In Tayag v. Lahey Clinic Hospital, Inc., the U.S. Court of Appeals for the First Circuit found that an employee’s seven-week leave of absence to accompany her husband on a “spiritual healing trip” did not constitute medical care within the meaning of the Family and Medical Leave Act (FMLA).

Lahey Clinic Hospital hired Maria Lucia Tayag in 2002 to work as a health management clerk. In 2003, Tayag began to request intermittent FMLA leave in one- and two-day increments to care for her husband, who suffered from several serious medical issues. Lahey routinely granted Tayag’s requests.

In June 2006, Tayag requested a seven-week leave to assist her husband while he traveled to the Philippines on a “spiritual healing trip.” For this longer leave of absence, Lahey required Tayag to provide a note from her husband’s primary care physician detailing the need for Tayag to accompany him on the trip. Rather than submitting the requested documentation from her husband’s physician, however, Tayag produced a note from her own doctor, which stated that Tayag should receive time off to accompany her husband to the Philippines.

On August 8, 2006, after the Tayags had already left for their trip, Mr. Tayag’s cardiologist submitted a certification form to Lahey indicating that, in fact, Tayag did not need to accompany her husband on the trip. Lahey attempted to contact Tayag to inform her that her leave was not approved, but Tayag did not respond. On August 18, 2006, Lahey terminated Tayag’s employment.

While in the Philippines, Mr. Tayag did not receive any conventional medical treatment. Instead, the Tayags attended Mass, prayed, and spoke with a priest and other pilgrims at the Pilgrimage of Healing Ministry at St. Bartholomew’s Parish. Tayag and her husband also spent time visiting other churches, and seeing family and friends. Tayag claimed that she assisted her husband throughout the trip.

In August 2008, Tayag sued Lahey in District Court, alleging that Lahey terminated her employment in violation of the FMLA. The Court resolved the case in Lahey’s favor, finding that Tayag’s trip was not “protected” under the FMLA because it was effectively a vacation. Tayag appealed to the First Circuit, which reaffirmed that decision, finding that the FMLA does not protect the type of “healing” trip taken by the Tayags.

In deciding this issue, the First Circuit looked to the express language of the statute and found that the concept of “medical care” did not encompass such a trip. The Court then examined the law’s treatment of faith healing, which considers Christian Science practitioners to be healthcare providers to the extent that they are “others capable of providing healthcare services” within the meaning of the regulation. Although Tayag argued that the faith-healing exception is unconstitutional because it distinguishes between different religions, the First Circuit found her briefing on this issue to be so cursory that it considered the argument waived. Accordingly, the Court found that the faith-healing exception did not apply to Tayag’s claim and that the FMLA did not otherwise cover “healing pilgrimages.” Moreover, the First Circuit found that Tayag’s failure to provide adequate certification for her FMLA leave was independently sufficient to affirm the District Court’s decision to award summary judgment in the employer’s favor.

This decision serves as a reminder that not all requests for leave are covered by the FMLA and that employees must provide sufficient medical certification to justify their absence from work, particularly when they are seeking unconventional forms of medical treatment.