# FMLA Medical Certifications > Overview This article focuses on the medical certification process under the federal Family and Medical Leave Act FMLA The information here is based on the Source: https://help.hellotilt.com/en_us/fmla-medical-certifications-rJwSpkKoke Last updated: 2025-03-07T22:11:21.810Z ## Overview This article focuses on the medical certification process under the federal Family and Medical Leave Act (FMLA). The information here is based on the FMLA regulations and guidance from the Department of Labor (DOL), the agency that enforces the FMLA.  ## Table of Contents [When is a Medical Certification Needed Under the FMLA?](#when-is) [Information Needed on an FMLA Medical Certification](#information-needed) [How Often Can the Employer Ask for an Updated Medical Certification?](#how-often)     [Second/Third Opinion](#opinion)     [Annual Renewal](#annual-renewal)     [Recertification](#recertification) [Other Considerations](#other-considerations) ## When is a Medical Certification Needed Under the FMLA? Under the FMLA, employers may require that employees submit a medical certification to support a leave of absence for the employee’s own serious health condition (including pregnancy/childbirth), the care of a family member with a serious health condition, or the care of a covered servicemember with a serious injury or illness.  When an employee requests leave for one of these reasons, the employer must give the employee written notice that a medical certification is required. In most cases, the employee must submit the completed certification within 15 calendar days.  The employer must also alert the employee to any potential consequences if the certification is not returned timely or if it is incomplete or insufficient.  There is no official form that must be used for the medical certification–although the DOL does offer optional forms–but the employer must supply the employee with a blank medical certification if one is needed. (For a list of the leave forms used at Tilt, please see this article.)  The FMLA regulations say that a certification is incomplete if one or more of the applicable entries have not been completed, and is insufficient if the information provided is vague, ambiguous, or non-responsive.  If the certification is deemed to be incomplete or insufficient, the employer must notify the employee in writing and allow the employee 7 calendar days to cure it and resubmit it.  ## Information Needed on an FMLA Medical Certification When the employee is requesting leave for their own serious health condition or for the care of a family member, the FMLA regulations say that employers can require that the medical certification include the following information: * Contact information of the health care provider as well as their medical credentials; * The date which the condition began, and its estimated duration;  * A statement of appropriate medical facts regarding the patient's health condition, which may include information on symptoms, diagnosis\*, hospitalization, doctor visits, medication, referrals for evaluation or treatment, or any other regimen of continuing treatment; * If the employee needs leave for their own condition, then information sufficient to establish that they cannot perform the essential functions of their job, and the nature and duration of any work restrictions; * If the employee needs leave to care for a family member, then information sufficient to establish that the family member needs care and that care by the employee is medically necessary, and an estimate of the frequency and duration of the leave required for the employee to care for the family member; and * For intermittent or reduced schedule leaves, information sufficient to establish the medical necessity and an estimate of the dates and duration of such treatments and any periods of recovery as well as the frequency and duration of episodes of incapacity. \*In California, employers cannot ask for a diagnosis, but employees can disclose one if they choose.  ## How Often Can the Employer Ask for an Updated Medical Certification? If the FMLA medical certification is complete and sufficient, the employer generally cannot ask for additional information. However, there are some exceptions to this rule: ### Second/Third Opinion If an employer has reason to doubt the validity of a medical certification, they may require the employee to obtain a second opinion at the employer’s expense. The employer can choose the healthcare provider for this second opinion, but typically, the selected provider cannot be someone the employer regularly employs.  If the opinions of the employee’s and employer’s designated healthcare providers differ, the employer may request a third opinion, also at the employer’s expense. This third opinion will be final and binding. The third healthcare provider must be chosen or approved jointly by both the employer and the employee, with both parties acting in good faith to reach an agreement on the selection. ### Annual Renewal  If an employee requires leave for their own serious health condition or to care for a family member that continues beyond one leave year, the employer can request a new medical certification for each additional leave year. Annual renewals are sometimes called recertifications. * For example, if the employee began their leave on May 1 of last year, the initial medical certification could be valid through April 30 of this year (a full leave year), assuming the health care provider certified that leave time. ### Recertification Recertification under the FMLA is the employer’s ability to ask for another medical certification, even if they have already received a complete and sufficient one for the same leave reason.  Generally, an employer may only request recertification after 30 days–and only in connection with an absence by the employee–if the employee is using leave for their own serious health condition or for the care of a family member.  If the certified leave is longer than 30 days, the employer must wait until that leave ends before requesting a recertification. However, in all cases, an employer may request a recertification every six months–and only in connection with an absence by the employee. There are some exceptions to the rules listed above, and in these instances, an employer may request a recertification of the employee’s approved leave, as outlined in the FMLA regulations: * **The circumstances described by the previous certification have changed significantly.** For example, if the certification noted that the employee would need 1 treatment per month, but the employee consistently reports 4 treatments per month. Or, if the certification noted that the employee would only need time off for treatments, but the employee consistently reports absences for episodes of incapacity. Or, if the certification noted that the employee would have unpredictable flare-ups of their condition, but the employee consistently reports a flare-up every Friday afternoon. All of these examples could mean that the circumstances have changed significantly.  * **The employer receives information that casts doubt upon the employee's stated reason for the absence or the continuing validity of the certification.** For example, if an employee has a chronic foot pain condition and reports an absence for an episode of incapacity, but posts on social media that they ran a 5k race that afternoon, then that could mean that the employer might have doubts about the stated reason for the absence. If you are considering recertification for an employee, please reach out to your Leave Success Manager for next steps.  ## Other Considerations This article focuses on the medical certification process under the FMLA. The information here is based on the FMLA regulations and guidance from the DOL. While many state laws follow the same regulations as the FMLA, some have their own rules around medical certifications. Please reach out to your Leave Success Manager with questions.  ## Related articles [What is FMLA and How Does it Work](https://help.hellotilt.com/what-is-fmla-and-how-does-it-work-ByT1EMELi#what-is) [Intermittent Leaves of Absence](https://help.hellotilt.com/en_us/intermittent-leaves-of-absence-SJk3Iz2aj) [Types of Documentation that Support an LOA](https://help.hellotilt.com/types-of-documentation-that-support-an-loa-SJmNPT_D3)