FMLA Response Scripting Flashcards
Try to come up with responses that are simple, short and complete
What could you say to a caller when you need to add disability to an ABS only claim?
I’m just updating your claim so that we will review for disability as well as absence. I will be getting this transferred to claim’s manager who handles disability and we will be sending you a letter to let you know if anything additional will be needed
(If whole claim is still pending CSP should instead adv EE what is currently needed)
How do you explain Salary Continuance Reimbursement?
We are sending your DBL to your ER as a partial reimbursement because they have reported that they are continuing to pay you.
If an EE asks when they will have ABS time coming back to them and the calendar basis is rolling backward how will you explain this to a caller?
You start with 12 wks of FMLA then as you use it your FMLA time decreases. Once an approved FMLA ABS is one year old that time gets added back into your FMLA bank.
Control number 50005: Normal Pregnancy
EE asks how much time can I be OOW?
How do you respond?
For a normal pregnancy the recovery time is 6 wks, then NY PFL also offers 12 wks paid bonding. That is a total of 18 wks (assuming EE is eligible and provided needed documentation)
How do you explain 6/21/22 pay being smaller?
6/21/22: $395 pay from to: 6/1/22-6/5/22
6/24/22: $1580 pay from to: 6/6/22-6/19/22
7/8/22: $1580 pay from to: 6/20/22-7/3/22
Your 6/21/22 check is smaller because it is a partial payment, meaning it is for a shorter period of time than the following checks which are full biwkly amounts.
Paula was approved 20 wks DBL due to a complicated pregnancy
Caller: I know NY has paid bonding, can you tell me how long it is for?
CSP: assuming no company leaves how do you adv EE?
NY has a cap in total bx of 26 wks, since you used 20 wks of DBL, you only have 6 wks remaining.
Jim has been OOW for 14 wks due to recovery from surgery, STD approved thru RTW but also denied due to exhaustion for his last 2 wks OOW
EE: What does this mean, why was I denied I know my doctor sent in the information?
CSP: Explain
CSP: I see here that your STD is approved thru RTW but I apologize your FMLA has a maximum of 12 wks so we were not able to approve the last 2 wks.
Intermittent ABS claim
Caller: “I got a letter here saying a couple of my ABS were denied because my doctor didn’t get the form in on time. If it is already denied what is the point in having him do it now?”
CSP: You find on DBA ER does allow late certs and that the more recent ABS are still pending MC, how do you explain?
CSP: “I see that your ER does allow late certifications so please have your doctor get that in to us as soon as possible”
Variation: “I see your ER does allow late certs, have you verified that your AP has rec’d the MC?”
Leaves that are Denied due to exhaustion, no med cert and late notice
Cap for PFL and DBL
overpayments
SOS: If EE opted into texting and pending MC how do you offer self services
EE on LTD how do you offer self service?
