Pregnant Workers Fairness Act (PWFA) Final Regulations: Summary for Medical Providers
The U.S. Equal Employment Opportunity Commission (EEOC) published their final regulations on the Pregnant Workers Fairness Act (PWFA) the week of 15 April 2024. The rules will go into effect on 18 June 2024. PWFA went into effect in June 2023 and provided the right to reasonable accommodations on the job and the right to job protected time off from work for pregnancy, childbirth, and pregnancy-related conditions for patients in workplaces with at least 15 employees.
The final regulations add additional detail and guidance on the law’s protections and interpretation. The regulations make some notable clarifications pertinent to medical providers, including the definition of ‘limitation’ and ‘pregnancy, childbirth, or related medical conditions;’ the definition of ‘reasonable documentation;’ and guidance for medical providers who may complete documentation for PWFA. Medical providers should note these explanations, which increase protections for patients seeking accommodations and establish requirements for medical documentation.
‘Limitation’
The final regulations define a limitation as “a physical or mental condition related to, affected by, or arising out of pregnancy, childbirth, or related medical conditions, of the specific employee in question.”
The physical or mental conditions are not required to be severe and/or continuous; they can be modest, minor, and/or episodic.
The final regulations make clear that the PWFA “does not require that pregnancy, childbirth, or related medical conditions be the sole, the original, or a substantial reason for the physical or mental condition.” The PWFA is intended to be inclusive of conditions and limitations that are impacted or exacerbated by pregnancy, childbirth, and related conditions.
‘Pregnancy, childbirth, or related medical conditions’
The final regulations defined ‘pregnancy’ and ‘childbirth’ as “the pregnancy or childbirth of the specific employee in question and include, but are not limited to, current pregnancy; past pregnancy; potential or intended pregnancy (which can include infertility, fertility treatment, and the use of contraception); labor; and childbirth (including vaginal and cesarean delivery).”
The EEOC ruled that there are certain medical conditions that are “readily apparent” as medical conditions that are related to pregnancy and childbirth. The non-exhaustive list of related conditions includes:
While abortion is included in the list of related medical conditions that may be covered, PWFA does not require health plans to cover abortion, nor does it change the legal status of abortion in states that have prohibited abortion.
‘Reasonable documentation’
The final regulations established the minimum sufficient documentation that is necessary to meet documentation requirements. Employers cannot require that employees submit documentation using a specific form. Documentation, at minimum, must include:
Medical providers who may complete documentation for PWFA
In cases where the employer can request reasonable documentation, the EEOC established that employees have agency in determining what type of medical provider will best meet their needs. The employer cannot request that employee be assessed by a medical provider of the employer’s choice.
The medical provider completing the documentation does not have to be the treating provider– they can be “any health care provider familiar enough with the individual's circumstances to provide the described information[...], whether or not they are treating the individual for the condition at issue.” In addition, telehealth providers can complete this documentation. The types of medical providers who can complete this documentation includes, but is not limited to:
Example templates for PWFA workplace accommodations:
Sample Medical Certification Form - Cocreated by The Center for WorkLife Law and Work+Family Insight HR Consulting
By C. Nickel
All quotations are from the EEOC’s final rule:
Implementation of the Pregnant Workers Fairness Act, 89 FR 29096 (proposed 19 April 2024) (to be codified at 29 CFR 1636).
