5.06.16 – (LAA/LUS) – APFA Health Department Update – Benefits Questions and Answers

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Friday, May 6, 2016

 

APFA Health Department Update – Benefits Questions and Answers – LAA/LUS

Why can I only receive prescriptions for 30 days and not 90 days at some CVS pharmacies?
CVS bought the pharmacies that were inside the Target stores. They are in the process of changing these store pharmacies to the CVS brand. It may take another year or so before this changeover is complete. In the meantime, CVS stores that are in the Target stores have not been integrated into the CVS systems for Express Scripts. If a Flight Attendant tries to get a 90-day prescription at the CVS in the Target store, it would be rejected. Flight Attendants need to use the stand alone CVS stores for their 90-day supply to be covered.

Why do I get a letter from the Company when I call out sick, even if I already have FMLA?
Under the FMLA regulations (825.300 (b) and (c)) the employer, when the Company acquires knowledge that an employee may be eligible for FMLA (e.g. you call out sick) they must notify the employee of their eligibility to take FMLA. This begins a clock for the employee to submit their FMLA application.  If you do not submit the application in a timely manner, you are not eligible for FMLA. The Company can then say they did their part by notifying the Flight Attendant.

Common errors made by Flight Attendants on the FMLA application that causes denials or issues:

1. Question #2 on the application is left blank.  If it is for the employee check “self”.  If for the care of a family member, check the appropriate box.
2. Questions 7 – 13 are all checked “no”.  One or more of them must be checked “yes”.
3. Questions #7 is for an overnight stay in the hospital.  This automatically qualifies the flight attendant for FMLA, as long as they have the number of duty hours and FMLA days available.
4. Question #14 can state why the Flight Attendant cannot perform their Flight Attendant duties, i.e. cannot bend, lift, stoop, push/pull, ,has weight restrictions on lifting, etc.
5. Questions #16 is for a block leave and the amount of time off you will need.
6. Question #17 is for an intermittent leave.  The start and end dates are for one year, e.g. May 3, 2106 to May 2, 2017.  Intermittent leaves must be applied for every year.
7. Frequency under #17 is extremely important. The number of times per year is often preferred. If the doctor states one time per month, and the flight attendant needs more than one episode in a month, another form must be completed. A Flight Attendant may want their physician to document 5 -6 times per year or 10 – 15 times per year depending on past history of the re-occurrence of the condition. In this manner, if a Flight Attendant has a second episode in a month, it is covered without completing a new form. The need for completing a new form is based upon Federal Law and how the physician is certifying the leave.
8. Under 17 B, the number of days may also be 1 -4, 1-6, etc. If the doctor states 3 days only and a fourth day is needed, another form must be completed.

Gabby Harty
APFA National Health Chair
[email protected]