There is a fee associated with this service.
If you are requesting a letter to be written on your behalf or forms to be completed, please keep in mind that your request will take 7-10 business days to complete. The minimum turn-a-round time for letters is one week, so please request them 1-2 weeks in advance. You will have to establish care with Dr. Williams as your mental health provider, which takes a minimum of 3 visits. These forms cannot be completed at your initial appointment. If you do not stay in care, I will not be able to write a return to work letter on your behalf or request for more time off if needed.
****Short Term Disability and FMLA Paperwork ONLY! We do not process paperwork or evaluate for Social Security Disability!****
FMLA Forms
The Family and Medical Leave Act (FMLA) provides “eligible employees” with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave. Such qualified medical and family reasons may include adoption, pregnancy, foster care placement, to care family member with a serious health condition, or to take medical leave for a serious health condition.
A serious health condition is defined by the FMLA as “an illness, injury, impairment, or physical or mental condition that involves: inpatient care in a hospital, hospice, or residential medical care facility, or continuing treatment by a health care provider.” Additionally, the serious health condition must be something that prevents the employee from performing his or her normal work functions regularly or for more than a few days.
Short-Term Disability Forms
If you are requesting assistance in completion of a disability claim, please make note of the following:
- Holistic Balance does not “give” disability. We can only report symptoms and response to treatment to the company that handles your disability insurance.
- We do not backdate disability.
- If regularly scheduled appointments are not kept, your disability carrier will be notified.
- Our providers priorities each day are to see scheduled patients; therefore, they will complete letters and forms as time permits.