Health care and disability related legislation

Occupational Safety and Health Administration (OSHA) Regulations

OSHA’s mission it to assure safe and healthful workplaces by setting and enforcing standards, and by providing training, outreach, education and assistance. Employers are also required to keep their workplaces free of “serious recognized hazards.

OSHA standards are rules that describe the method that employers must use to protect their employees from hazards. OSHA standards cover the areas of construction work, agriculture, maritime operations and general industry. These standards limit the amount of hazardous chemicals workers can be exposed to, require the use of certain safe practices and equipment, and require employers to monitor hazards and keep records of workplace injuries and illnesses. Examples of OSHA standards include, provide fall protection, prevent some infections diseases, prevent exposure to harmful substances like asbestos, and provide training for certain dangerous jobs. There is also a General Duty Clause, which requires employers to keep their workplace free of serious recognized hazards. 
OSHA covers private sector workers. Employees who work for state and local government are not covered by Federal OSHA. These state and local government workers may have an OSHA approved state program. Federal agencies must have a safety and health program that meet the same standards as private employers. OSHA does not fine federal agencies, but it does monitor federal agencies and respond to workers complaints.

Family Medical Leave Act (FMLA)

The Family and Medical Leave Act (FMLA) provides eligible employees up to 12 workweeks of unpaid leave a year for specified family and medical reasons, and requires group health benefits to be maintained during the leave as if employees continued to work instead of taking leave. Employees are also entitled to return to their same or an equivalent job at the end of their FMLA leave.

Eligible employees are those that:

  • work for a covered employer (public agencies, including State and Federal employers as well as local schools and private sector employees working for companies with 50 or more employees)
  • have worked 1,250 hours during the 12 months prior to the start of leave
  • have worked for the employer for 12 months.

FMLA may be take for:

  • birth, adoption, or foster care of a child
  • care of spouse, child or parent who has a serious health condition
  • serious health condition that makes the employee unable to perform the essential functions of his or her job

FMLA does not have to be take all at one, it can be taken intermittently- taking leave in separate blocks of time for a single qualifying reason-  or to reduce the employee’s daily or weekly work schedule. FMLA works on a rolling year not a calendar year. The first day leave is taken as the beginning of the year.

The FMLA only requires unpaid leave. However, the law permits an employee to elect, or the employer to require the employee, to use accrued paid vacation leave, paid sick or family leave for some or all of the FMLA leave period. An employee must follow the employer’s normal leave rules in order to substitute paid leave. When paid leave is used for an FMLA-covered reason, the leave is FMLA-protected. If leave is unpaid, the employee must continue to pay their portion of their medical insurance that was normally deducted from their paycheck.

Mental Health Parity Act of 1996

The Mental Health Parity Act does not mandate mental health benefits to be offered in health insurance plans. However, It does require that when this benefit is provided, no lifetime or annual dollar limits on mental health care can be imposed, unless the same limits apply to medical or surgical benefits.  Substance abuse and chemical dependency are not covered under this act.

Pregnancy Discrimination Act

The pregnancy Discrimination Act:

  • forbids discrimination based on pregnancy in any aspect of employment, including hiring, firing, pay, job assignments, leave and health insurance.
  • Requires health insurance provided by the employer to cover expenses for pregnancy related conditions on the same basis as costs for other medical conditions.
  • Ensures employees on leave due to pregnancy related conditions are treated the same as other temporarily disabled employees.

Newborns’ and Mothers’ Health Protection Act of 1996

The Newborns’ and Mothers’ Health Protection Act requires that health plans and insurance issuers not restrict a mother’s or newborn’s benefits for a hospital length of stay that is connected to childbirth to less than 48 hours following a vaginal delivery or 96 hours following a delivery by cesarean section. However, the attending provider (who may be a physician or nurse midwife) may decide, after consulting with the mother, to discharge the mother or newborn child earlier.

Incentives (either positive or negative) that could encourage an attending provider to give less than the minimum protections under the Act as described above are prohibited.

A mother cannot be encouraged to accept less than the minimum protections available to her under the Newborns’ Act and an attending provider cannot be induced to discharge a mother or newborn earlier than 48 or 96 hours after delivery.

Women’s Health and Cancer Rights Act of 1998

Requires the group health plans that provide coverage for mastectomies also cover the following services:

  • Reconstruction of the breast that was removed by mastectomy
  • Surgery and reconstruction of the other breast to make the breasts appear symmetrical
  • Breast prostheses
  • Complications at all stages of mastectomy including lymphedema