sign off about the mother's medical status makes no sense.

I guess what I'm saying is you should try claiming the "Family" part of the Family and Medical Leave Act rather than the "Medical" part.

Please see this site on FMLA guidelines for more information as it pertains to you.

ETA: even fathers are entitled to 12 weeks off after a baby is born, which a lot of people aren't aware of...but surely no one makes them go to the doctor to document that they were pregnant and just gave birth. Ask your HR for whatever documents fathers are required to fill out when they take FMLA after a child's birth, as they have every legal right to do. You should be able to fill out the same forms.

[heathenmom]

Originally Posted by wednesday

You're entitled to FMLA after your child's birth in order to care for your newborn, not because you are medically unable to return to work. Seems to me a birth certificate should be documentation enough. This thing where employers require new moms to have a doctor sign off about the mother's medical status makes no sense.

I guess what I'm saying is you should try claiming the "Family" part of the Family and Medical Leave Act rather than the "Medical" part.

Please see this site on FMLA guidelines for more information as it pertains to you.

ETA: even fathers are entitled to 12 weeks off after a baby is born, which a lot of people aren't aware of...but surely no one makes them go to the doctor to document that they were pregnant and just gave birth. Ask your HR for whatever documents fathers are required to fill out when they take FMLA after a child's birth, as they have every legal right to do. You should be able to fill out the same forms.

Actually, per my company's disability group & HR department , the first 6 weeks (or 8 weeks for a c/s) is for the recovery of the mother. That is the only part that my company will PAY for me to be out on "sick leave." Any other time I take off, while still covered under FMLA, is not considered medically necessary and I have to take vacation for it to be paid. So, while I could claim the "family" instead of the "medical," I wouldn't get paid for the time.

[heathenmom]

Originally Posted by aisraeltax

as far as the 2 month ordeal, all you have to do is tell them you need the forms by x date. when you go for your first visit, get it signed then. if for some reason they cant sign it then, ask what day that week you can come pick it up b/c you HAVE to have it ASAP.

and whoever told you that you would be charged with additional fees? thats ludicruous. at each visit, they bill you for services and submit claiims to the insurance co. you pay a copay at that time. they cant go back and bill you extra. its early so i cant think of what laws that woudl violate but there are several.

I can't for the life of me find the thread this came up in. The woman who told me this could happen said she worked in an ob office and that they were allowed to and did do this. I have no personal experience with it, it's just one more thing that I feel like I might get screwed on, ya know?