Fired Nurse With Stage One Kidney Disease Didn't Have FMLA Condition, 8th Cir. Rules

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By Jay-Anne Casuga

April 7 — A fired care delivery director for an Iowa skilled nursing facility who was diagnosed with stage one chronic kidney disease wasn't entitled to Family and Medical Leave Act protection because she didn't have a “serious health condition” under the law, the U.S. Court of Appeals for the Eighth Circuit ruled April 7.

Affirming summary judgment for ManorCare of West Des Moines IA LLC, the Eighth Circuit said medical testimony revealed that Lucinda Dalton's stage one chronic kidney disease wasn't considered “an advanced disease,” but a “warning that the kidneys are working too hard.”

Although Dalton also argued that her symptoms of unexplained edema and weight gain should be considered a serious health condition under the FMLA, the court said she didn't dispute that those conditions had no effect on her ability to perform her job functions or that ManorCare consistently allowed her to attend diagnostic medical appointments related to those conditions.

Even if Dalton showed she had a serious health condition, the appeals court said her FMLA interference claim still must fail because ManorCare terminated Dalton for performance problems unrelated to any medical conditions or attendance issues.

Judge James B. Loken wrote the opinion, joined by Judges Kermit E. Bye and Lavenski R. Smith.

Worker Didn't Have Serious Health Condition

In 2010, Dalton began to gain significant weight and to have excess swelling known as edema. After a number of medical appointments, she eventually saw a kidney specialist, Dr. Robert Leisy, who diagnosed her with stage one chronic kidney disease associated with obesity. Further testing revealed that Dalton had normal kidney function.

Under the FMLA, the Eighth Circuit explained, a serious health condition is one that causes an employee to “be absent from work on a recurring basis or for more than few days for treatment or recovery.”

Although kidney disease “can be a serious health condition,” the court said Dalton's condition wasn't one within the meaning of the FMLA.

“Dr. Leisy testified that Stage One CKD is a warning that the kidneys are working too hard, and not an advanced disease, and renal testing of Dalton revealed no abnormal kidney functions,” the court said.

It rejected Dalton's argument that the edema and weight gain themselves were serious health conditions.

“It is undisputed the conditions did not affect her ability to perform the functions of her position, and she did not request leave other than time needed to attend periodic medical appointments, which ManorCare consistently allowed,” the court said.

Dalton further argued that she also experienced “atypical” chest pains requiring an emergency room visit and her absences related to that condition impermissibly led to her termination.

But the court said Dalton presented no evidence that the chest pain was because of a chronic condition.

Termination for Performance Issues

Additionally, the Eighth Circuit held that even if Dalton had a serious health condition, she can't proceed with an FMLA claim because ManorCare showed it fired her for reasons separate from her work absences.

Prior to the ER-related absences that preceded her termination, Dalton received a final written warning and was placed on a performance improvement plan because she made negative work comments in areas where patients could overhear, took extended lunch breaks and failed to attend patient care conferences.

ManorCare eventually fired Dalton a few months later because she didn't timely complete a number of work tasks.

“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.”

Sherinian & Walker represented Dalton. Littler Mendelson represented ManorCare.

To contact the reporter on this story: Jay-Anne Casuga in Washington at

To contact the editor responsible for this story: Susan J. McGolrick at

Text of the opinion is available at Dalton_v_Manor_Care_of_West_Des_Moines_et_al_ Docket_No_13.


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