Looking for a Oregon Legal Forms And Templates? Download it for free!

DEFINITIONS

This page defines the various serious health condition categories listed in section 1, A-G on the front of this certification.

A “serious health condition” is defined as an illness, impairment, physical or mental condition that involves one or

more of the following:

A. Hospital care: Inpatient care (i.e. overnight stay) in a hospital, hospice, or residential medical care facility, including

any period of incapacity or subsequent treatment in connection with or as a consequence of such inpatient care.

B. Absence plus treatment: A period of incapacity of more than three consecutive calendar days, including any

subsequent treatment or period of incapacity relating to the same condition, that also involves one or both of the

following:

a. Treatment received in person, two or more times by a health care provider, a nurse, or a physician’s assistant

under direct supervision of a health care provider, or a provider of health care services (e.g., physical therapist)

under orders of or referred by a health care provider.

b. Treatment by a health care provider on at least one occasion resulting in a regimen of continuing treatment under

the supervision of the health care provider.

c. Regimen of Continuing Treatment: Includes a course of prescription medication such as an antibiotic or physical

therapy requiring special equipment to resolve or alleviate the health condition. A regimen of treatment does not

include taking over-the-counter medications such as aspirin, antihistamines or salves, bed-rest, drinking fluids,

exercise, and other similar activities that an individual can initiate without a visit to a health care provider.

C. Pregnancy or pregnancy disability: Any period of incapacity for pregnancy, pregnancy-related illness including

severe morning sickness, or for prenatal care or post pregnancy recovery.

D. Chronic conditions requiring treatments: A chronic serious health condition is one which:

a. Requires periodic in-person treatments by a healthcare provider, nurse, or physician’s assistant under direct

supervision of a healthcare provider.

b. Continues over an extended period of time, including recurring episodes of a single underlying condition.

c. May cause episodic rather than continuing periods of incapacity; for example, asthma, diabetes, epilepsy.

E. Permanent or long-term conditions requiring supervision: A period of incapacity that is permanent or long-term

due to a condition for which treatment is potentially ineffective. The employee or family member is under supervision

of a health care provider, not necessarily receiving active treatment. Examples are Alzheimer’s disease, a severe

stroke, the terminal stages of a disease.

F. Multiple treatments (non-chronic conditions): Any period of absence to receive multiple treatments (including any

period of recovery) by a health care provider or by a provider of health care services under orders of, or on referral by

a health care provider for restorative surgery after an accident or other injury, or for a condition that in the absence of

treatment or medical intervention, will likely result in a period of incapacity of more than three consecutive calendar

days. For example: chemotherapy or radiation for cancer, physical therapy for severe arthritis, dialysis for kidney

disease.

G. None of the above: The patient does not have a serious health condition as described above.

Incapacity: The inability to work, attend school or perform other regular daily activities due to a serious health

condition or treatment for or recovery from a serious health condition.

Family Medical Leave Act (Fmla) And Oregon Family Leave Act (Ofla) Forms Packet, Form Cd 1422 - Employee Medical Status Report Page 3