Deborah Hansler v. Lehigh Valley Hospital Network ( 2015 )


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  •                                        PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    No. 14-1772
    DEBORAH HANSLER,
    Appellant
    v.
    LEHIGH VALLEY HOSPITAL NETWORK,
    _____________
    On Appeal from the United States District Court
    for the Eastern District of Pennsylvania
    (D.C. Civ. No. 5-13-cv-03924)
    District Judge: Honorable James Knoll Gardner
    _____________
    Argued on January 13, 2015
    Before: AMBRO, FUENTES, and ROTH, Circuit Judges
    (Filed: August 19, 2015)
    Samuel A. Dion, Esq.       [ARGUED]
    Dion & Goldberger
    1845 Walnut Street
    Suite 1199
    Philadelphia, PA 19103
    Counsel for Appellant
    Darren M. Creasy, Esq.
    Karyn Dobroskey Rienzi, Esq.
    A. James Johnston, Esq.
    Andrea M. Kirshenbaum, Esq.    [ARGUED]
    Post & Schnell
    1600 John F. Kennedy Boulevard
    Four Penn Center, 14th Floor
    Philadelphia, PA 19103
    Glenn Guanowsky, Esq.
    Lehigh Valley Hospital
    Department of Legal Services
    1200 South Cedar Crest Boulevard
    P.O. Box 689
    Allentown, PA 18103
    Counsel for Appellee
    OPINION
    FUENTES, Circuit Judge.
    Deborah Hansler requested intermittent leave from her
    former employer, Lehigh Valley Health Network (“Lehigh
    Valley”), under the Family Medical Leave Act of 1993
    (“FMLA” or the “Act”), 29 U.S.C. § 2601 et seq.1
    Specifically, Hansler submitted a medical certification
    1
    The case name incorrectly refers to Lehigh Valley Health
    Network as Lehigh Valley Hospital Network.
    2
    requesting leave for two days a week for approximately one
    month. As alleged in the complaint, the medical certification
    refers to the length of her requested leave but not the nature
    or duration of her condition. A few weeks later, after she took
    several days off work, Lehigh Valley terminated Hansler’s
    employment without seeking any clarification about her
    medical certification, as required by law. Lehigh Valley cited
    excessive absences and informed her that the request for leave
    had been denied. Hansler sued Lehigh Valley for violations of
    the Medical Leave Act, and the District Court dismissed the
    complaint on the basis that the medical certification
    supporting Hansler’s request for leave was “invalid.” We
    conclude that, by alleging that Lehigh Valley terminated her
    instead of affording her a chance to cure any deficiencies in
    her medical certification, Hansler has stated a claim that
    Lehigh Valley violated the Medical Leave Act. Accordingly,
    we reverse and remand for further proceedings.
    I.
    Hansler was hired by Lehigh Valley in 2011 to work
    as a technical partner. In early March 2013, Hansler began
    experiencing shortness of breath, nausea, and vomiting. At
    the time, the cause of these symptoms was unknown. On
    March 13, Hansler’s physician completed a medical
    certification form “requesting intermittent leave at a
    frequency of 2 times weekly starting on March 1, 2013 and
    lasting for a probable duration of one month– or until about
    April 1, 2013.” App. 44. Hansler submitted the certification to
    Lehigh Valley as part of a formal request for leave under the
    Medical Leave Act. As a result of her condition, Hansler was
    unable to work on March 13, 14, 23, 24, and 25.
    3
    Without seeking further information about the medical
    certification from either Hansler or her physician, Lehigh
    Valley terminated Hansler at the end of her shift on March
    28. The basis for Hansler’s termination was absenteeism,
    including the five days she took off in March. Hansler
    reminded Lehigh Valley that she had requested time off under
    the Medical Leave Act, but Lehigh Valley informed her, for
    the first time, that her request had been denied. Following the
    last of her absences, Hansler learned of a letter dated March
    26 explaining that her request for “leave of absence (FMLA)
    for the period of 3/1/13-3/11/13” was denied because her
    “condition presently does not qualify as a serious health
    condition under the criteria set forth by the [Medical Leave
    Act].” App. 45. In early April 2013, after her dismissal,
    Hansler received a diagnosis of diabetes and high blood
    pressure. She alleges that these previously undiagnosed and
    untreated conditions are what caused her March absences.
    Hansler sued Lehigh Valley under the Medical Leave
    Act for interfering with her substantive rights to medical
    leave and for terminating her in retaliation for seeking leave.
    In her complaint, Hansler alleges she has chronic serious
    health conditions and argues that Lehigh Valley improperly
    denied her request for leave without providing her an
    opportunity to cure her medical certification. The District
    Court granted Lehigh Valley’s motion to dismiss for failure to
    state a claim. It concluded that Hansler’s request for leave
    was defective because her medical certification indicated that
    her condition would last only one month, but the Medical
    Leave Act requires that a chronic serious health condition
    persist for an “extended period of time.” The District Court
    held that because the certification showed that Hansler was
    not entitled to leave, Lehigh Valley was not required to afford
    4
    Hansler a cure period and was permitted to terminate Hansler
    for her subsequent absences. That Hansler was later
    diagnosed with diabetes and high blood pressure was of no
    consequence. According to the Court, “[a]lthough the timing
    of events for plaintiff was, without question unfortunate, the
    fact remains that her diagnosis with diabetes and high blood
    pressure did not occur until after her leave request was denied
    and she was fired by defendant.” Hansler v. Lehigh Valley
    Health Network, No. 13-cv-03924, 
    2014 WL 1281132
    , at *10
    (E.D. Pa. Mar. 28, 2014). Hansler filed this appeal.2
    II.
    Congress passed the Medical Leave Act “to balance
    the demands of the workplace with the needs of families” and
    “to entitle employees to take reasonable leave for medical
    reasons.” 29 U.S.C. § 2601(b). The Medical Leave Act
    2
    The District Court had jurisdiction under 28 U.S.C. § 1331,
    and we have jurisdiction to review the District Court’s final
    order under 28 U.S.C. § 1291. We exercise plenary review
    over a district court’s grant of a motion to dismiss under
    Federal Rule of Civil Procedure 12(b)(6). Pearson v. Sec’y
    Dep’t of Corr., 
    775 F.3d 598
    , 601 (3d Cir. 2015). To survive
    a motion to dismiss under Rule 12(b)(6), a plaintiff must
    allege “enough facts to state a claim to relief that is plausible
    on its face.” Bell Atl. Corp. v. Twombly, 
    550 U.S. 544
    , 570
    (2007). A court must accept all factual allegations in the
    complaint as true and draw all reasonable inferences in favor
    of the plaintiff. Phillips v. Cnty. of Allegheny, 
    515 F.3d 224
    ,
    231 (3d Cir. 2008).
    5
    carries out these objectives by providing that eligible
    employees are entitled to 12 workweeks of leave during any
    12-month period if the employee has a “serious health
    condition” that makes the employee unable to perform the
    functions of her position. 
    Id. § 2612(a)(1)(D).
    After a worker
    returns from leave, the worker is entitled to be reinstated to
    her previous position or an equivalent one. 
    Id. § 2614(a)(1).
    A “serious health condition” is one that involves
    inpatient care in a hospital or “continuing treatment by a
    health care provider.” 
    Id. § 2611(11).
    In its implementing
    regulations, the Department of Labor defines “[c]ontinuing
    treatment by a health care provider” to include “chronic
    serious health condition[s]” that (i) “[r]equire[] periodic visits
    (defined as at least twice a year) for treatment by a health care
    provider,” (ii) “[c]ontinue[] over an extended period of time,”
    and (iii) “[m]ay cause episodic rather than a continuing period
    of incapacity (e.g., asthma, diabetes, epilepsy, etc.).” 29
    C.F.R. § 825.102.
    Prior to taking leave, an employee must give her
    employer notice of the request for leave, “stat[ing] a
    qualifying reason for the needed leave.” 
    Id. § 825.301(b).
    An
    employer may require its employees to support their requests
    for leave with a certification issued by a health care provider.
    29 U.S.C. § 2613(a). A “sufficient” medical certification must
    state (1) the date on which the serious health condition began,
    (2) the probable duration of the condition, (3) relevant
    medical facts, (4) a statement that the employee is unable to
    perform the functions of her position, (5) the dates and
    duration of any planned medical treatment, and (6) the
    expected duration of the intermittent leave. 
    Id. § 2613(b).
    6
    Significantly, the Department of Labor’s regulations
    govern how employers are to respond to perceived
    deficiencies in employee notices generally, and in medical
    certifications in particular. While an employee seeking
    FMLA leave must “state a qualifying reason for the needed
    leave” and fulfill notice requirements, the employee “does not
    need to expressly assert rights under the Act or even mention
    the FMLA.” 29 C.F.R. § 825.301(b). Instead, in “any
    circumstance where the employer does not have sufficient
    information about the reason for an employee’s use of leave,
    the employer should inquire further of the employee . . . to
    ascertain whether leave is potentially FMLA-qualifying.” 
    Id. § 825.301(a).
    In addition, an employer “shall advise an
    employee whenever the employer finds a certification
    incomplete or insufficient, and shall state in writing what
    additional information is necessary to make the certification
    complete and sufficient.” 
    Id. § 825.305(c).
    A certification is
    “incomplete” if the “employer receives a certification, but one
    or more of the applicable entries have not been completed.”
    
    Id. A certification
    is “insufficient” if the “employer receives a
    complete certification, but the information provided is vague,
    ambiguous, or non-responsive.” 
    Id. If the
    employer
    determines that a certification is either incomplete or
    insufficient, it may deny the requested leave on the basis of
    an inadequate certification. But it may only do so if it has
    “provide[d] the employee with seven calendar days (unless
    not practicable under the particular circumstances despite the
    employee’s diligent good faith efforts) to cure any such
    deficiency.” Id.; see Hansen v. Fincantieri Marine Grp., LLC,
    
    763 F.3d 832
    , 837 (7th Cir. 2014) (“[T]he regulations do not
    authorize the employer to deny FMLA leave where the
    employee fails to provide a complete and sufficient
    certification but is not given the opportunity to cure the
    7
    deficiency.”).
    A.
    Hansler’s first claim is that Lehigh Valley interfered
    with her rights under the Medical Leave Act by failing to
    afford her a chance to cure deficiencies in her medical
    certification. This claim is based on statutory text providing
    that employers may not “interfere with, restrain, or deny the
    exercise of or attempt to exercise” rights granted under the
    Act. 29 U.S.C. § 2615(a)(1). Moreover, “[a]ny violations of
    the Act or of these regulations constitute interfering with” the
    exercise of an employee’s rights. 29 C.F.R. § 825.220(b). To
    assert an interference claim, an employee must establish,
    among other things, that she was denied benefits under the
    Act. Ross v. Gilhuly, 
    755 F.3d 185
    , 191-92 (3d Cir. 2014).
    The District Court held that Hansler was not entitled to
    leave or a cure period because her certification was “invalid”
    and “negative on its face.” The Court reasoned that while
    Hansler’s certification requested leave for one month, this
    was not an “extended period of time,” and, therefore, her
    condition did not qualify as a chronic serious health
    condition. In other words, her certification was not merely
    insufficient or incomplete—it demonstrated that she did not
    have a chronic serious health condition.
    Hansler does not argue on appeal that her certification
    established the “extended period of time” requirement, and
    8
    we do not decide that issue here.3 Instead, Hansler maintains
    she was entitled to the cure period set forth in the regulations
    because the certification was insufficient, rather than negative
    on its face. We agree.
    The regulations make no reference to negative
    certifications, the basis on which the District Court rejected
    Hansler’s claim. Instead, they provide that whenever an
    employer finds a certification “incomplete” or “insufficient,”
    the employer shall so advise the employee and provide seven
    days to cure the deficiencies. 29 C.F.R. § 825.305(c). A
    negative certification is a judicially crafted concept with roots
    in a decision from the Seventh Circuit Court of Appeals. See
    Stoops v. One Call Commc’ns, Inc., 
    141 F.3d 309
    (7th Cir.
    1998). In Stoops, the employee’s physician provided a
    medical certification stating that the employee was “not
    3
    A chronic serious health condition is one that, among other
    things, “[c]ontinues over an extended period of time.” 29
    C.F.R. § 825.102. Neither the Act nor the regulations provide
    further clarity as to what “extended period of time” means.
    We have found that a three-year duration for an employee’s
    condition constitutes an extended period of time. See
    Victorelli v. Shadyside Hosp., 
    128 F.3d 184
    , 189 (3d Cir.
    1997). Other courts have held that chronic illnesses “must
    exist for well more than a few weeks.” Taylor v. Autozoners,
    LLC, 
    706 F. Supp. 2d 843
    , 852 (W.D. Tenn. 2010) (quoting
    Flanagan v. Keller Prods., Inc., No. 00-542-M, 
    2002 WL 313138
    , at *7 (D.N.H. Feb. 25, 2002)). We will assume here,
    and Hansler does not argue otherwise, that a condition lasting
    for one month does not satisfy the “extended period of time”
    requirement.
    9
    presently incapacitated and would not have to work
    intermittently or on a reduced work schedule.” 
    Id. at 311.
    The
    Seventh Circuit described this as a “negative certification”
    because a serious health condition is one that prevents an
    employee from performing his job, but the employee’s
    physician in Stoops explicitly stated that the employee could
    perform his job functions. 
    Id. at 312-13.
    “Where an employer
    . . . requests from the employee and receives a physician’s
    certification that indicates that an employee’s serious health
    condition does not require him to miss work, the employer
    may rely on that certification.” 
    Id. at 313.
    Following Stoops, several other Courts of Appeals
    have discussed or alluded to negative certifications. In
    Hoffman v. Professional Med Team, the employee, like the
    one in Stoops, submitted a certification from a physician
    stating she would not need to work intermittently or on a less-
    than-full schedule as a result of her condition. Hoffman, 
    394 F.3d 414
    , 416 (6th Cir. 2005). The Sixth Circuit explained
    that, “[t]o be valid, a certification must show that the
    employee’s serious health condition makes her unable to
    perform job functions.” 
    Id. at 419.
    In Branham v. Gannett
    Satellite Information Network, Inc., the Sixth Circuit referred
    to a negative certification as one “indicating that [the
    employee] does not have a serious health condition that
    prevents her from performing her job.” 
    619 F.3d 563
    , 572
    (6th Cir. 2010). Similarly, the First Circuit found that an
    employer was justified in denying leave where the medical
    certification stated that the employee was “not incapacitated”
    and “disavowed the need for any leave.” Tayag v. Lahey
    Clinic Hosp., Inc., 
    632 F.3d 788
    , 793 (1st Cir. 2011).
    10
    We need not decide whether in certain circumstances a
    medical certification may be negative because, even if we
    were to agree with the cases finding negative certifications,
    we still would not find those cases persuasive here. The
    certifications in those cases contained affirmative statements
    from the employees’ physicians that the employees would not
    miss any work. To qualify for FMLA leave, however, an
    employee must have a “serious health condition,” defined as a
    physical or mental condition involving either inpatient care or
    continuing treatment involving a period of incapacity or
    treatment for incapacity. 29 U.S.C. §§ 2611(11),
    2612(a)(1)(D); 29 C.F.R. § 825.102. Thus, the certifications
    in those cases were facially incompatible with entitlement to
    FMLA leave.
    In contrast, the certification here—which requested
    “intermittent leave at a frequency of 2 times weekly . . . and
    lasting for a probable duration of one month,” App. 44—did
    not on its face disqualify Hansler from FMLA eligibility.
    Rather, because a “sufficient certification” for intermittent
    leave under 29 U.S.C. § 2613(b) must address both “the
    expected duration of the intermittent leave” and the “probable
    duration of the condition,” and because the certification here
    failed to specify whether the “probable duration of one
    month” referred to the duration of the leave request, the
    duration of the medical condition, or both, the certification
    was not a “negative certification,” but was instead “vague,
    ambiguous, or non-responsive,” meeting the definition of
    “insufficient.” 29 C.F.R. § 825.305(c); see Kauffman v. Fed.
    Express Corp., 
    426 F.3d 880
    , 886-87 (7th Cir. 2005)
    11
    (rejecting argument that certification was negative where
    physician omitted the incapacity’s expected duration).4
    In short, we hold today simply that when a
    certification submitted by an employee is “vague, ambiguous,
    or non-responsive” (or “incomplete,” for that matter) as to
    any of the categories of information required under 29 U.S.C.
    § 2613(b), the employer “shall advise [the] employee . . .
    what additional information is necessary to make the
    certification complete and sufficient” and “must provide the
    employee with seven calendar days . . . to cure any such
    deficiency.” 29 C.F.R. § 825.305(c). The plain and mandatory
    language of the statute and regulations requires no less.
    Lehigh Valley’s additional arguments in support of a
    negative certification are unavailing. It emphasizes that the
    Medical Leave Act is not a forward-looking statute and “does
    not require an employer to be clairvoyant.” Lichtenstein v.
    Univ. of Pittsburgh Med. Ctr., 
    691 F.3d 294
    , 303 (3d Cir.
    2012) (internal citations and quotation marks omitted).
    According to Lehigh Valley, the short duration of Hansler’s
    symptoms prior to her leave request provided no basis for it to
    4
    Lehigh Valley maintains that Hansler waived her argument
    concerning a distinction between the length of the requested
    leave and the expected duration of her condition by not
    raising it before the District Court. See Brennan v. Norton,
    
    350 F.3d 399
    , 415 n.12 (3d Cir. 2003). We disagree.
    Although Hansler did not mention this nuance in 29 U.S.C.
    § 2613(b), she did argue generally, with a supporting case and
    citations to regulations, that her certification was insufficient
    and that Lehigh Valley should have given her a chance to
    cure. Accordingly, Hansler has preserved the issue for appeal.
    12
    know that Hansler was suffering from a prolonged and
    chronic illness. This argument would carry more force if the
    issue at stake was notice. See 
    Ross, 755 F.3d at 191-92
    (explaining that to state a claim for interference, a plaintiff
    must give notice to the defendant of his or her intention to
    take leave). But no one disputes notice; Hansler provided
    Lehigh Valley with a certification specifically requesting
    leave under the Act. Thus, nothing in this opinion burdens
    employers with the troublesome task of predicting, on their
    own, the nature and trajectory of their employees’ illnesses.
    The relevant question here is not whether Lehigh Valley
    could have known Hansler was suffering from a chronic
    condition at the time she requested leave; instead, it is
    whether the certification was insufficient and/or incomplete.
    Receipt of an insufficient or incomplete certification triggers
    certain regulatory obligations on an employer that are
    unrelated to its understanding of the employee’s health
    condition.
    Similarly, Lehigh Valley maintains that Hansler’s
    post-termination diagnoses of diabetes and high blood
    pressure foreclose her ability to establish that she had a
    chronic serious health condition at the time she requested
    leave. See Navarro v. Pfizer Corp., 
    261 F.3d 90
    , 96 (1st Cir.
    2001) (explaining that operative time for determining whether
    a particular condition qualifies as a serious health condition is
    the time that leave is requested or taken). Again, this misses
    the point. That Hansler was diagnosed with her illnesses after
    she was fired does not affect the determination of whether her
    medical certification was insufficient.
    Having concluded that Hansler plausibly alleges her
    certification was insufficient rather than negative, the next
    13
    question is whether she states a claim for interference under
    the Act. Upon receipt of her insufficient certification, Lehigh
    Valley was required to (1) advise Hansler that her
    certification was insufficient, (2) state in writing what
    additional information was necessary to make it sufficient,
    and (3) provide her with an opportunity to cure before
    denying her request for leave. See 29 C.F.R. § 825.305(c).
    Lehigh Valley ignored these requirements and, instead,
    terminated Hansler without first notifying her that the request
    for leave had been denied. Assuming that she can prove she
    was denied benefits to which she was otherwise entitled,
    Hansler may premise her interference claim on these alleged
    regulatory violations.
    Though our Court has not yet ruled on this issue,
    several district courts in this circuit have found interference
    claims following an employer’s breach of its obligations
    under § 825.305 where the employee established entitlement
    or likely entitlement to FMLA benefits.5 The few relevant
    5
    See Patel v. Saint Vincent Health Ctr., No. 12-298, 
    2015 WL 630260
    , at *13 (W.D. Pa., Feb. 12, 2015) (“[Employer]
    interfered with Plaintiff’s FMLA rights by not informing her
    that the certification submitted by [the physician] was
    incomplete and insufficient.”); Herco v. Se. Pa. Transp.
    Auth., No. 10-796, 
    2011 WL 294493
    , at *3 (E.D. Pa. Jan. 25,
    2011) (finding interference claim based on employee’s
    submission of an incomplete medical certification and
    employer’s failure to request additional information);
    Marrero v. Camden Cnty. Bd. of Soc. Servs., 
    164 F. Supp. 2d 455
    , 466 (D.N.J. 2001) (“[T]ermination is not an appropriate
    response for an inadequate certification. [The regulations]
    14
    decisions from the Courts of Appeals suggest that qualifying
    employees who allege harm arising from the employers’
    failure to provide a cure period may assert a cause of action
    for interference. See 
    Kauffman, 426 F.3d at 886-87
    ; Darst v.
    Interstate Brands Corp., 
    512 F.3d 903
    , 910 (7th Cir. 2008);
    Sorrell v. Rinker Materials Corp., 
    395 F.3d 332
    , 337 (6th Cir.
    2005).
    Moreover, we find support for an interference claim
    based on this Court’s precedent concerning notice
    interference. In Conoshenti v. Public Service Electric & Gas
    Co., the plaintiff’s claim was based on his employer failing to
    advise him of his substantive rights under the Act in violation
    of regulatory requirements.6 
    364 F.3d 135
    , 142 (3d Cir.
    2004). The plaintiff there insisted that, if he had received the
    necessary information, “he would have been able to make an
    informed decision about structuring his leave and would have
    structured it, and his plan of recovery, in such a way as to
    preserve the job protection afforded by the Act.” 
    Id. at 142-
    43. We held this was a viable theory of recovery, explaining
    that the plaintiff “will show an interference with his right to
    provide[] that where an employer finds a certification
    incomplete, it must give the employee a reasonable
    opportunity to cure any deficiencies.”).
    6
    The regulations contain a number of provisions requiring
    employers to provide employees with notice of their rights
    and obligations. See generally 29 C.F.R. § 825.300. For
    example, an employer covered by the Act must include a
    notice in its employee handbooks explaining benefits and
    leave rights. 
    Id. § 825.300(a)(3).
    15
    leave under the FMLA . . . if he is able to establish that this
    failure to advise rendered him unable to exercise that right in
    a meaningful way, thereby causing injury.” 
    Id. at 143.
    Put
    another way, we found a cause of action for notice
    interference in the event plaintiff was able to show prejudice
    as a result of the violation. 
    Id. at 144;
    see also Ruder v.
    Pequea Valley Sch. Dist., 
    790 F. Supp. 2d 377
    , 394 (E.D. Pa.
    2011) (finding interference claim where the defendant’s
    failure to advise plaintiff of his eligibility to take leave
    “rendered him unable to exercise his rights”); Schaar v.
    Lehigh Valley Health Servs., Inc., 
    732 F. Supp. 2d 490
    , 496-
    97 (E.D. Pa. 2010) (finding interference claim where plaintiff
    alleged that “had she been informed that FMLA was an
    option for her absence, she would have taken her absence as
    FMLA leave”).
    The logic of Conoshenti naturally extends to an
    employer’s failure to comply with its regulatory obligations
    following receipt of an insufficient or incomplete medical
    certification. Just like employers must advise their employees
    of their rights under the Act, 29 C.F.R. § 825.300, they also
    must advise their employees of deficiencies in their medical
    certifications and provide them with an opportunity to cure,
    
    id. § 825.305(c).
    These modest burdens imposed on
    employers help ensure that employees are equipped with at
    least basic information about the Act’s requirements and have
    an opportunity to exercise their rights in a meaningful way.
    And to encourage employer compliance, the regulations
    provide injured employees with a cause of action for
    interference. See 29 C.F.R. § 825.220(b) (“Any violations of
    the Act or of these regulations constitute interfering with,
    restraining, or denying the exercise of rights provided by the
    16
    Act.”). If we were to find otherwise, employees would be left
    without a remedy.
    Based on the facts alleged in the complaint, we
    conclude that Hansler states a claim for interference under 29
    U.S.C. § 2615(a)(1). She alleges that, in violation of the
    regulations, Lehigh Valley failed to identify deficiencies in
    her medical certification and failed to provide her with an
    opportunity to cure. Hansler alleges she was prejudiced by
    these failures because, “[h]ad [Lehigh Valley] properly
    requested that [her] physician provide more information to
    show a serious health condition, [her] physician would have
    been [in] a position to provide the full diagnosis of [her]
    chronic health conditions.” App. 45. Instead of having the
    chance to exercise her rights in a meaningful way and
    demonstrate her entitlement to leave, Lehigh Valley fired her.
    As such, Hansler sufficiently alleges she was prejudiced as a
    result of Lehigh Valley’s regulatory violations. Indeed,
    Lehigh Valley does not appear to dispute a finding of
    prejudice, instead focusing its efforts on arguing that Hansler
    was not entitled to a cure period in the first instance—an
    argument we have rejected. Appellee Br. at 8 (“While it may
    be true that, had Hansler been given more time, she would
    have been able to offer additional information, this simply is
    not relevant to whether Hansler was entitled, under the
    FMLA regulations, to a cure period.”).
    Not only is our conclusion dictated by precedent as
    well as the statutory and regulatory text, but we believe the
    cure period makes abundant sense in this context. Faced with
    nascent symptoms from a yet-to-be diagnosed condition, an
    employee’s physician may need some additional time to
    provide the required elements of a sufficient certification,
    17
    including more specific information regarding relevant
    medical facts and the probable duration of the condition, the
    planned medical treatment, and the intermittent leave. 29
    U.S.C. § 2613(b). As this case illustrates, for an employee
    with an emerging condition, the difference between a medical
    certification that supports leave and one that is deficient
    might be a matter of days.7
    B.
    Hansler’s second claim is that Lehigh Valley
    terminated her in retaliation for seeking leave. Retaliation
    claims arise out of the Medical Leave Act’s prohibition on
    employers “discharg[ing] or in any other manner
    discriminat[ing] against any individual for opposing any
    practice made unlawful.” 29 U.S.C. § 2615(a)(2); see 29
    7
    The sine qua non of eligibility for leave is not a diagnosis,
    but a qualifying health condition to which a physician may
    attest by providing the specified categories of information,
    such as “appropriate medical facts . . . regarding the
    condition,” the “probable duration of the condition,” and,
    where intermittent leave is requested, “the expected duration
    of the intermittent leave.” 29 U.S.C. § 2613(b). Where a
    certification is incomplete or insufficient as to any one of the
    categories, nothing in the statute or the implementing
    regulations prevents the cure period from functioning as a
    grace period for the employee to obtain such information; on
    the contrary, they compel it. See 29 C.F.R. § 825.305(c). And
    if the employee happens to learn the name of her condition in
    the interim, that may well provide additional support for her
    request, but it surely does not negate the validity of the grace
    period.
    18
    C.F.R.     § 825.220(c)    (prohibiting    employers      from
    “discriminating or retaliating against an employee or
    prospective employee for having exercised or attempt[ing] to
    exercise FMLA rights”). To state such a claim, Hansler must
    allege (1) she invoked her right to leave, (2) she suffered an
    adverse employment decision, and (3) the adverse action was
    causally related to her invocation of rights. See 
    Lichtenstein, 691 F.3d at 301-02
    .
    The District Court dismissed Hansler’s retaliation
    claim, finding she did not make a “valid” request for leave.
    This conclusion flowed from our holding that “firing an
    employee for a valid request for FMLA leave may constitute
    interference with the employee’s FMLA rights as well as
    retaliation against the employee.” Erdman v. Nationwide Ins.
    Co., 
    582 F.3d 500
    , 509 (3d Cir. 2009). The District Court
    reasoned that because her leave request was “premised upon
    the existence of a serious chronic health condition and her
    medical certification was a negative certification with respect
    to such a condition, [Hansler’s] leave request was not a valid
    request entitling her to FMLA leave and, accordingly, may
    not form the basis for an FMLA retaliation claim.” Hansler,
    
    2014 WL 1281132
    , at *13.
    As we disagree with the underpinnings of this
    conclusion—i.e., the certification was negative and Hansler
    was not entitled to benefits under the Act—we hold that
    Hansler’s claim should not be dismissed at this stage. Hansler
    alleges she attempted to invoke her right to leave, she was not
    advised of deficiencies in her medical certification, she was
    not provided a cure period, and she was fired a few weeks
    later as a result of her leave request. Through discovery,
    Hansler might be able to show that Lehigh Valley had a
    19
    retaliatory motive and that the stated reason for termination
    was pretextual. See Lupyan v. Corinthian Colls. Inc., 
    761 F.3d 314
    , 325-26 (3d Cir. 2014); 
    Lichtenstein, 691 F.3d at 309-10
    .
    III.
    For the foregoing reasons, we reverse the order of the
    District Court and remand for further proceedings consistent
    with this opinion.
    20