Stage One Kidney Disease Not FMLA “Serious Health Condition”

Darrell VanDeusen
Darrell VanDeusen

The Eighth Circuit has held that stage one kidney disease is not a serious health condition under the Family and Medical Leave Act (FMLA). Dalton v. ManorCare of West Des Moines IA, LLC, 2015 U.S. App. LEXIS 5536 (8th Cir. Apr. 7, 2015).

Lucinda Dalton worked for a skilled nursing facility in Iowa when she was diagnosed with stage one kidney disease. She had significant weight gain and an edema. Following a series of doctor visits in January 2011, she went to a kidney specialist who diagnosed her with stage one kidney disease related to obesity. Additional tests, however, showed that Dalton had normal kidney function.

Dalton was also having performance problems at work. She had received a final written warning and placed on a performance improvement plan (PIP) for her negative work comments that patients could overhear, her failure to attend patient care conferences, and her excessive lunch breaks.

On February 28, 2011, Dalton called in to work to say she was having chest pains and was going to the emergency room. She was discharged that same day without any diagnosis. She did, however, get a doctor’s note excusing her from work until March 2. When she came to work on March 2, she was suspended pending investigation into further performance problems. At that time she asked about FMLA leave, but was told that she was ineligible.

The next day she received a warning for her poor performance, which when combined with her other previous warnings resulted in termination. Dalton sued, claiming that her termination interfered with her FMLA rights. The trial court granted ManorCare’s motion for summary judgment. The Eighth Circuit affirmed.

First, based upon testimony from Dalton’s own doctor, the court noted that stage one kidney disease is a “warning that the kidneys are working too hard, not an advanced disease, and renal testing of Dalton revealed no abnormal kidney functions.” The court stressed that “[w]e do not doubt that edema and fluid retention may be signs of a potentially serious condition, such as congestive heart failure, liver disease, or primary kidney disease. But no such condition was ever diagnosed, and ManorCare did not interfere with Dalton’s frequent medical appointments to obtain needed diagnosis and treatment.”

Second, the court held that even if Dalton had a chronic serious health condition so that her visit to the emergency room on February 28 was FMLA protected, the record showed that Dalton was terminated for reasons unrelated to her absences from work. “Unlike nearly all our prior FMLA interference cases, this was not a termination for excessive absenteeism,” the court said. “Dalton’s termination was the end of an on-going, unrelated disciplinary process.”


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