continuous medical supervision and not on his or her inability to perform the essential functions of the position.  We believe the health care provider must first determine that the condition or illness qualifies as a serious health condition.  Secondly, the health care provider must be aware of the essential functions of the employee's position in order to make a determination that if treatment or supervision is not provided, the employee cannot perform the essential functions of his or her position. If an employee must be absent from work to receive medical treatment for a serious health condition, the employee is considered to be unable to perform the essential functions of the position during the absence for treatmen.

The regulations require that the written medical certification include the date the serious health condition commenced, the probable duration of the serious health condition, and the appropriate medical facts within the knowledge of the health care provider.  However, in the situations described, the dates of treatment and duration are unknown.  In response to these comments, we have revised the regulations to permit the health care provider to specify that the serious health condition is a chronic or continuing condition with an unknown duration.  The health care provider must also specify whether the patient is currently incapacitated and the likely duration and frequency of episodes of incapacity.

Section § 630.1207(i) has been revised to provide that an agency may waive the requirement for an initial medical certification in a subsequent 12-month period if leave for a serious health condition is for the same chronic or continuing condition.  Also, the regulations have been revised to stipulate that for most serious health conditions (excluding pregnancy, chronic conditions, or permanent or long-term conditions under the continuing supervision of a health care provider), if the health care provider has specified on the medical certification a minimum duration of the period of incapacity, the agency may not request recertification until that minimum duration has passed.  Section § 630.1207(i) continues to permit agencies to require more frequent medical recertification if an employee requests that the original leave period be extended, the circumstances described in the original medical certification have changed significantly, or the agency receives information that casts doubt upon the continuing valdity of the medical certification.  These revisions are consistent with DOL's final regulations.

A commenter suggested that OPM incorporate DOL's provision that an employee must submit a medical certification within the time frame set by the employer (i.e., allowing at least 15 days for an employee to do so).  We believe the establishment of time limitations is at an agency's discretion.  Therefore, this change was not made.

Four agencies requested that OPM develop a standardized, user-friendly medical certification form that can be used Governmentwide.  Three organizations recommended that OPM not adopt DOL's medical certification form because it is unnecessarily detailed and confusing.  In the Supplementary