Understanding the Gaps and Overlap Between FMLA and Workers’ Compensation

When an employee is injured or becomes ill because of their job, two systems often come into play: the Family and Medical Leave Act (FMLA) and workers’ compensation. While they serve different purposes, they often overlap — and understanding how they work together can help employers avoid compliance issues and confusion.

The Basics of Each

Workers’ Compensation

Workers’ compensation isn’t one federal law — it’s a type of employer-provided insurance required under state law. It provides medical care, rehabilitation, and partial wage replacement for employees who suffer job-related injuries or illnesses. While nearly all states mandate coverage, each has its own rules for eligibility, benefits, and job reinstatement rights. Generally, it covers lost wages but does not guarantee job protection under federal law.

FMLA (Family and Medical Leave Act)

The FMLA is a federal law that gives eligible employees up to 12 weeks of unpaid, job-protected leave per year for serious health conditions, family care, or childbirth/adoption. Covered employers (those with 50 or more employees) must maintain group health benefits during leave and restore employees to the same or an equivalent position afterward.

How FMLA and Workers’ Comp Intersect

A work-related injury that causes hospitalization or incapacitates an employee for more than three days usually qualifies as a serious health condition under the FMLA. In these cases, FMLA leave and workers’ compensation benefits can run at the same time, as long as the employer designates the time off as FMLA leave and notifies the employee.

Here’s how the two often interact:

• Concurrent Leave: When both apply, the employee can receive workers’ comp benefits (wage replacement and medical care) while using FMLA-protected leave. Because workers’ comp provides income, the FMLA’s paid-leave substitution rules usually don’t apply unless both sides agree to supplement benefits.
• Light Duty: If a doctor clears an employee for light-duty work, they can choose whether to accept it. Declining the offer may stop workers’ comp payments, but FMLA job protection continues until the 12-week entitlement is used.
• Benefits: During concurrent leave, employers must maintain group health coverage as if the employee were still working.
• Medical Certification: Employers can require FMLA medical certification and also follow state workers’ comp rules for communicating with treating providers.

Employer Strategies for Managing Leave Requests

Navigating FMLA, workers’ comp, and sometimes state leave laws can be complicated. These steps can help simplify compliance:

• Know what applies. FMLA applies to employers with 50+ employees; workers’ comp generally applies to almost all employers under state law.
• Assess each case. Determine whether the situation is work-related (workers’ comp), a serious health condition (FMLA), or both.
• Run leave concurrently when appropriate. Designate qualifying time off as FMLA leave to avoid stacking separate leave periods.
• Communicate clearly. Provide written notices and explain how pay, benefits, and leave time interact.
• Plan for return-to-work. Consider light-duty options, accommodations, or ADA coverage once leave ends.

The Bottom Line

Medical leave can trigger multiple protections at once — and it’s up to employers to manage them correctly. Understanding where FMLA and workers’ compensation overlap (and where they don’t) helps ensure compliance and fairness for everyone involved. When in doubt, consult your HR advisor or legal counsel to confirm you’re meeting both federal and state requirements.