Md. Code Regs. 11.02.13.02

Current through Register Vol. 51, No. 22, November 1, 2024

Section 11.02.13.02 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Chronic serious health condition" means a condition which:

(a) Requires periodic visits for treatment by a health care provider, or by a nurse or physician's assistant under the direct supervision of a health care provider;

(b) Continues over an extended period of time, including recurring episodes of a single underlying condition; and

(c) May cause episodic, rather than continuing, periods of incapacity, for example, asthma, diabetes, or epilepsy.

(2) "Continuing treatment by a health care provider" has the meaning stated in §C of this regulation.

(3) "Employment benefits" means benefits provided or made available to employees by the Department, including group life insurance, health insurance, disability insurance, sick leave, annual leave, educational benefits, and pensions.

(4) "Equivalent position" means a position having:

(a) The same pay, benefits, and working conditions;

(b) The same or substantially similar duties and responsibilities;

(c) Substantially equivalent skill, effort, responsibility, and authority;

(d) The same work site or a geographically proximate work site;

(e) The same shift or an equivalent schedule; and

(f) The same opportunity for nondiscretionary payments.

(5) "Family member" means a spouse, parent, son, or daughter.

(6) "FMLA leave" means unpaid family medical leave taken under the provisions of this chapter.

(7) "Group health plan" means any plan of, or contributed to by, the Department, including a self-insured plan, to provide health care, directly or otherwise, to the Department's employees.

(8) "Health care provider" means a:

(a) Doctor of medicine or osteopathy who is authorized to practice medicine or surgery;

(b) Podiatrist, performing within the scope of the podiatrist's practice as defined under State law;

(c) Dentist, performing within the scope of the dentist's practice as defined under State law;

(d) Clinical psychologist, performing within the scope of the clinical psychologist's practice as defined under State law;

(e) Optometrist, performing within the scope of the optometrist's practice as defined under State law;

(f) Chiropractor, limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by X-ray to exist, performing within the scope of the chiropractor's practice as defined under State law;

(g) Nurse practitioner, nurse midwife, and clinical social worker who are authorized to practice under State law and who are performing within the scope of their practice as defined under State law;

(h) Christian Science practitioner listed with the First Church of Christ, Scientist in Boston, Massachusetts; and

(i) Health care provider from whom a benefits manager for State of Maryland group health plans will accept certification of the existence of a serious health condition to substantiate a claim for benefits.

(8-1) "Incapacity" means an inability to work, attend school, or perform other regular daily activities because of a serious condition, treatment, or recovery.

(9) "Intermittent leave" means leave taken in separate periods of time due to a single illness or injury of an employee or family member.

(10) "Paid leave" means vacation, personal, compensatory, holiday, and earned sick leave.

(11) "Parent" means the biological parent of an employee or an individual who stands or stood in loco parentis to an employee when the employee was a child.

(12) "Physical or mental disability" means a physical or mental impairment that substantially limits one or more of the major life activities of an individual.

(13) "Reduced work schedule" means a leave schedule that reduces the usual number of hours per workweek, or hours per workday, of an employee.

(13-1) Return to Work.

(a) "Return to work" means a return to work by an employee for a period of at least 30 calendar days.

(b) "Return to work" includes cases in which an employee retires within 30 calendar days or retires directly from FMLA leave.

(14) Serious Health Condition.

(a) "Serious health condition" means an illness, injury, impairment, or physical or mental condition that involves:

(i) Inpatient care, any subsequent treatment in connection with the inpatient care, or continuing treatment by a health care provider;

(ii) Restorative dental or plastic surgery after an injury or removal of cancerous growths if all FMLA requirements are met;

(iii) Mental illness resulting from stress or allergies, if all FMLA requirements are met; or

(iv) Substance abuse, if all FMLA requirements are met and treatment for the substance abuse is provided by a health care provider or a provider of health care services.

(b) "Serious health condition" does not include:

(i) Conditions for which cosmetic treatments are administered, such as most treatments for acne or plastic surgery, unless inpatient hospital care is required or complications develop;

(ii) Absences resulting from substance abuse, except as specified in §B(14)(a)(iv) of this regulation;

(iii) The common cold, the flu, earaches, upset stomach, headaches other than migraines, routine dental or orthodontic problems, periodontal disease, and other routine health problems.

(14-1) "Son or daughter" means a biological child, adopted child, foster child, stepchild, or legal ward of a person standing in loco parentis, who is younger than 18 years old, or 18 years old or older and incapable of self-care because of a physical or mental disability.

(15) "Spouse" means a husband or wife as defined or recognized by the state in which the employee resides.

(16) "State" means any state of the United States, the District of Columbia, or a possession of the United States.

C. Continuing Treatment by a Health Care Provider.

(1) Specific.

(a) "Continuing treatment by a health care provider" means a situation in which the employee or family member has a serious health condition involving a period of incapacity of more than 3 consecutive calendar days, including any subsequent treatment or period of incapacity relating to the same condition, and that also involves treatment:

(i) Two or more times by a health care provider, a nurse or physician's assistant under the direct supervision of a health care provider, or a provider of health care services, such as a physical therapist, under orders of, or on referral by, a health care provider; or

(ii) By a health care provider on at least one occasion which results in a regimen of continuing treatment under the supervision of a health care provider.

(b) In this subsection, "treatment" includes, but is not limited to, examinations to determine if a serious health condition exists and evaluations of that condition. "Treatment" does not include routine physical, eye, or dental examinations.

(2) General. "Continuing treatment by a health care provider" also means a period of:

(a) Incapacity for pregnancy or for prenatal care;

(b) Incapacity or treatment for the incapacity due to a chronic serious health condition;

(c) Incapacity which is permanent or long-term due to a condition for which treatment may not be effective, and for which the employee or family member is under the continuing treatment of, but not necessarily receiving active treatment from, a health care provider, for example, Alzheimer's disease or a severe stroke;

(d) Absence taken to receive multiple treatments, including periods of recovery, from a health care provider or by a provider of health care services under the orders of, or on referral by, a health care provider.

Md. Code Regs. 11.02.13.02

Regulation .02 amended effective January 27, 1997 (24:2 Md. R. 116)