What medical paperwork do I need for intermittent FMLA leave, and when can my employer ask for more?

Quick answer
For intermittent FMLA leave, the healthcare provider must list a full date range (start and end date) and the parameters of the leave, such as the frequency and duration of appointments or flare-ups, even if these are estimates. Without this information, the leave could be denied for insufficient paperwork.

Who this applies to / Prerequisites

• Employees requesting intermittent FMLA leave, and their healthcare provider completing the medical certification.

Steps

1. Enter your leave request in Tilt. You'll be notified immediately if a medical certification is required.
2. Have your healthcare provider complete the certification form provided by Tilt, including the full date range and the frequency/duration of appointments or flare-ups, even as estimates.
3. Submit the completed certification through Tilt. You'll see confirmation once the certification is received and reviewed.

What if it doesn't work

• My certification didn't include a date range or frequency/duration: Have your healthcare provider add this information — leave can be denied without it.
• My employer is asking for more documentation: This is only allowed in specific circumstances (see Limits and exceptions below); contact your Leave Success Manager with questions.
• If none of these apply, contact your Leave Success Manager.

Limits and exceptions

• If the initial medical certification is complete and sufficient, employers generally cannot request additional information (recertification).
• Employees do not need to submit return-to-work or fitness-for-duty documents after each individual absence, even for a flare-up.
• Employers may request recertification only in these circumstances: the employee requests leave for dates outside the originally certified range; the originally certified period was longer than six months (employers can require mandatory six-month recertifications for all employees in this case, though Tilt does not consider this best practice); the circumstances described in the certification have changed significantly (e.g., certified for 1 appointment/month but consistently reporting 5/month); or the employer receives information casting doubt on the stated reason for absence or the certification's continuing validity.
• As of a January 5, 2026 U.S. Department of Labor opinion letter, FMLA leave includes reasonable travel time to and from appointments related to a serious health condition, and a medical certification does not need to separately estimate or reference travel time — employers should not deny otherwise qualifying travel time solely because it isn't addressed in the certification.
• HR/People teams should work with Tilt if they believe an employee needs a recertification, rather than requesting it directly from the employee.

Related questions

• How does intermittent leave work under FMLA?
• How do I report intermittent leave absences in Tilt?