Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
Deciding to get treatment for a substance use disorder is a big step. For many working adults, the next question is practical: can I take time off without losing my job? The federal Family and Medical Leave Act (FMLA) may help. It provides eligible employees with job-protected leave for serious health conditions, and that can include treatment for substance use disorders.
Here’s a general overview of how FMLA works for treatment leave in Texas. This is general information, not legal advice.
What FMLA Provides
FMLA allows eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons. Key features include:
- Up to 12 workweeks of leave in a 12-month period for a qualifying reason
- Continuation of group health coverage on the same terms as if you were working
- The right to return to the same job or an equivalent one when leave ends
Are You Eligible?
FMLA applies to covered employers, which generally include private-sector employers with 50 or more employees for at least 20 workweeks in the current or previous calendar year, as well as public agencies and public and private elementary and secondary schools.
To be an eligible employee, you generally must:
- Have worked for the employer for at least 12 months, which don’t have to be consecutive
- Have worked at least 1,250 hours during the 12 months before leave begins
- Work at a location where the employer has at least 50 employees within 75 miles
How FMLA Applies to Substance Use Treatment
A substance use disorder may qualify as a serious health condition under FMLA. The U.S. Department of Labor explains that leave can be used for substance use treatment provided by a health care provider, or by a provider of health care services on referral from a health care provider. That can include medical detox and residential treatment.
There are important limits. Absence because of the use of a substance, rather than for treatment, doesn’t qualify for FMLA protection. And if an employer has an established policy, applied consistently and communicated to all employees, that allows termination for substance use in certain circumstances, the employer may still act under that policy. What an employer can’t do is take action against you because you used FMLA leave for treatment.
FMLA can also apply to mental health conditions that involve inpatient care or continuing treatment by a health care provider, such as residential mental health treatment for depression, anxiety or PTSD.
Leave to Care for a Family Member
FMLA may also let you take leave to care for a spouse, child or parent with a serious health condition, which can include a family member receiving substance use treatment. For children 18 and older, additional requirements apply. Participating in a loved one’s care, such as attending family sessions, may be part of this, depending on the circumstances.
Intermittent Leave and Continuing Care
FMLA leave doesn’t always have to be taken all at once. When medically necessary, it can be taken intermittently or on a reduced schedule. That can help with follow-up care after residential treatment, such as a virtual intensive outpatient program that meets several days a week, or regular therapy and medication management appointments.
Pay During Leave
FMLA leave is unpaid. However, your employer may require you, or you may choose, to use accrued paid leave such as vacation or sick time at the same time. Some employers also offer short-term disability insurance, which may replace part of your income during a medical leave. That’s a separate benefit with its own rules and paperwork, so ask HR about both.
How to Request FMLA Leave
- Give notice. When leave is foreseeable, you generally must give 30 days’ notice. When it isn’t, give notice as soon as practicable. Follow your employer’s usual procedures.
- Share enough information. Give enough detail for your employer to know the leave may qualify. You don’t have to use the words “FMLA.”
- Watch for employer notices. Your employer should tell you whether you’re eligible and explain your rights and responsibilities.
- Return the certification. Your employer may ask for a certification from a health care provider, and your treatment team can help complete it. Your employer must allow a reasonable amount of time to return it.
- Keep copies. Save copies of all forms, emails and notices.
Texas Considerations
Texas doesn’t have a separate, broad family and medical leave law for private-sector employees, so federal FMLA and your employer’s own policies usually set the rules. Some employers offer more generous leave than the law requires. Public employees in Texas may have additional leave policies through their agencies. Check your handbook or talk with HR.
Returning to Work
When your leave ends, you generally have the right to return to the same or an equivalent job. Your employer may require a fitness-for-duty certification if it applies that requirement consistently. Planning your return as part of aftercare can help you protect your recovery as you step back into work.
Frequently Asked Questions
Can I be fired for taking FMLA leave for rehab?
Your employer can’t retaliate against you for using FMLA leave for treatment. It may still enforce a consistently applied substance use policy.
Can I use FMLA for detox?
Medical detox provided by or on referral from a health care provider may qualify as treatment under FMLA.
Will my coworkers know why I’m on leave?
Employers must keep medical information from FMLA certifications confidential and separate from general personnel files.
What if I don’t qualify for FMLA?
Your employer may still offer leave under its own policies, and other laws may provide protections. Ask HR what options exist.
Plan Your Treatment With Confidence
We can provide a free, confidential insurance verification and help you plan next steps. Visit our insurance options page, contact us, or call (469) 546-9303.