A serious health condition is an illness, injury, impairment, or physical or mental condition that involves (A) Inpatient Care
in a hospital, hospice, nursing home or residential medical care facility; or (B) Continuing Treatment
, including outpatient treatment, by a Health Care Provider. A person has a serious health condition if they have one or more of the following conditions listed below.
- Inpatient care: an overnight stay in a hospital, hospice, nursing home, or residential medical care facility. This may also include any subsequent treatment in connection with the inpatient care. Leave is covered even if the surgery is elective but requires an overnight stay.
- Continuing treatment by a Health Care Provider (one or more of the following)
- Incapacity5 and treatment: (including pregnancy) A period of incapacity of more than 3 consecutive calendar days, and any subsequent treatment or period of incapacity relating to the same condition, but it must also involve:
- Two or more in-person visits to a health care provider or by a nurse or physician’s assistant under direct supervision of a health care provider, or by a provider of health care services (e.g. physical therapist) under orders of, or on referral by, a health care provider for treatment within 30 days of the first day of incapacity, unless extenuating circumstances exist.
- At least one in-person visit to a health care provider for treatment within seven days of the first day of incapacity, which results in a regimen of continuing treatment under the supervision of the health care provider.
- Chronic conditions requiring treatments: any period of incapacity due to or treatment for a chronic serious health condition (such as diabetes, epilepsy, asthma) which
- Requires periodic visits for treatment by a healthcare provider at least twice a year; and
- Continues over an extended period of time (including recurring episodes of a single underlying condition); and
- May cause episodic incapacity rather than a continuing period of incapacity.
Any period of incapacity due to pregnancy, or for prenatal care.
Permanent/long-term conditions: A period of Incapacity which is permanent or long-term due to a condition for which treatment may not be effective, but which requires the continuing supervision of a Health Care Provider. Examples include Alzheimer’s disease; terminal states of cancer; severe stroke.
Multiple treatments for non-chronic conditions (such as chemotherapy; physical therapy):
- Restorative surgery after an accident or other injury; or
- A condition that would likely result in a period of incapacity of more than 3 consecutive full calendar days if the employee or employee’s family member did not receive treatment .