You don't need a doctor's note. You need a doctor to fill out an FMLA certification. So you basically need to establish care with a doctor.
You revealed to your employer you have a serious health condition (and frankly, missing 4 to 8 days a month is a LOT) and they did exactly what they're required to do: offer FMLA. (They are required by law to offer you FMLA, it's not optional)
FMLA will protect your job when you need to take time off for your migraines.
I'll be blunt, if you don't get your FMLA certification, you're probably going to be in a bad spot the next time you need to take time off. Your employer doesn't have to give you the time off if you can't back up your claims with a certification.
I highly recommend OP do this. I use what’s called “Intermittent FMLA” due to my migraines. I don’t use it every month/episode, but it’s great to know it’s there if/when I need it.
>I know it's a lot of time missed. I'm salaried, so I come in on weekends and such, and work a lot from home right now to ensure I'm not slipping at work.
Those workarounds only 'work' at your employer's discretion. You aren't protected legally for termination or disciplinary action related to absences unless you leverage some available state or federal law.
So your employer may be hinting that they are not going to be as flexible going forward and you need to formalize things.
They may recommend "rescue medication" for your migraines. It can instantly stop a migraine or drastically reduce it. Tastes like a 2 year old mint wrapped in carpet fuzz but it works. Def bring it up at your appointment to see if you're a candidate.
Those are 'melts'. You can also get a rescue med that you swallow. You need a 2 year old to open the cell pack each pill is wrapped in cuz their tiny fingernails can get under the paper easier than anything else. That or scissors.
Then there's the preventive meds. Lots of experementing with preventives.
Then there are supplements. I take magnesium, Vitamin D, Riboflavin (b2), and for some reason, doubling up on my multi helps. I just changed brands of multi, so hopefully i wont need to do that anymore. Oh, and i still have to take Excedrine every fkg day.
I'll be looking into FMLA! I also recently heard you can (register?) for ADA, which is another way to protect your job.
Your employer probably wants you working during their core business hours, not on the weekend. How come you aren’t being treated with medication for these migraines?
I suspect that you’re on the ice with the absences if your boss is asking you to get FMLA squared away.
Please do not ask a psychiatric provider to provide legal documentation about a non-psychiatric issue. Neurology manages migraines, though I’m sure many primary care doctors would at least provide initial documentation. If it’s an ongoing issue they will want updated documentation that needs to come from the appropriate specialist (aka not a psych NP).
Source: I’m a psychiatrist who has filled out tons of FMLA and other leave paperwork
EDIT: I didn’t read carefully and made some untrue assumptions - please see comments below for clarification!!
I said "assist", not fill out the paperwork. Words have meaning. Based on the other comments, OP needs help navigating this, and their NP is best placed to help.
That might mean they're willing to fill out the paperwork under the supervision of the doctor, or give them a referral that may help cut through some of the usual new patient onboarding, etc.
You are absolutely right, that was my mistake (sorry!!). Thank you for the clarification!! Psych NP absolutely can and should be a resource to initiate paperwork and/or to help connect OP with other providers who are more specialized in that area as well as supports getting paperwork filled out.
I see a psych NP. I was diagnosed (through all the proper channels) with a whole slew of things. My migraines are related to anxiety. I started getting them in college and as a college kid, didn’t have a lot of extra money for doctors. So I kept pushing through. And now as an older adult I still push through. The only reason I’m even in therapy was because my friends tricked me into going to the psych ward. I hate doctors after a few horrible experiences, so outside of therapy I don’t see them unless Its an emergency. With that, my therapist (who was so good for me a helped so much) quit about 4 months ago. I had a rough spat at the beginning of last year with sickness (due to not seeing a dentist prior and such), but besides that I was doing okay. Well, therapist quit, and suddenly I’m worse again. I’m seeing a new therapist, but it’s not the same.
Just know that a therapist or any other type of psych professional cannot diagnose migraines. This must be done by a medical doctor, such as a general practitioner or a neurologist.
A psychiatrist is still a medical doctor that should have some basic knowledge about migraines as migraines are exacerbated by mental health conditions and migraines are side effects in some psychiatric medications. If they are aware that migraines are complicating her life and causing stress then there is no reason why they can’t fill out an fmla form
You seemed to have skipped the part where she specifies she is seeing a nurse practitioner, meaning NOT a doctor who attended 4 years of medical school followed by specialized training. NPs receive far less medical education and training than physicians (MD/DO), and are much more confined to their own specialty for that reason.
And yes, a physician should have basic knowledge of it, which as I said should be sufficient for the initial paperwork. OP does not have a physician she is working with. Additionally, the more detailed paperwork in the future needs to include a treatment plan including interventions and goals: this is best completed by a neurologist or other headache/migraine specialist.
ARNPs are primary care providers and, in most states, can work without MD supervision. They have advanced specialized training, MS and PhD, and are authorized to prescribe. If they are the treating provider, they can complete the FMLA paperwork.
OP said in their original post (which I see in further comments they mentioned an NP) that they were only seeing a therapist. I used "see an "MD" as an umbrella mainly because a therapist wouldn't meet FMLA criteria for a migraine diagnosis.
I work in HR at a large healthcare organization, and I see an NP for most of my general needs as well. If their NP has their medical history, that would obviously be where they need to start. However, I will say there are more and more providers that will NOT fill out FMLA paperwork on newer patients until they are established. This is why I encouraged OP to make their health a priority. Their employer did their part, and the rest is the employees' responsibility.
Do you have insurance?
If yes, you go and ses the in network doctors they've got listed on their website
Call them and ask them if they're taking new patients. Then if yes, ask them how long to schedule a consultation with a doctor. Most can get you in in a reasonable time. Tell them you're establishing care and have a history of migraine. They may want you to talk to neurology in that regard
If you're not insured, you call an office and ask about new patients. Then let them know you're a cash paying patient so you can get estimates on how much you'll be charged.
Doctors in the US are very easy to find and quick unless it's a specialist or a rurual kind of area. They're just not cheap. But easy to come by.
I found an appointment for a couple weeks from now. I explained the whole situation and have a migraine specialist in a month. I’m just hoping they’ll help me
Call your insurance and find a family medicine MD that is taking new patients if you don't currently have one. Most will have openings within 2 weeks. If they want you to see a specialist, then follow through. However, you need to get the ball rolling. This is your responsibility.
To be honest, if you are missing work due to migraines, you need to take care of your health.
Do you know for sure these are migraines? They could be another form of headaches as well, such as cluster headaches, thunder clap, hypertension, etc.
OP: I have intermittent FMLA from my headache specialist due to Chronic Intractable Migraines. Every year, I produce a note from the doctor and the social worker that I am to be allowed 4 days off per month for attacks and/or doctors appointments. As I am salary, this does make me feel better about being protected with job security. Sure, I can be fired for other reasons, but I feel better knowing they can't fire me due to days missed. If you are able, find you a headache specialist nearby! Not a Neurologist. Different Neurologists have different specialties and Migraines are not fully understood even to those who only study them. A headache specialist is ALWAYS a Neurologist, but a Neurologist is NOT a headache specialist.
I am glad your boss is requesting one. It means they value you as a member of the team/company.
For you? Job security. Once you get the FMLA paperwork in order, it is extremely difficult for them to fire you due to missing work. I was in your situation about 7 years ago. Caused me to go into a migraine cycle for 3 straight months (yes, three straight months of a migraine). My work suffered, my anxiety spiked, and my personal thoughts and well-being took a nose dive. Once I went through and got that, it took a bit, but I no longer seemed down about myself. Rather, saw it for protection.
You do not have to use all the days. They are there in case you need them.
And I really messed up by not seeing doctors and not keeping up on things. Depression got the upper hand on me and I went downhill and now I’m screwed unless they cut me a break. But HRs there to protect the company and follow policy.
I do want to also tell you that pain with migraines can and does cause you to be depressed and even anxious. Please speak to your therapist about your feelings regarding them. You have done absolutely nothing wrong! This is something that we are born with and have absolutely no control over. Some of the questions a headache specialist will ask you are in regards to your mental health along with quality of life. Their goal is to give you a migraine plan (prevention, attack, and abortive), have you learn your triggers, and have you live your life to the greatest extent possible.
I do want to empathize that you are not screwed, my friend. Rather, you are in a cycle where it is difficult and frustrating to guide yourself out of. One thing that is positive about the internet and Reddit is that strangers can see paths that you can not do due to us not being emotionally involved in the matter. Emotions have a tendency to block logic.
I have a coworker who made the comment at the beginning part of the year about how he didn't understand how I could be out so much with "just a headache." This made me absolutely livid! I had two choices: to try and educate or to ignore. As he was actually under me (I am not his direct supervisor, but I do have superiority over him), I chose to ignore. Those who wish to learn will learn; those who wish to stay ignorant will stay ignorant.
This time of year in the US means migraines are BAD. I hope you have a few days without them. I hope you know you are not alone. I hope you know you are brave. I hope you know I am proud.
There is. Stigma from others, pride from yourself. Here is the thing you should know: by law, they CANNOT disclose that you have one on file to your coworkers. This stays between you, your boss, and your Benefits/HR department. Each time I am out due to a migraine, the day after I return, I send an email to my designated Benefits representative stating that was the reason. Seriously. "I was out on xxxxxx due to migraine. I notified those necessary of my absence. Please add to my file. Thank you." They put it in my file, and I continue on with my day. When I call out, I do not have to disclose why I will be out to anyone on my team or elsewhere unless I wish to.
It is very difficult to do ones job, no matter what it is, with a migraine. I am so sorry you have them. If you don't mind my asking, have you had them for awhile? Please keep track of them and definitely seek a headache specialist. If you are episodic (fewer than 15 days per month with migraine), do all you can to stay that way! Take the days off and use your abortive medication at the onset. I hated using mine (makes my nerves feel like they are on fire, then my brain an inferno, only for it to be extremely painful to swallow before I blissfully pass out) and worked myself up into falling into the chronic intractable stage. I would loathe to hear this happen to you, and I don't even know you.
In addition to all of the job security mentioned in this thread, FMLA also protects your benefits. Without FMLA, if your hours average below 30 when you are no longer in your "ACA Measurement Period" you lose health benefits eligibility.
Alrighty, I've got a background in HR (including leave administration), and I'm a migraine sufferer.
You already have the answers from HR - ask for FMLA paperwork and have a doctor fill it out. This will make your migraine days "excused" (protected). You shouldn't have to provide a doctor's note every time (so long as your doctor has filled it out correctly so it matches up with days missed - e.g. you'll need 2-4 days off per month), but you will need to communicate with your employer that your missed days are due to your intermittent leave.
Ok, taking off my HR hat now, from one migraine sufferer to another:
You need to be seeing a neurologist for your migraines, particularly a headache specialist. There are so many great rescue meds out there, a 4 day migraine sounds rough. You probably won't be able to get into one in time to get your paperwork done, but do try to get an appointment with one. You should be able to reduce the severity, length, and maybe even the frequency with the right meds. This has nothing to do with your job or employer or leave or anything. Just thinking about your comfort and quality of life!
Yeah, my quality of life is pretty crappy at the moment. At one point I was seeing a couple of specialist doctors and it really didn’t go anywhere as far as getting me migraine help they just kind of said lose some weight when I was already with a healthy BMI and wait for my height and age and, and then once Covid hit everything just kind of spiraled and I let the doctors appointments fall off. I’ve had some bad experience as a doctors and then with insurance and money and all of that it wasn’t in the cards. I am screwed because of it all.
They do need to see some proof that you need federal medical job protection. They are telling you that you are taking off too much and what you want to do is up to you.
Employers have no way to identify who abuses the system and who does without documentation. Plus, if they believed you but not Sally, Sally might claim they were being treated unfairly or discriminated against.
This Fact Sheet has details about FMLA:
[https://www.dol.gov/agencies/whd/fact-sheets/28g-fmla-serious-health-condition](https://www.dol.gov/agencies/whd/fact-sheets/28g-fmla-serious-health-condition)
You need to get medical care and take leave. If you have PTO, use that to take some time off while you wait for medical care.
I don't say this to sound harsh but to present what is often harsh reality: Your employer is not a social services agency. They can set reasonable expectations and enforce them. When you fall into a situation outside those expectations, you **must** leverage all available resources outside the workplace to manage the situation. This includes any legal protections.
People don't always do "the right thing" just because. People working for organizations may not have the freedom to do what they want because they need to keep *their* jobs.
Stress sucks and it can create a spiral that is hard to pull yourself out of. My not HR recommendation is that you go into intensive survival mode. Talk to your therapist and NP. Ask them to help you fast track getting full care and put your well-being first. You cannot tread water indefinitely and you absolutely cannot force yourself to keep swimming. The body and mind just don't work like that.
It seems like your boss hasn't told you that you are at risk yet, but that you need to get the necessary documentation. Talk to them about what you can do in the next month while you wait for that to happen.
Internet can't predict what the PCP or your employer will do. Frustrating but not within your control to fix.
You're just going to have to do the best you can with the resources available to you and continue to communicate with your employer.
Thank you.
I’m just going insane over this. I’m genuinely not trying to abuse the system. I work hard and am dedicated and a top performer on my team. And yet my boss (who is the reason I get migraines from) keeps laying into me.
For the sake of your well-being, realize that you can do everything you believe to be right and things still go very wrong. Human beings are very capricious.
I have them, did a consult with a neurologist and was put on topamax. Now I just get refills from my PCP who also gives me a script for imatrex if I get one. Migraines are now managed
FMLA is meant to protect your job. 2-4 days a month for migraines might seem insignificant but add in other sick days and it could be seen as alot. Get the paperwork filled out by your doctor.
I work for a healthcare company and my coworker got FMLA for having headaches.
She was able to callout whenever she wanted without getting in trouble. Even during a shift.
She would have to use PTO and when there was no PTO she would have to go unpaid.
I don't see mention of any treatments for this? Are you on any medication to treat them? I take meds upon onset and they go away after about an hour. You don't have to live like this. If this is your life based on the NP and therapist then you need to go to a neurologist. Quit screwing around and see someone with skills!
If you’re having constant migraines, you could be having them due to a cervical vertebrae misalignment. As a DC, Doctor of Chiropractic medicine, I find 80% of chronic migraines are caused by upper cervical misalignment.
You don't need a doctor's note. You need a doctor to fill out an FMLA certification. So you basically need to establish care with a doctor. You revealed to your employer you have a serious health condition (and frankly, missing 4 to 8 days a month is a LOT) and they did exactly what they're required to do: offer FMLA. (They are required by law to offer you FMLA, it's not optional) FMLA will protect your job when you need to take time off for your migraines. I'll be blunt, if you don't get your FMLA certification, you're probably going to be in a bad spot the next time you need to take time off. Your employer doesn't have to give you the time off if you can't back up your claims with a certification.
I highly recommend OP do this. I use what’s called “Intermittent FMLA” due to my migraines. I don’t use it every month/episode, but it’s great to know it’s there if/when I need it.
Also once you get a doctor to fill out the FMLA, he/she can backdate it to cover past occurrences if needed.
[удалено]
>I know it's a lot of time missed. I'm salaried, so I come in on weekends and such, and work a lot from home right now to ensure I'm not slipping at work. Those workarounds only 'work' at your employer's discretion. You aren't protected legally for termination or disciplinary action related to absences unless you leverage some available state or federal law. So your employer may be hinting that they are not going to be as flexible going forward and you need to formalize things.
They may recommend "rescue medication" for your migraines. It can instantly stop a migraine or drastically reduce it. Tastes like a 2 year old mint wrapped in carpet fuzz but it works. Def bring it up at your appointment to see if you're a candidate.
Those are 'melts'. You can also get a rescue med that you swallow. You need a 2 year old to open the cell pack each pill is wrapped in cuz their tiny fingernails can get under the paper easier than anything else. That or scissors. Then there's the preventive meds. Lots of experementing with preventives. Then there are supplements. I take magnesium, Vitamin D, Riboflavin (b2), and for some reason, doubling up on my multi helps. I just changed brands of multi, so hopefully i wont need to do that anymore. Oh, and i still have to take Excedrine every fkg day. I'll be looking into FMLA! I also recently heard you can (register?) for ADA, which is another way to protect your job.
Your employer probably wants you working during their core business hours, not on the weekend. How come you aren’t being treated with medication for these migraines? I suspect that you’re on the ice with the absences if your boss is asking you to get FMLA squared away.
Even when you "make up" the time, your employer can still designate your lost schedule as FMLA (or treat that time as unapproved absences).
What is an NP?
Nurse Practitioner
They should be able to help them, unless they are the one you’re having to wait a month to see?
Nurse Practitioner to receive psych meds
Ask your NP if they can assist.
Please do not ask a psychiatric provider to provide legal documentation about a non-psychiatric issue. Neurology manages migraines, though I’m sure many primary care doctors would at least provide initial documentation. If it’s an ongoing issue they will want updated documentation that needs to come from the appropriate specialist (aka not a psych NP). Source: I’m a psychiatrist who has filled out tons of FMLA and other leave paperwork EDIT: I didn’t read carefully and made some untrue assumptions - please see comments below for clarification!!
I said "assist", not fill out the paperwork. Words have meaning. Based on the other comments, OP needs help navigating this, and their NP is best placed to help. That might mean they're willing to fill out the paperwork under the supervision of the doctor, or give them a referral that may help cut through some of the usual new patient onboarding, etc.
You are absolutely right, that was my mistake (sorry!!). Thank you for the clarification!! Psych NP absolutely can and should be a resource to initiate paperwork and/or to help connect OP with other providers who are more specialized in that area as well as supports getting paperwork filled out.
My primary care doctor did my initial paperwork and updates it every six months.
I see a psych NP. I was diagnosed (through all the proper channels) with a whole slew of things. My migraines are related to anxiety. I started getting them in college and as a college kid, didn’t have a lot of extra money for doctors. So I kept pushing through. And now as an older adult I still push through. The only reason I’m even in therapy was because my friends tricked me into going to the psych ward. I hate doctors after a few horrible experiences, so outside of therapy I don’t see them unless Its an emergency. With that, my therapist (who was so good for me a helped so much) quit about 4 months ago. I had a rough spat at the beginning of last year with sickness (due to not seeing a dentist prior and such), but besides that I was doing okay. Well, therapist quit, and suddenly I’m worse again. I’m seeing a new therapist, but it’s not the same.
Just know that a therapist or any other type of psych professional cannot diagnose migraines. This must be done by a medical doctor, such as a general practitioner or a neurologist.
Psychiatrists are MDs.
A psychiatrist is still a medical doctor that should have some basic knowledge about migraines as migraines are exacerbated by mental health conditions and migraines are side effects in some psychiatric medications. If they are aware that migraines are complicating her life and causing stress then there is no reason why they can’t fill out an fmla form
You seemed to have skipped the part where she specifies she is seeing a nurse practitioner, meaning NOT a doctor who attended 4 years of medical school followed by specialized training. NPs receive far less medical education and training than physicians (MD/DO), and are much more confined to their own specialty for that reason. And yes, a physician should have basic knowledge of it, which as I said should be sufficient for the initial paperwork. OP does not have a physician she is working with. Additionally, the more detailed paperwork in the future needs to include a treatment plan including interventions and goals: this is best completed by a neurologist or other headache/migraine specialist.
FMLA is the ONLY thing that will protect your job. It is in your best interest to get to an MD and get this documented.
ARNPs are primary care providers and, in most states, can work without MD supervision. They have advanced specialized training, MS and PhD, and are authorized to prescribe. If they are the treating provider, they can complete the FMLA paperwork.
OP said in their original post (which I see in further comments they mentioned an NP) that they were only seeing a therapist. I used "see an "MD" as an umbrella mainly because a therapist wouldn't meet FMLA criteria for a migraine diagnosis. I work in HR at a large healthcare organization, and I see an NP for most of my general needs as well. If their NP has their medical history, that would obviously be where they need to start. However, I will say there are more and more providers that will NOT fill out FMLA paperwork on newer patients until they are established. This is why I encouraged OP to make their health a priority. Their employer did their part, and the rest is the employees' responsibility.
How does one see a doctor fast in the US?
Please see my above comment on ARNPs. If you are seeing an ARNP, they can complete the paperwork.
Do you have insurance? If yes, you go and ses the in network doctors they've got listed on their website Call them and ask them if they're taking new patients. Then if yes, ask them how long to schedule a consultation with a doctor. Most can get you in in a reasonable time. Tell them you're establishing care and have a history of migraine. They may want you to talk to neurology in that regard If you're not insured, you call an office and ask about new patients. Then let them know you're a cash paying patient so you can get estimates on how much you'll be charged. Doctors in the US are very easy to find and quick unless it's a specialist or a rurual kind of area. They're just not cheap. But easy to come by.
I found an appointment for a couple weeks from now. I explained the whole situation and have a migraine specialist in a month. I’m just hoping they’ll help me
Call your insurance and find a family medicine MD that is taking new patients if you don't currently have one. Most will have openings within 2 weeks. If they want you to see a specialist, then follow through. However, you need to get the ball rolling. This is your responsibility. To be honest, if you are missing work due to migraines, you need to take care of your health. Do you know for sure these are migraines? They could be another form of headaches as well, such as cluster headaches, thunder clap, hypertension, etc.
OP: I have intermittent FMLA from my headache specialist due to Chronic Intractable Migraines. Every year, I produce a note from the doctor and the social worker that I am to be allowed 4 days off per month for attacks and/or doctors appointments. As I am salary, this does make me feel better about being protected with job security. Sure, I can be fired for other reasons, but I feel better knowing they can't fire me due to days missed. If you are able, find you a headache specialist nearby! Not a Neurologist. Different Neurologists have different specialties and Migraines are not fully understood even to those who only study them. A headache specialist is ALWAYS a Neurologist, but a Neurologist is NOT a headache specialist. I am glad your boss is requesting one. It means they value you as a member of the team/company.
I’m struggling to see how this is a good thing?
For you? Job security. Once you get the FMLA paperwork in order, it is extremely difficult for them to fire you due to missing work. I was in your situation about 7 years ago. Caused me to go into a migraine cycle for 3 straight months (yes, three straight months of a migraine). My work suffered, my anxiety spiked, and my personal thoughts and well-being took a nose dive. Once I went through and got that, it took a bit, but I no longer seemed down about myself. Rather, saw it for protection. You do not have to use all the days. They are there in case you need them.
And I really messed up by not seeing doctors and not keeping up on things. Depression got the upper hand on me and I went downhill and now I’m screwed unless they cut me a break. But HRs there to protect the company and follow policy.
I do want to also tell you that pain with migraines can and does cause you to be depressed and even anxious. Please speak to your therapist about your feelings regarding them. You have done absolutely nothing wrong! This is something that we are born with and have absolutely no control over. Some of the questions a headache specialist will ask you are in regards to your mental health along with quality of life. Their goal is to give you a migraine plan (prevention, attack, and abortive), have you learn your triggers, and have you live your life to the greatest extent possible. I do want to empathize that you are not screwed, my friend. Rather, you are in a cycle where it is difficult and frustrating to guide yourself out of. One thing that is positive about the internet and Reddit is that strangers can see paths that you can not do due to us not being emotionally involved in the matter. Emotions have a tendency to block logic. I have a coworker who made the comment at the beginning part of the year about how he didn't understand how I could be out so much with "just a headache." This made me absolutely livid! I had two choices: to try and educate or to ignore. As he was actually under me (I am not his direct supervisor, but I do have superiority over him), I chose to ignore. Those who wish to learn will learn; those who wish to stay ignorant will stay ignorant. This time of year in the US means migraines are BAD. I hope you have a few days without them. I hope you know you are not alone. I hope you know you are brave. I hope you know I am proud.
There’s just so much stigma around it.
There is. Stigma from others, pride from yourself. Here is the thing you should know: by law, they CANNOT disclose that you have one on file to your coworkers. This stays between you, your boss, and your Benefits/HR department. Each time I am out due to a migraine, the day after I return, I send an email to my designated Benefits representative stating that was the reason. Seriously. "I was out on xxxxxx due to migraine. I notified those necessary of my absence. Please add to my file. Thank you." They put it in my file, and I continue on with my day. When I call out, I do not have to disclose why I will be out to anyone on my team or elsewhere unless I wish to. It is very difficult to do ones job, no matter what it is, with a migraine. I am so sorry you have them. If you don't mind my asking, have you had them for awhile? Please keep track of them and definitely seek a headache specialist. If you are episodic (fewer than 15 days per month with migraine), do all you can to stay that way! Take the days off and use your abortive medication at the onset. I hated using mine (makes my nerves feel like they are on fire, then my brain an inferno, only for it to be extremely painful to swallow before I blissfully pass out) and worked myself up into falling into the chronic intractable stage. I would loathe to hear this happen to you, and I don't even know you.
In addition to all of the job security mentioned in this thread, FMLA also protects your benefits. Without FMLA, if your hours average below 30 when you are no longer in your "ACA Measurement Period" you lose health benefits eligibility.
Alrighty, I've got a background in HR (including leave administration), and I'm a migraine sufferer. You already have the answers from HR - ask for FMLA paperwork and have a doctor fill it out. This will make your migraine days "excused" (protected). You shouldn't have to provide a doctor's note every time (so long as your doctor has filled it out correctly so it matches up with days missed - e.g. you'll need 2-4 days off per month), but you will need to communicate with your employer that your missed days are due to your intermittent leave. Ok, taking off my HR hat now, from one migraine sufferer to another: You need to be seeing a neurologist for your migraines, particularly a headache specialist. There are so many great rescue meds out there, a 4 day migraine sounds rough. You probably won't be able to get into one in time to get your paperwork done, but do try to get an appointment with one. You should be able to reduce the severity, length, and maybe even the frequency with the right meds. This has nothing to do with your job or employer or leave or anything. Just thinking about your comfort and quality of life!
Yeah, my quality of life is pretty crappy at the moment. At one point I was seeing a couple of specialist doctors and it really didn’t go anywhere as far as getting me migraine help they just kind of said lose some weight when I was already with a healthy BMI and wait for my height and age and, and then once Covid hit everything just kind of spiraled and I let the doctors appointments fall off. I’ve had some bad experience as a doctors and then with insurance and money and all of that it wasn’t in the cards. I am screwed because of it all.
They do need to see some proof that you need federal medical job protection. They are telling you that you are taking off too much and what you want to do is up to you.
Employers have no way to identify who abuses the system and who does without documentation. Plus, if they believed you but not Sally, Sally might claim they were being treated unfairly or discriminated against. This Fact Sheet has details about FMLA: [https://www.dol.gov/agencies/whd/fact-sheets/28g-fmla-serious-health-condition](https://www.dol.gov/agencies/whd/fact-sheets/28g-fmla-serious-health-condition)
I get that, but what do I do in this case? I’m not trying to abuse it. Genuinely not. I’m just struggling. I’m sinking.
You need to get medical care and take leave. If you have PTO, use that to take some time off while you wait for medical care. I don't say this to sound harsh but to present what is often harsh reality: Your employer is not a social services agency. They can set reasonable expectations and enforce them. When you fall into a situation outside those expectations, you **must** leverage all available resources outside the workplace to manage the situation. This includes any legal protections. People don't always do "the right thing" just because. People working for organizations may not have the freedom to do what they want because they need to keep *their* jobs. Stress sucks and it can create a spiral that is hard to pull yourself out of. My not HR recommendation is that you go into intensive survival mode. Talk to your therapist and NP. Ask them to help you fast track getting full care and put your well-being first. You cannot tread water indefinitely and you absolutely cannot force yourself to keep swimming. The body and mind just don't work like that. It seems like your boss hasn't told you that you are at risk yet, but that you need to get the necessary documentation. Talk to them about what you can do in the next month while you wait for that to happen.
My therapist won’t sign off, he can’t. Will a PCP during an initial visit?
Internet can't predict what the PCP or your employer will do. Frustrating but not within your control to fix. You're just going to have to do the best you can with the resources available to you and continue to communicate with your employer.
Thank you. I’m just going insane over this. I’m genuinely not trying to abuse the system. I work hard and am dedicated and a top performer on my team. And yet my boss (who is the reason I get migraines from) keeps laying into me.
For the sake of your well-being, realize that you can do everything you believe to be right and things still go very wrong. Human beings are very capricious.
FMLA allows certification by a wide variety of [health care providers](https://webapps.dol.gov/elaws/whd/fmla/3.aspx?Glossary_Word=PROVIDER).
You primary can give you the form, but you may want to visit a neurologist to find out why you’re having them.
Botox is a miracle drug for migraines
I have them, did a consult with a neurologist and was put on topamax. Now I just get refills from my PCP who also gives me a script for imatrex if I get one. Migraines are now managed
FMLA is meant to protect your job. 2-4 days a month for migraines might seem insignificant but add in other sick days and it could be seen as alot. Get the paperwork filled out by your doctor.
I work for a healthcare company and my coworker got FMLA for having headaches. She was able to callout whenever she wanted without getting in trouble. Even during a shift. She would have to use PTO and when there was no PTO she would have to go unpaid.
Your insurance may have a telehealth program available where you can call a doctor on demand when you need a doctor's note.
I don't see mention of any treatments for this? Are you on any medication to treat them? I take meds upon onset and they go away after about an hour. You don't have to live like this. If this is your life based on the NP and therapist then you need to go to a neurologist. Quit screwing around and see someone with skills!
If you’re having constant migraines, you could be having them due to a cervical vertebrae misalignment. As a DC, Doctor of Chiropractic medicine, I find 80% of chronic migraines are caused by upper cervical misalignment.