OBJECTIVES: To examine the use of paid leaves and the overlap with non-paid Family and Medical Leaves (FMLs) in United States (US) employees with major depressive disorder (MDD).

METHODS: Retrospective analysis of the Workpartners Research Reference Database (RRDb) included employees with two years of post MDD diagnosis FML (unpaid job-protection leave for self or family illness mandated in US), Short- and Long-term Disability (STD and LTD, respectively used for non-work-related injuries/illnesses), and Workers’ Compensation (WC, used for work-related injuries/illnesses) eligibility from 2018 through 2022. Employees with MDD were identified and indexed by the initial ICD-10 codes claims. FML utilization based on employer human resource data. The control group was a 3:1 random subset of employees without MDD, with an index date randomly assigned between 2018 and 2020. The following outcomes were reported: FML claims opened in the year after the index date; STD, LTD, and WC leaves initiated during the first 2 years after the index date; and STD, LTD, and WC leaves initiated during the year following an FML leave to measure overlap. All reported comparisons P<0.01.

RESULTS: There were 7888 employees with MDD and 23,586 controls. FML claims were filed by 1806 (22.9%) of those with MDD and 1950 (8.3%) controls. In the year following the FML claim, MDD patients and controls filed claims for: STD 12.3% vs 3.3%; LTD 0.3% vs 0.1%; and WC 0.8% vs 0.1%, respectively. Compared with controls, employees with MDD were more likely to have claims in the 2 years for: STD 277%; LTD 272%; and WC 306%. Further, compared with controls, employees with MDD taking FML were more likely to have overlapping claims for STD 370%; LTD 505%; and WC 580%.

CONCLUSIONS: Employees with major depressive disorder utilize a variety of paid and unpaid leaves approximately three times more than controls.