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What is a Serious Health Condition?
What is a serious health condition?
A serious health condition is an illness, injury or impairment or physical or mental condition that involves inpatient care or continuing treatment.
Inpatient Care is defined as an overnight stay in a hospital, hospice, or residential medical care facility. This includes any period of incapacity or any subsequent treatment in connection with the overnight stay.
Note: Even if the surgery is elective, it counts as a serious health condition if an overnight stay in the hospital is required.
What is NOT considered a serious health condition?
The following ailments are NOT considered to be a “serious health condition” unless complications develop such that inpatient care or continuing treatment, as defined above, is required:
- routine physical examinations
- common cold
- flu
- earaches
- upset stomach
- minor ulcers
- headaches, other than migraines
- routine dental work or orthodontia problems
- periodontal disease
- cosmetic treatments, such as most treatments for acne or outpatient plastic surgery
Note: Restorative dental or plastic surgery after an injury or removal of cancerous growths are serious health conditions provided all the other conditions are met.
Continuing Treatment by a Healthcare Provider is Defined as Any One or More of the Following
Pregnancy
Pregnancy means any period of incapacity due to pregnancy, including pre-natal appointments.
Chronic conditions requiring treatment
Chronic conditions requiring treatment refers to any period of incapacity due to or treatment for a chronic serious health condition which requires periodic visits for treatments by a healthcare provider at least 2 times per year and recurs over an extended period of time. It may cause episodic rather than a continuing period of incapacity.
Examples: asthma, migraine headaches, diabetes, epilepsy
Permanent/Long-Term conditions
Permanent/long-term conditions refers to a period of incapacity which is permanent or long-term due to a condition for which treatment may not be effective, but which requires the continuing supervision of a healthcare provider.
Examples: Alzheimer's disease, terminal stages of cancer, severe stroke
Multiple treatments for non-chronic conditions
Multiple treatments for non-chronic conditions refers to restorative surgery after an accident or other injury, or a condition that would likely result in a period of incapacity of more than 3 consecutive full calendar days if the employee did not receive treatment.
Examples: chemotherapy, physical therapy
Organ or bone marrow donation
Organ donation and bone marrow donation are considered to be serious health conditions.
- Organ donation is the process of surgically transferring a donated organ to someone diagnosed with organ failure. In this context, “organ” refers to all or part of a human liver, pancreas, kidney, intestine or lung. Organ donor leave is leave taken in order to donate an organ to another person.
- A bone marrow donation is a procedure in which stem cells are removed from the bone marrow, filtered and given to another person. Bone marrow donor leave is leave taken in order to donate bone marrow to another person.
A worker may receive benefits for the following reasons:
- Pre-donation medical appointments, i.e., required tests, examinations and counseling, and
- Surgery and recovery from the surgery
Frequently Asked Questions
Simply being exposed to COVID-19 or even being diagnosed with COVID-19 is not necessarily a serious health condition as defined by CT Paid Leave. Therefore, it is not necessarily a qualifying reason for income replacement benefits under CT Paid Leave.
An eligible worker may receive CT Paid Leave benefits in connection with an exposure to or diagnosis with COVID-19 only if they can provide medical documentation from their health care provider demonstrating that the COVID-19 exposure/diagnosis results in the person having a condition that rises to the definition of a "serious health condition".
The elements of the definition of a "serious health condition" that are most likely to apply are as follows:
- The condition requires an overnight stay in a hospital or other medical care facility; or
- The condition incapacitates the employee (for example, unable to work) for more than three consecutive days and that include ongoing medical treatment (either multiple appointments with a health care provider, or a single appointment and follow-up care, such as prescription medication) or,
- The condition results in or exacerbates a chronic condition that causes occasional periods when the employee is incapacitated, and which require treatment by a health care provider at least twice a year.
Similarly, an eligible worker may receive CT Paid Leave benefits because they need to serve as a caregiver to a family member who was exposed to or diagnosed with COVID-19 only if the family member’s health care provider certifies that the family member’s exposure/diagnosis results in the family member having a serious health condition.
