Family Medical Leave Act (FMLA), Short Term Disability (STD), Long Term Disability (LTD), and Employment Accommodations Documentation
Information Pertaining To FMLA, STD, LTD, Employment Accommodations:
Such documentation will not be completed unless your provider has met with you for at least 3-6 counseling sessions to establish the therapeutic relationship and gather necessary clinical information. Documentation will not be completed if the provider believes they cannot support the requested documentation based on what is presented during intake and ongoing sessions.
Completion of documentation does not guarantee approval of FMLA, STD, LTD, or accommodation requests. The final decision rests with the employer or insurance carrier.
Initially, such documentation generally requires a minimum of one (1) hour to complete, due to review of received documents and clinical chart, corroborating with the client, completion of requested documents, and the need to provide supporting documentation. These documents are often not a one-time request, and insurance carriers and employers will generally request updates or new documentation every one (1) to three (3) months. Therefore, scheduled ongoing sessions are important in this process, as your provider will typically be required to provide statements and clinical judgment on an ongoing basis based on client presentation in sessions.
Insurance plans utilized for counseling services do not cover payment for these services. The client or responsible party is responsible for payment, which is due at the time of the request of any necessary supporting documents received by the provider.
Fees:
- Initial FMLA/STD/LTD Paperwork Completion: $200
- FMLA/STD/LTD Paperwork Update/Recertification:
- Simple Forms: $100
- These are typically short, straightforward forms requiring minimal review of records and limited clinical narrative.
- Moderate or High Complexity: $150
- These forms require more in-depth review of records, a more detailed clinical narrative, and/or communication with client and/or third parties.
- Letter of Support for Employment Accommodations (Non-FMLA): $130
- Review of Existing Documentation: $125
- *EXPEDITED REQUESTS:
- Expedited response or documentation within one (1) business day will be assessed an additional fee of $150.
- Expedited response or documentation within three (3) business day will be assessed an additional fee of $100.
Regarding Court Appearances or Legal Matters
Fees:
A retainer in the amount of $2000 will be required, even if called to testify by another party. Upon completion, if there is a credit allocated, the amount will be refunded to the credit card initially charged on file.
$1400 of retainer is NON-REFUNDABLE for a 4-hour block of provider’s schedule, unless required appearance is cancelled 48 hours in advance of appearance.
Initial fee - $600
- Does not include time in court, deposition, or any appearance related to a legal matter.
- Includes preparation (e.g.: consulting with attorney, reviewing the client’s clinical chart, consulting with provider’s attorney, consulting with other professionals involved in the client’s case, preparing testimony), up to one hundred (100) total miles travel to and from designated address, and parking (if required).
- If provider must travel over one hundred (100) total miles to and from their home address to designated address:
- An additional fee will be assessed according to IRS standard mileage rate per mile.
- The provider may choose alternative methods of transportation, such as air travel or train, and the client or responsible party will be responsible for the reasonable, preapproved costs associated with that transportation, including but not limited to airfare, train, hotel, and car rental.
For every 60 minutes in court - $200
Letter for court or summary of services - $150 per hour of time to complete
Phone call or correspondence over 10 minutes with client regarding legal matter, attorney related to client legal matter, or any other party directly involved in client’s case regarding legal matter of client - $50 per 15-minute increment