Integrated disability and absence management: one intake, every leave program, and who pays each week
One intake for FMLA, state leave, STD and LTD, with each week's payer.
See one case, screen by screen ↓Integrated disability and absence management (IDAM) coordinates every program one absence touches — FMLA, state paid family and medical leave, short-term and long-term disability and employer pay — in one case, instead of each being worked on its own. This solution takes the intake once, checks eligibility for every program and draws the leave as a week-by-week payer calendar with the net benefit after offsets.
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A single absence — a pregnancy, a surgery, a parent's treatment — can touch FMLA, a state paid family and medical leave program, short-term disability, long-term disability and the employer's own sick or parental pay. Each has its own eligibility test, clock, notice and benefit formula, and the STD plan is usually reduced by whatever the state pays for the same week.
Today the intake specialist takes the call before anyone knows which programs apply, so facts are missed and the case manager calls back. The weekly benefit is worked out on a spreadsheet and payroll learns what to pay from an email. When the disability plan pays its full 60% before the state benefit is known, or payroll defaults PTO into a leave week, the employee is paid twice — and the recovery letter goes to someone who has just had a baby.
Estimated split for one multi-program leave, by hand and with the solution, in days.
Six agents capture the leave, decide each program, work out the offsets and dates; the case manager signs.
Alicia Moreno, a process engineer at Bramwell Instruments in Lowell, Massachusetts, calls on Monday 12 October about a scheduled caesarean on 23 November. Here is what happens next, screen by screen, in the working solution.
Renée carries 118 open leaves across 14 employers in 9 states. Her Leaves screen shows the 10 that change this month on one time axis, each with a payer strip across its weeks: Ellen Marsh is back 23 November but payroll still shows leave; Samuel Whitaker's LTD decision is due 16 November; a new leave for Alicia Moreno starts 16 November.
Tomás takes the call on the leave line. Beside the transcript, every fact fills in with the line it came from — delivery date, first day off on the doctor's order, Dr. Helen Ashby at Merrimack Valley Women's Health, 12 weeks with the baby, PTO top-up declined. Hire date, 2,080 hours, base pay, 412 employees within 75 miles, a 96-hour PTO balance and the disability class come from Bramwell's payroll and enrolment feed.
Intake listener: “Ask whether it is a scheduled caesarean — it sets the disability weeks after delivery (6 or 8).”
With nothing missing, Tomás presses Build the leave plan. The eligibility checker tests FMLA, Massachusetts PFML, disability and employer pay; the benefit calculator works out the weekly amounts; the timeline planner lays out 21 weeks; the notice drafter dates 10 notices; the payroll reconciler reads Bramwell's file. Six agents, 2 min 11 s, and the plan waits for Renée.
“Payroll reconciler · Bramwell file — 40 h PTO in the week of 23 Nov would pay 160.0% — instruction drafted.”
FMLA: eligible — 3 years 2 months of service, 2,080 hours, 412 employees within 75 miles (29 CFR 825.110). Massachusetts PFML: eligible — base-period earnings $121,410 against $36,911.70 needed. STD under Calder Point policy GSD-118204: class 1, 7-day elimination, 8 weeks after a caesarean to 17 January. LTD: not expected. Bramwell sick pay covers week 1; paid parental leave tops up two bonding weeks.
“You agree or change each one; a denial is always yours.”
Twenty-one week columns from Monday 16 November to her return on Monday 12 April 2027. Lanes for FMLA (job protection, unpaid), Massachusetts PFML in teal, short-term disability in blue for Calder Point, Bramwell pay in violet, Bramwell's own payroll file and the notices. Under every week, the net to Alicia as a bar against guides at 60% and 100%.
In the week of 30 November the state pays $1,230.39. The disability plan pays 60% of $2,403.85 = $1,442.31, less the state benefit for the same week, so Calder Point pays $211.92. FMLA protects the job and pays nothing. Over 21 weeks she receives $31,053.93, 61.5% of pay. The state pays 79.2% of that, Calder Point 5.5% and Bramwell 15.3%.
Every amount shows its formula, with the policy section and the statute behind it: Disability plan §4.3, M.G.L. c.175M §3.
Switch Coordinate benefits off and the calendar is recomputed the way it is often paid by hand: the plan pays its full $1,442.31 on top of the state. Each disability week jumps to $2,672.70, 111.2% of pay, in red — $9,843.12 paid twice over 8 weeks, to be recovered from Alicia after the leave.
For the pay period 16–29 November, cut-off Wednesday 25 November at 12:00, the reconciler compares Bramwell's file with every open plan. Seven employees on leave, five match. Alicia has 40 h PTO defaulted into the week of 23 November — with the state and Calder Point that week would pay $3,846.16, 160.0% of pay, and she declined a top-up on the call. Ellen Marsh is back 23 November but still coded as on leave, so she would be paid nothing.
The reconciler never edits payroll — it sends instructions to Marcus Lindqvist, Bramwell's payroll manager.
The WH-380-E certification request went to Dr. Ashby at 09:31, due back by Tuesday 27 October. The WH-381 notice of eligibility and rights is drafted for Monday 19 October — five business days from the call — in plain words, with what each program pays each week. The employer statement is with Gail Fitzgerald in Bramwell HR; the WH-382 designation notice waits on the certification.
Before she signs, four checks are on screen: no week above 100% of pay, the PTO conflict, the FMLA notice on its clock, and the bonding weeks at 51.2% with her 96 h of PTO offered as her choice, not applied. Renée signs version 1: the state pays $24,607.80, Calder Point $1,695.36, Bramwell $4,750.77, and the WH-381 and plan letter go to Alicia on Monday 19 October.
“Any change after this is a new version with its reason.”
The same leave, seen by the four people who handle it — what their week looked like, and what it looks like now.
Six agents capture the leave, decide each program, work out the offsets and dates; the case manager signs.
Captures the leave facts from the call, the portal or HR's request, each linked to the line it came from, pulls service, hours, pay, headcount, PTO and coverage from the employer feed, and prompts the specialist for what is missing.
Applies FMLA, the state program, short-term and long-term disability and the employer's policies, each with its test, the employee's values and the rule.
Works out the state weekly benefit, the disability benefit, the offset and any employer top-up for every week, with the net and the percentage of pay.
Lays the programs out week by week — concurrency, waiting weeks, exhaustion and return dates — and redraws when a date changes.
Drafts FMLA forms WH-381, WH-380-E and WH-382, the state and disability forms and the plan letter, in plain words and dated from the plan.
Compares each employer's payroll file with every active plan before the cut-off and drafts the instructions.
Agrees eligibility, signs the plan. The agents propose; a named person decides.
Case managers ask in plain words — or say what to change in a plan. Every answer names its source.
Why is week 3 exactly 60% of Alicia's pay?
In the week of 30 Nov three programs overlap. Massachusetts pays $1,230.39. The disability plan pays 60% of $2,403.85 = $1,442.31, less the state benefit for the same week, so Calder Point pays $211.92. FMLA protects her job and pays nothing. Net: $1,442.31 — exactly 60.0%.
What would Alicia be paid without the offset?
The plan would pay its full $1,442.31 on top of the state's $1,230.39: $2,672.70 a week, 111.2% of pay, for 8 weeks. That is $9,843.12 paid twice, which Calder Point would have to recover from her after the leave.
Which payroll entries conflict with the leave plans?
Two in Bramwell's file for 16–29 Nov: Alicia Moreno has 40 h PTO in the week of 23 Nov — that week would pay $3,846.16, 160.0% of pay, and she declined a top-up at intake. Ellen Marsh returns on 23 Nov but is still coded as on leave, so she would be paid nothing. Both instructions are drafted.
Show me the FMLA notice that is due this week
The WH-381 notice of eligibility and rights is due Mon 19 Oct — 5 business days from Alicia's call on 12 Oct. It is drafted in plain words with her dates and what each program pays each week, and it goes with the plan letter.
12 screens from the working solution, on its sample data. Pick one to see it large.
The rules the agents apply. A change is saved as a new version and applies to plans built after it.
| Setting | Default | Choose from |
|---|---|---|
| Reduce STD by state paid leave and disability benefits | On — same week, same condition | On · Off |
| STD benefit, share of weekly earnings | 60% | 60% · 66⅔% · 70% |
| STD weekly maximum | $1,500 | $1,500 · $2,000 · $2,500 |
| Disability weeks after a caesarean delivery, unless the doctor certifies longer | 8 weeks | 8 weeks · 6 weeks |
| FMLA notice of eligibility and designation notice | 5 business days | 5 · 3 business days (stricter) |
| Certification due back | 15 calendar days | 15 · 20 calendar days |
| Payroll file from each employer | 06:00, 2 days before cut-off | 2 days · 1 day before |
| Second signature on any week above 100% or any recovery | Team lead (Darnell Fisher) | Team lead · Case manager |
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“demo” = seen in the working solution, on its sample leave data · “target” = the design goal, measured in the live solution · “estimated” = our estimate · “typical” = published figures and rules (29 CFR 825.300(b): FMLA eligibility notice within 5 business days; US DOL Women's Bureau: 13 states and the District of Columbia with paid family and medical leave laws). The $9,843.12 is computed in the demo from the sample case (8 weeks × $1,230.39). People, employers, the carrier and amounts named on this page are fictional — characters and sample data in the working solution.
Integrated disability and absence management (IDAM) coordinates every program one absence touches — FMLA, state paid family and medical leave, short-term and long-term disability and employer pay — in one case, instead of each being worked on its own. This solution takes the intake once, checks eligibility for every program and draws the leave as a week-by-week payer calendar with the net benefit after offsets.
The benefit calculator pays the disability benefit as a share of weekly earnings to the plan maximum, then reduces it by the state benefit paid for the same week, as the policy requires. In the sample case, 60% of $2,403.85 is $1,442.31, less the state's $1,230.39, so the carrier pays $211.92 and the employee receives exactly 60.0% of pay.
No. The eligibility checker shows each program's test, the employee's values and the rule, and the absence case manager agrees or changes each decision with a reason. The agents never deny a program.
FMLA, state paid family and medical leave and disability programs, short-term and long-term disability and employer sick, parental and PTO policies. The settings list the 13 states and the District of Columbia with paid leave laws; the sample book runs nine of them — MA, NY, NJ, CA, WA, CT, CO, OR and RI.
Before each cut-off the payroll reconciler reads the employer's payroll file and lays it on the same weeks as every open plan. It flags PTO the employee did not choose and leave codes that outlast the leave, then drafts instructions for the employer's payroll manager. It never edits payroll.
Yes. The notice drafter dates every notice from the plan — the WH-381 notice of eligibility within 5 business days of the request, the WH-382 designation notice within 5 business days of a complete certification, certification due back in 15 calendar days — and drafts each one in plain words. Nothing is sent without the case manager.
Yes. The case manager agrees eligibility and signs every plan; any week above 100% of pay or any recovery needs a second signature from the team lead; changes after signing are new versions with the reason. Every agent step and human decision is on the audit trail.
The Agentic Solution Engine builds and deploys it from your requirements — your group policies, employer leave policies, notice templates and a sample of open leaves — and it goes live once every quality gate has passed. We will walk you through it on your own leaves first.
Any census layout quote-ready the day the RFP arrives, every change on the record.
1-min demoEvidence of Insurability AutomationSimple EOI approvals stop waiting behind complex medical cases.
1-min demoGroup Premium ReconciliationOnly the real billing differences left for a person to resolve.
1-min demoWe'll run Integrated Disability & Absence Management on a sample of your own open leaves.