Legal Research AI. Understand the law

Hurlbert Ex Rel. Estate of Hurlbert v. St. Mary's Health Care System, Inc.

Court: Court of Appeals for the Eleventh Circuit
Date filed: 2006-02-16
Citations: 439 F.3d 1286
Copy Citations
158 Citing Cases
Combined Opinion
                                                                       [ PUBLISH]


               IN THE UNITED STATES COURT OF APPEALS

                        FOR THE ELEVENTH CIRCUIT                      FILED
                          ________________________          U.S. COURT OF APPEALS
                                                              ELEVENTH CIRCUIT
                                                                 February 16, 2006
                                No. 05-10252                   THOMAS K. KAHN
                          ________________________                 CLERK

                     D. C. Docket No. 03-00080-CV-CAR-3


BARBARA J. HURLBERT,
Executor of the Estate of Thomas Hurlbert

                                                               Plaintiff-Appellant,

                                      versus

ST. MARY'S HEALTH CARE SYSTEM, INC.,

                                                              Defendant-Appellee.


                          ________________________

                   Appeal from the United States District Court
                       for the Middle District of Georgia
                        _________________________

                               (February 16, 2006)

Before BIRCH, WILSON and COX, Circuit Judges.

WILSON, Circuit Judge:

      Barbara J. Hurlbert, executor of the estate of Thomas Hurlbert, appeals the
district court’s order granting summary judgment to Thomas Hurlbert’s

(“Hurlbert”) former employer, St. Mary’s Health Care System, Inc. (“St. Mary’s”),

on Hurlbert’s claims under the Family and Medical Leave Act of 1993 (“FMLA”

or the “Act”).1 The district court determined that Hurlbert could not establish

statutory entitlement to FMLA leave, and that his FMLA interference and

retaliation claims must therefore fail. With respect to Hurlbert’s retaliation claim,

the court further found Hurlbert had failed to present sufficient evidence that St.

Mary’s proffered reason for his termination was pretextual. We hold that the

district court erred in construing pertinent regulatory language, and in assessing the

evidence of pretext. As a result, we reverse and remand for further proceedings on

both the interference and the retaliation claims.



                                      I. BACKGROUND

       Hurlbert started working for St. Mary’s in 1989, as a paramedic. In addition

to fulfilling his duties at St. Mary’s, Hurlbert worked full-time with the Rockdale

County Fire Department (“Rockdale”). His duties at Rockdale included

firefighting and dealing with hazardous materials, although he was also able to



       1
         At oral argument, appellant’s counsel stated that Hurlbert, the original Plaintiff in this
action, had recently died in the line of duty while serving as a firefighter. For ease of reference,
we will refer to Hurlbert in the present tense.

                                                  2
employ his paramedic skills as needed.

       Shortly after being hired by St. Mary’s, Hurlbert was promoted to a

supervisory position that involved the maintenance of St. Mary’s emergency

medical services (“EMS”) vehicles. Approximately five years later Hurlbert’s

duties changed, and he became responsible for supervising one of St. Mary’s three

emergency medical technician (“EMT”) shifts. Among other things, Hurlbert was

required to ensure that EMS units were adequately staffed during his shift, to visit

and check on the various duty stations from which the units operated, and to

transport linens.

       Hurlbert suffered a heart attack in October of 1999. After he underwent a

successful angioplasty and stent replacement, he was released by his cardiologist,

Dr. Thomas Murphy, to return to work at St. Mary’s on November 9th, and at

Rockdale on November 16th. Prior to his release, Hurlbert was diagnosed with

depression and anxiety, as well as sinusitis. Among the medications he was

prescribed was Paxil, for anxiety and stress.2 Hurlbert did return to full-time work,

however, at both St. Mary’s and Rockdale.

       In February of 2002, St. Mary’s underwent an internal reorganization. The

oversight of EMS was transferred from vice-president Marilyn Hill to executive


       2
        It is uncontroverted that Hurlbert remained on Paxil up through the time he filed suit in
August of 2003, and that his dosage was increased at one point.

                                                3
director Bonnie Butler, who had been directing various other services at St. Mary’s

for eight years. After conducting a departmental review of EMS, Butler concluded

that its director position should be replaced by that of a working manager. In July

of 2002, Butler eliminated the position of EMS director held by Frank “Sparky”

Wilson, and promoted Jeff Sosby to the new working manager position.3

       As part of Butler’s departmental review, she reassessed a number of

unresolved patient complaints, including one about medical services rendered by

Hurlbert to a five-year old child back in late February of 2002. Butler ultimately

concluded that Hurlbert had falsified his account of events, and should have been

terminated by Sparky Wilson. Given the age of the complaint, however, she issued

Hurlbert a disciplinary letter instead of terminating him. Hurlbert, who denied

engaging in any falsification, filed a grievance regarding the disciplinary action.

During the early stages of the grievance process, Butler decided to have Hurlbert

undergo a competency evaluation.4

       Around that time Hurlbert also learned that his mother would have to

undergo open heart surgery, and used several vacation days in early August to go

visit her. On August 14th, the EMS medical director, Dr. Jerome Howell,

       3
           Sosby, like Hurlbert, had been serving as one of the EMS shift supervisors.
       4
         Butler testified in her deposition that she was concerned the father of the child with the
seizure disorder might bring a lawsuit against St. Mary’s or Hurlbert, and that she “felt like it
was our responsibility to protect Tom [Hurlbert] by proving his competency.”

                                                  4
administered a skills competency test to Hurlbert. Although each of the seven

competency areas on the exam was pass/fail only, and Hurlbert passed five, Dr.

Howell did not mark either “pass” or “fail” in two of the competency areas.

Instead, Dr. Howell commented that Hurlbert (1) seemed “rusty” in his use of the

Lifepak 10 and was not familiar with the use of the Lifepak 12, and (2) needed to

review the use of drugs contained in the EMS “drug bag,” as well as how those

drugs are administered. Dr. Howell does not recall discussing the results of the

examination with Butler, but did tell education director Mike McElhannon that

Hurlbert needed to do some additional review. Hurlbert likewise recalls Dr.

Howell telling him to brush up on the drug bag portion of the test.

       On September 4th, Hurlbert received a hearing before an internal committee

on his grievance. The committee upheld Butler’s disciplinary action, but removed

her reference to “falsification.” Later that same day, Hurlbert met with Dr. Howell

to complete the Lifepak and drug bag portions of Hurlbert’s earlier competency

exam.5 Hurlbert remembers making a mistake in describing one drug, but claims

Dr. Howell told him it didn’t matter because St. Mary’s was going to remove that

drug from the drug box altogether. Hurlbert also contends that Dr. Howell never

said that Hurlbert failed the test. Dr. Howell’s recollection is that Hurlbert had


       5
        Although Dr. Howell cannot recall whether he tested Hurlbert on the use of the Lifepak
10 and 12 at this meeting, Hurlbert does remember doing a Lifepak test.

                                               5
clearly studied and was making his best effort, but had not necessarily established

that he was prepared to perform the duties of his position. Dr. Howell was

concerned about Hurlbert’s ability to perform under stress, and suggested to

Hurlbert that he might need to “tak[e] some time off or tak[e] a break or maybe,

you know, stay[] off the truck and do[] something else for a while.” Similarly,

Hurlbert recalls discussing with Dr. Howell the increasing stress and exhaustion

created by Hurlbert’s heavy workload, the feeling of being singled out for

discipline, and his mother’s health. Hurlbert remembers stating that he needed to

visit his mother, and didn’t want to continue working as a paramedic until he had

done so. According to Hurlbert, Dr. Howell advised him to relax and assured him

that he (Howell) would help Hurlbert get some time off to visit his mom.

      After finishing with Hurlbert, Dr. Howell went to speak with Mike

McElhannon about Hurlbert’s status. Howell explained to McElhannon (and Jeff

Sosby, who also was present) that he (Howell) thought Hurlbert “was showing

signs that his confidence in his own knowledge and experience was in doubt and I

think under stress, he was wavering a little.” Howell recalls stating that it would

be helpful if Hurlbert could take on a more laid-back job, but denies ever saying

that Hurlbert should not serve as a paramedic/EMT, or that Hurlbert should be

terminated. At some point after Dr. Howell finished speaking with McElhannon



                                          6
and Sosby, Hurlbert located Sosby and asked about taking leave:

      I indicated to him that I wanted to put in for a leave. And he told me
      he didn’t know how to do that, that he was new at that job, which he
      had just been put into it [sic]. He wasn’t really familiar with it and he
      didn’t know if he had paperwork and all this other [sic]. And I says,
      “Well, okay. Well, I surely would appreciate it if you would make the
      arrangements because I would just like to take off and get out of here
      and . . . go see my mom.”

Sosby replied that he would look into the matter, and later obtained a leave form

for Hurlbert.

      At some point between the end of Hurlbert’s examination on September 4th

and the morning of September 6th, Bonnie Butler met with Dr. Howell. According

to Butler, Dr. Howell explained that Hurlbert had improved in his understanding of

medications, but became confused about how to use them when given certain

scenarios. Butler contends that Dr. Howell could not recommend putting Hurlbert

“back on the truck.” Dr. Howell did ask, however, whether there were other jobs

within St. Mary’s system that Hurlbert could perform, and Butler replied that she

would check and see. It appears that Butler also met with St. Mary’s vice president

of human resources and support services, Jeff English, who testified in his

deposition that Butler told him Dr. Howell “felt like it wasn’t the right thing to do

to put Tom [Hurlbert] back on the truck.” According to English, Butler also

discussed with him several options she had been thinking about regarding Hurlbert:



                                           7
(1) try to help Hurlbert find a different job within St. Mary’s system; (2) let

Hurlbert resign and provide him thirty days’ severance pay; or (3) terminate

Hurlbert’s employment. English acknowledged that leave was not discussed as an

option in his conversation with Butler, but explained that he was not then aware of

Hurlbert’s desire to go on leave.

       On September 6th, Hurlbert again met with Sosby in order to fill out leave-

related paperwork. According to Hurlbert, Sosby initially agreed to help with the

paperwork, but when Hurlbert returned to Sosby’s office after leaving to use the

restroom, Sosby informed him that plans had changed: Hurlbert could either resign

and receive a month’s severance pay, or be fired.6 Hurlbert described his response

as follows:

       “Mr. Sosby, my answer to that is I’m not going to resign. I absolutely
       refuse to resign. So I would think by default that I’m terminated, so I
       suppose my next step, which I’m fixing to go do, is go clock out and
       I’m going to go home. I don’t intend to stay here for free.”

When Hurlbert arrived at his home, however, he received a phone call from Bonnie

Butler. According to Hurlbert, Butler stated that he wasn’t fired and asked him to

come to her office that afternoon. When Hurlbert arrived, Butler and another St.

       6
         Sosby’s account is somewhat different. He recalls stating to Hurlbert that Dr. Howell
did not recommend that Hurlbert “go back on the truck,” because Hurlbert “seemed to know his
medications but when placed in a situation or under stress–or in a situation of how to use them or
under any type of stress, then he would go in any direction . . . .” Hurlbert could resign and
probably be placed in another hospital position that would be less stressful, or face probable
termination.

                                                8
Mary’s employee named Karen were present. Butler explained that Hurlbert could

no longer serve as a paramedic at St. Mary’s, and Hurlbert then inquired about his

leave:

         And I says, “Well, Ms. Butler, I have one question before we keep
         going on in this–discussing this anymore.” I figured right then I was
         terminated, but I asked her also, I says, “What’s important to me
         now,” I says, “the leave isn’t going to happen, is it?” And she says,
         “No, it’s not.” Talking about my medical leave that I requested [sic].

Hurlbert then stated that the meeting was over, the refusal of leave was illegal, and

he would be speaking to his attorney.7 Sosby, who was also present during the

meeting, testified that after Hurlbert left, he (Sosby) probably told Butler that

Hurlbert had requested FMLA leave and that Sosby had brought the paperwork

with him.

         On September 10th, Sosby received a letter from Hurlbert. The letter

purported to be a “follow up” to Hurlbert’s “request to take FMLA leave as was

recommended by Dr. Howell last week.” Hurlbert explained in the letter that he

had been treated by his family physician, Dr. Samuel Griffin, and that Dr. Griffin

agreed Hurlbert needed to take a 30 day leave of absence because of the mental

         7
         Butler’s account of the meeting is somewhat different. She testified that she gave
Hurlbert the three options discussed earlier (find another job at St. Mary’s, resign and receive
severance, or be terminated), and that Hurlbert refused to seek another job or resign, and left.
Butler disputes Hurlbert’s claim that he asked about his leave. After Hurlbert left, Butler called
Jeff English to inform him about what had happened. English recalls that he advised her to
follow through with termination, because walking out on a meeting with superiors was
“borderline insubordinate behavior.”

                                                 9
stress Hurlbert was under and its impact on his health. Hurlbert attached a note

from Dr. Griffin, dated September 9, 2002, which indicated that Hurlbert was

under Dr. Griffin’s treatment and could return to work on October 9, 2002. In the

letter Hurlbert also expressed his understanding that leave papers had been sent to

Sosby for Hurlbert to complete, but that Hurlbert’s meeting with Butler “prevented

these papers from being completed and submitted.” Hurlbert asked if he needed to

complete any paperwork “to formally request leave,” and requested that his

accrued paid sick and vacation leave be applied during the 30 day period.

       Although Sosby and Butler discussed Hurlbert’s letter, Butler advised that

St. Mary’s could not grant leave after Hurlbert had been terminated.8 A corrective

counseling action form dated September 6, 2002, which was stamped received by

human resources on September 9th, appears to have been signed by Butler, Sosby,

and one Karen Joyce. The form states that Hurlbert was discharged due to his

“inability to pass the competency review.” Butler’s name also appears on a

personnel action request form (“PAR”) dated September 6th. Although the PAR

indicates that Hurlbert was terminated, and that termination requires the

completion of certain additional sections on the form (including the reason for

termination), these sections are blank. According to Jeff English, the issuance of


       8
         Like Butler, Sosby testified that he understood Hurlbert to have been terminated due to
what transpired in Hurlbert’s meeting with Butler, Sosby, and Karen.

                                               10
corrective counseling action form and PAR formalize the termination process, and

human resources will typically prepare a separation notice within a day or two of

receiving the PAR. Although Hurlbert’s PAR is stamped received by human

resources on September 9th, his separation notice was not issued until September

18th, though it was backdated to September 6th.9 The notice identifies the reason

for Hurlbert’s separation as “[f]ailure to meet competency requirements.”

       Approximately 11 months after receiving his separation notice, Hurlbert

filed suit against St. Mary’s under the FMLA, pleading for damages and

declaratory and injunctive relief. Hurlbert alleges that St. Mary’s terminated him

following his request for leave, thus interfering with Hurlbert’s right to take FMLA

leave and retaliating against him in violation of the FMLA.

       The district court granted St. Mary’s motion for summary judgment on both

claims. Although the court found genuine issues of fact on whether Hurlbert had

requested FMLA leave before or after termination, the court determined that

Hurlbert could not establish statutory entitlement to the leave because: (1) the

stress suffered by Hurlbert was not a “serious health condition” under the statute;

(2) Hurlbert could not link the stress to the period of incapacity caused by his heart


       9
         On September 12th, Hurlbert’s attorney sent a letter to Butler indicating that Hurlbert
had not received any written notice of termination, and requesting the reasons for termination if
Hurlbert had in fact been terminated. Butler testified that she received this letter, but did not
remember when she received it.

                                                11
attack in 1999; and (3) Hurlbert could not rely on his mother’s health condition

because he had not raised it in his complaint. Without statutory eligibility for

leave, the court concluded, Hurlbert’s interference claim must fail. Hurlbert’s

retaliation claim likewise failed, the district court determined, because Hurlbert

“could not have availed himself of FMLA rights that he did not possess.” Even if

Hurlbert could bring a retaliation claim, the court added, Hurlbert’s only evidence

of pretext was his own subjective belief about the basis for his termination, which

is insufficient to survive summary judgment. Hurlbert appeals both

determinations.



                           II. STANDARD OF REVIEW

      “We review the district court’s grant of summary judgment de novo,

applying the same legal standards that bound the district court, and viewing all

facts and reasonable inferences in the light most favorable to the nonmoving

party.” Cruz v. Publix Super Mkts., Inc., 428 F.3d 1379, 1382 (11th Cir. 2005)

(internal quotes and emphasis omitted). Summary judgment is appropriate where

“the pleadings, depositions, answers to interrogatories, and admissions on file,

together with the affidavits, if any, show that there is no genuine issue as to any

material fact and that the moving party is entitled to judgment as a matter of law.”

Fed. R. Civ. P. 56(c).

                                          12
                                 III. DISCUSSION

      The FMLA grants an eligible employee the right to take up to 12 workweeks

of unpaid leave annually for any one or more of several reasons, including

“[b]ecause of a serious health condition that makes the employee unable to perform

the functions of the position of such employee.” 29 U.S.C. § 2612(a)(1)(D). The

Act creates a private right of action to seek equitable relief and money damages

against employers who “interfere with, restrain, or deny the exercise of or the

attempt to exercise” FMLA rights. 29 U.S.C. §§ 2615(a)(1), 2617(a); see Nev.

Dep’t of Human Res. v. Hibbs, 538 U.S. 721, 724-25, 123 S. Ct. 1972, 1976, 155

L. Ed. 2d 953 (2003). We have recognized that § 2615(a) creates two types of

claims: “interference claims, in which an employee asserts that his employer

denied or otherwise interfered with his substantive rights under the Act, and

retaliation claims, in which an employee asserts that his employer discriminated

against him because he engaged in activity protected by the Act.” Strickland v.

Water Works and Sewer Bd. of the City of Birmingham, 239 F.3d 1199, 1206 (11th

Cir. 2001) (internal citations omitted).

A.    Interference Claim

      To establish an interference claim, “an employee need only demonstrate by a

preponderance of the evidence that he was entitled to the benefit denied.” Id. at

1207. The employee need not allege that his employer intended to deny the

                                           13
benefit–“the employer’s motives are irrelevant.” Id. at 1208. Hurlbert contends

the district court erred in determining that he did not suffer from a “serious health

condition,” and thus was not entitled to FMLA leave. As defined in the FMLA,

“serious health condition” means “an illness, injury, impairment, or physical or

mental condition that involves– (A) inpatient care in a hospital, hospice, or

residential medical care facility; or (B) continuing treatment by a health care

provider.” 29 U.S.C. § 2611(11). Hurlbert points to the fact that he was diagnosed

with anxiety following his 1999 heart attack as evidence of a mental condition

involving “continuing treatment by a health care provider.” We must consider this

argument not only under the language of the statute, but also under pertinent

regulations promulgated by the Department of Labor:

      (a) For purposes of FMLA, “serious health condition” entitling an
      employee to FMLA leave means an illness, injury, impairment, or
      physical or mental condition that involves:

      ....

      (2) Continuing treatment by a health care provider. A serious health
      condition involving continuing treatment by a health care provider
      includes any one or more of the following:

      (i) A period of incapacity (i.e., inability to work, attend school or
      perform other regular daily activities due to the serious health
      condition, treatment therefor, or recovery therefrom) of more than
      three consecutive calendar days, and any subsequent treatment or
      period of incapacity relating to the same condition, that also involves:

      (A) Treatment two or more times by a health care provider, by a nurse

                                          14
       or physician’s assistant under direct supervision of a health care
       provider, or by a provider of health care services (e.g., physical
       therapist) under orders of, or on referral by, a health care provider; or

       (B) Treatment by a health care provider on at least one occasion
       which results in a regimen of continuing treatment under the
       supervision of the health care provider.

29 C.F.R. § 825.114; see Russell v. North Broward Hosp., 346 F.3d 1335, 1342

(11th Cir. 2003).10

       Hurlbert argues that he meets the requirements of § 825.114(a)(2)(i),

because his October 1999 heart attack resulted in a period of incapacity exceeding

three calendar days, and his subsequent treatment for anxiety “related to” that

condition and involved a regimen of continuing treatment, i.e., a Paxil

prescription.11 The district court found this argument unpersuasive, because it

found “no evidence that Hurlbert’s heart attack and that period of incapacity almost

three years prior was sufficiently related to the events at issue.” We agree, in that

Hurlbert’s argument tends to conflate his heart attack and his anxiety. Section

825.114(a)(2)(i) refers to a “period of incapacity . . . due to the serious health



       10
          Congress authorized the Secretary of Labor to promulgate regulations “necessary to
carry out” the FMLA, 29 U.S.C. § 2654, and “[t]he Secretary’s judgment that a particular
regulation fits within this statutory constraint must be given considerable weight.” Ragsdale v.
Wolverine World Wide, Inc., 535 U.S. 81, 86, 122 S. Ct. 1155, 1160, 152 L. Ed. 2d 167 (2002).
Here, there is no claim that any applicable regulations promulgated by the Secretary are
“arbitrary, capricious, or manifestly contrary to the statute.” Id. (internal quotations omitted).
       11
         As the district court correctly acknowledged, a regimen of continuing treatment under
§ 825.114(a)(2)(i)(B) includes “a course of prescription medication.” 29 C.F.R. § 825.114(b).

                                                15
condition . . . and any subsequent treatment or period of incapacity relating to the

same condition . . . .” (emphasis omitted). Although Hurlbert was incapacitated by

his heart attack, the summary judgment evidence is not that Hurlbert was

prescribed Paxil for his heart attack, but rather for anxiety, with which he was

separately diagnosed before returning to work. Thus, we are not persuaded that

any treatment for or period of incapacity caused by Hurlbert’s anxiety “relates to”

his heart attack for purposes of § 825.114(a)(2)(i).

      Even if this is so, Hurlbert argues, he still meets the conditions described in

§ 825.114(a)(2)(i), because his anxiety was itself the cause of a period of

incapacity–the thirty day period described in Hurlbert’s September 10th letter

(which stated that he needed a thirty day leave of absence due to mental stress) and

evidenced by Dr. Griffin’s note. The district court rejected this argument on the

grounds that Hurlbert was not “incapacitated” within the meaning of § 825.114,

because Hurlbert had continued to work at Rockdale during the thirty day period in

question. In reaching this conclusion, the district court held that Hurlbert’s

showing of incapacity “must be made in accordance with the Americans with

Disabilities Act (ADA), 42 U.S.C. § 12101, et seq., and the regulations at 29

C.F.R. § 1630.2(n), 29 C.F.R. § 825.115.” Under these provisions, the court

reasoned, one must show that he is substantially limited or significantly restricted

in the ability to perform either a class of jobs, or a broad range of jobs in various

                                           16
classes, as compared to an average person with comparable training, skills, and

abilities. While Hurlbert may not have been able to work as a paramedic at St.

Mary’s, the court explained, his work at Rockdale was sufficiently similar to

preclude him from establishing the requisite period of incapacity.

       The district court erred when it conducted an incapacity analysis under the

ADA and corresponding regulations. Section 825.115 does refer to the ADA and

29 C.F.R. § 1630.2(n) as relevant for purposes of determining whether an

employee is “unable to perform the functions of the position of the employee”

under 29 U.S.C. § 2612(a)(1)(D), but that statutory inquiry is distinct from the

inquiry into whether an employee has a “serious health condition,” which is where

the term “incapacity” comes into play. See, e.g., Stekloff v. St. John’s Mercy

Health Sys., 218 F.3d 858, 860-62 (8th Cir. 2000). As the Eighth Circuit pointed

out in Stekloff, there may be some parallels between the ADA and FMLA, but

applicable regulations explicitly state that “ADA’s ‘disability’ and [the] FMLA’s

‘serious health condition’ are different concepts, and must be analyzed separately.”

Id. at 861 (quoting 29 C.F.R. § 825.702(b)).

       The definition of “incapacity” is set out in § 825.114: “A serious health

condition . . . includes . . . [a] period of incapacity (i.e., inability to work, attend

school or perform other regular daily activities due to the serious health condition,




                                             17
treatment therefor, or recovery therefrom) . . . .” 29 C.F.R. § 825.114(a)(2).12 For

the reasons stated above, however, we decline to identify the meaning of “inability

to work” with the ADA inquiry into whether a person is unable to perform the

“major life activity of working,” 29 C.F.R. § 1630.2(j)(3). Instead, we agree with

the analysis of the Eighth Circuit in Stekloff:

       Upon consideration of the declared purposes of the FMLA and its
       legislative history, we hold that a demonstration that an employee is
       unable to work in his or her current job due to a serious health
       condition is enough to show that the employee is incapacitated, even if
       that job is the only one the employee is unable to perform.”

218 F.3d at 861 (emphasis added). But cf. 29 C.F.R. § 1630.2(j)(3)(i) (explaining

that under the ADA “[t]he inability to perform a single, particular job does not

constitute a substantial limitation in the major life activity of working”). We

therefore reject St. Mary’s claim that, as a matter of law, Hurlbert could not have

experienced an “inability to work” (in his position at St. Mary’s) within the

meaning of § 825.114(a)(2)(i) when he continued to perform similar duties for

Rockdale.13

       St. Mary’s argues that summary judgment was nevertheless appropriate,

because Hurlbert presented no medical evidence of an inability to work for three


       12
         The foregoing language also appears as part of the definition of “continuing treatment”
in 29 C.F.R. § 825.800, which contains various definitions applicable to Part 825 of Title 29.
       13
         We further note that there is a genuine issue of fact as to the degree of similarity, if
any, between Hurlbert’s job at St. Mary’s and his job at Rockdale.

                                                 18
days or more, or an inability to “perform the functions of his position.”14 Having

reviewed the record in the light most favorable to Hurlbert, including the testimony

of Dr. Howell and Hurlbert’s note from Dr. Griffin, we find that there are genuine

issues of fact precluding summary judgment for St. Mary’s on these grounds. We

must therefore reverse the district court’s grant of summary judgment on

Hurlbert’s interference claim and remand it for further proceedings.

       In addition to the theories discussed above, Hurlbert asserted two other

arguments in support of his interference claim. One was that he could satisfy

§ 825.114(a)(2)(iii), because his anxiety amounted to a “chronic serious health

condition” described therein.15 Like Hurlbert’s claim under § 825.114(a)(2)(i), the

       14
            Title 29 C.F.R. § 825.115 states in relevant part:

       An employee is “unable to perform the functions of the position” where the health
       care provider finds that the employee is unable to work at all or is unable to perform
       any one of the essential functions of the employee’s position within the meaning of
       the Americans with Disabilities Act (ADA), 42 USC 12101 et seq., and the
       regulations at 29 CFR § 1630.2(n).
       15
         A serious health condition involving continuing treatment by a health care provider
may include:

       (iii) Any period of incapacity or treatment for such incapacity due to a chronic
       serious health condition. A chronic serious health condition is one which:

       (A) Requires periodic visits for treatment by a health care provider, or by a nurse or
       physician’s assistant under direct supervision of a health care provider;

       (B) Continues over an extended period of time (including recurring episodes of a
       single underlying condition); and

       (C) May cause episodic rather than a continuing period of incapacity (e.g., asthma,
       diabetes, epilepsy, etc.).

                                                   19
district court found this argument unavailing because a chronic serious health

condition requires a “period of incapacity” and, under the district court’s

interpretation of the applicable regulations, Hurlbert’s work at Rockdale precluded

such a finding. As we disagree with that aspect of the district court’s

interpretation, and as St. Mary’s has presented no further argument (other than

those already discussed above) on why § 825.114(a)(2)(iii) could not apply,

Hurlbert is free to reassert this theory on remand. However, the district court

correctly rejected Hurlbert’s final argument–that he was entitled to FMLA leave in

order to care for his mother, who was recovering from heart surgery.

       The FMLA authorizes leave “[i]n order to care for the . . . parent, of the

employee, if such . . . parent has a serious health condition.” 29 U.S.C.

§ 2612(a)(1)(C). Hurlbert’s complaint, however, provided no notice whatsoever

that he believed he was entitled to leave on this basis. Indeed, the only person in

the complaint alleged to have a experienced a serious health condition is Hurlbert.

We have previously held that Rule 8(a)’s liberal pleading standard is inapplicable

once discovery has commenced, and that “[a]t the summary judgment stage, the




29 C.F.R. § 825.114(a)(2)(iii). The regulations further note that absences attributable to
incapacity under paragraph (iii) “qualify for FMLA leave even though the employee . . . does not
receive treatment from a health care provider during the absence, and even if the absence does
not last more than three days.” Id. at § 825.114(e).


                                               20
proper procedure for plaintiffs to assert a new claim is to amend the complaint in

accordance with Fed. R. Civ. P. 15(a).” Gilmour v. Gates, McDonald and Co., 382

F.3d 1312, 1315 (11th Cir. 2004) (per curiam). Hurlbert argues that this rule is

inapplicable, because his allegations about his mother do not raise a new “claim,”

and are merely additional facts asserted in support of the interference claim already

pled in his complaint. We disagree. The sole basis for entitlement to FMLA leave

pled in Hurlbert’s interference claim was his alleged serious health condition. See

29 U.S.C. § 2612(a)(1)(D). Thus, the subsequent assertion of an additional,

separate statutory basis for entitlement to leave (caring for a parent’s serious health

condition) effects a fundamental change in the nature of Hurlbert’s interference

claim. See id. at § 2612(a)(1)(C). Having proceeded through discovery without

amending (or seeking to amend) his complaint to reflect that fundamental change,

Hurlbert was not entitled to raise it in the midst of summary judgment. See

Gilmour, 381 F.3d at 1315 (“A plaintiff may not amend [his] complaint through

argument in a brief opposing summary judgment.”).

B.    Retaliation Claim

      Where, as here, a plaintiff alleges an FMLA retaliation claim without direct

evidence of the employer’s retaliatory intent, we apply the burden shifting

framework established by the Supreme Court in McDonnell Douglas Corp. v.

Green, 411 U.S. 792, 93 S. Ct. 1817, 36 L. Ed. 2d 668 (1973). Strickland, 239

                                          21
F.3d at 1207. To establish a prima facie case of retaliation, the plaintiff must show

that: (1) he engaged in statutorily protected activity; (2) he experienced an adverse

employment action; and (3) there is a causal connection between the protected

activity and the adverse action. See id.; Smith v. BellSouth Telecomms., Inc., 273

F.3d 1303, 1314 (11th Cir. 2001). If the plaintiff makes out a prima facie case, the

burden then shifts to the defendant to articulate a legitimate reason for the adverse

action. Smith, 273 F.3d at 1314. If the defendant does so, the plaintiff must then

show that the defendant’s proffered reason for the adverse action is pretextual. Id.

       The district court held that Hurlbert’s retaliation claim failed based on the

court’s determination that Hurlbert failed to establish he was entitled to FMLA

leave in the first place.16 We cannot agree with this reasoning, because we

determined above that Hurlbert did raise genuine issues of material fact on whether

he was entitled to leave. By doing so, Hurlbert likewise raised genuine issues of

material fact on whether he engaged in statutorily protected activity under the

FMLA–and St. Mary’s does not argue that he failed to establish or raise a genuine

issue of material fact on the second and third elements of his prima facie case.



       16
          We have held that one cannot bring an FMLA retaliation claim based on “an attempt to
exercise a right that is not provided by [the] FMLA,” such as “the right to leave before one
becomes eligible therefor.” Walker v. Elmore County Bd. of Educ., 379 F.3d 1249, 1253 (11th
Cir. 2004). We do not address whether this principle would apply to the instant case, because we
have determined that Hurlbert raised genuine issues of material fact on whether he was entitled
to FMLA leave.

                                              22
Hurlbert’s termination is certainly an adverse employment action, and the facts,

when read in the light most favorable to Hurlbert, indicate that his termination

occurred within days of his request for leave. Close temporal proximity between

protected conduct and an adverse employment action is generally “sufficient

circumstantial evidence to create a genuine issue of material fact of a causal

connection.” Brungart v. Bellsouth Telecomms., Inc., 231 F.3d 791, 799 (11th Cir.

2000). An exception to this rule applies where there is “unrebutted evidence that

the decision maker did not have knowledge that the employee engaged in protected

conduct,” id., but genuine issues of material fact preclude the application of this

exception to the instant case. The summary judgment evidence, when considered

in the light most favorable to Hurlbert, suggests that Jeff Sosby, Bonnie Butler, and

Jeff English were all involved in the decision to terminate Hurlbert. It appears that

by September 4th, Sosby was aware of Hurlbert’s desire to take leave–and that

Sosby was also present on September 6th when Hurlbert claims to have again

raised the issue of leave in his meeting with Butler, who then conferred with Sosby

and contacted English. Although St. Mary’s claims that Hurlbert was terminated

no later than September 6th, a number of irregularities in the termination process

call this claim into question. See infra. Thus, a jury could reasonably infer that the

person who decided to terminate Hurlbert (or who made a critical recommendation

on the issue) had prior knowledge of his request for leave.

                                          23
      The district court, however, also found that Hurlbert had failed to present

evidence of pretext sufficient to rebut St. Mary’s proffered reasons for his

termination. St. Mary’s reasons, as outlined by the district court, were Hurlbert’s

disciplinary status, unacceptable job performance, and the results of his two skills

evaluations. In response to these, the court found, Hurlbert had presented nothing

more than “his own explanations of his job performance and why [St. Mary’s]

decisions were unfair to [him] under those circumstances.” We disagree, and hold

that Hurlbert did present evidence of pretext sufficient to preclude summary

judgment.

      To show pretext, a plaintiff must “‘come forward with evidence, including

the previously produced evidence establishing the prima facie case, sufficient to

permit a reasonable factfinder to conclude that the reasons given by the employer

were not the real reasons for the adverse employment decision.’” Chapman v. AI

Transp., 229 F.3d 1012, 1024 (11th Cir. 2000) (en banc) (quoting Combs v.

Plantation Patterns, 106 F.3d 1519, 1528 (11th Cir. 1997)). The close temporal

proximity between Hurlbert’s request for leave and his termination–no more than

two weeks, under the broadest reading of the facts–is evidence of pretext, though

probably insufficient to establish pretext by itself. See Wascura v. City of South

Miami, 257 F.3d 1238, 1244-45 (11th Cir. 2001) (holding that three and one-half

month period between employee’s protected activity and her termination was,

                                          24
standing alone, insufficient to establish pretext). Hurlbert’s evidence of temporal

proximity, however, does not stand alone.

      We have recognized that an employer’s failure to articulate clearly and

consistently the reason for an employee’s discharge may serve as evidence of

pretext. See id. at 1245-46; Donnellon v. Fruehauf Corp., 794 F.2d 598, 601-02

(11th Cir. 1986). Here, the corrective counseling statement and separation notice

documenting Hurlbert’s termination make no reference to his disciplinary status or

job performance, and identify the sole reason for his termination as an “inability to

pass the competency review” or “[f]ailure to meet competency requirements.”

Furthermore, Jeff English testified that he advised Butler to follow through with

termination because of Hurlbert’s “borderline insubordinate behavior” in walking

out of the September 6th meeting with her, yet no charge of insubordination

appears in the foregoing termination documents.

      Similarly, an employer’s deviation from its own standard procedures may

serve as evidence of pretext. See Bass v. Bd. of County Com’rs, Orange County,

Fla., 256 F.3d 1095, 1108 (11th Cir. 2001) (stating that employer’s violation of its

own hiring procedure could be evidence of pretext); accord Rudin v. Lincoln Land

Community Coll, 420 F.3d 712, 727 (7th Cir. 2005) (“An employer’s failure to

follow its own internal employment procedures can constitute evidence of

pretext.”). Here, English indicated that St. Mary’s usually prepares separation

                                          25
notices within a day or two of termination, but Hurlbert’s separation notice was not

issued until September 18th–twelve days after St. Mary’s claims he was

terminated, and six days after his attorney sent Butler a letter demanding to know

the basis for Hurlbert’s termination.17

       Such inconsistencies are inconsequential, St. Mary’s argues, because the

decision to terminate Hurlbert had been set in motion before Butler learned of

Hurlbert’s request for FMLA leave. When read in the light most favorable to

Hurlbert, however, the summary judgment evidence indicates that there is at least a

genuine issue of material fact on this point. Furthermore, although St. Mary’s

notes that Butler first ordered Hurlbert to submit to a skills evaluation back in

August of 2002 (well before Hurlbert claims to have requested leave), this does not

demonstrate that the decision to terminate him was itself made before the request

for leave, or that termination would have occurred regardless of the request.

Hurlbert presented evidence of pretext sufficient to preclude summary judgment on

his retaliation claim.



                                    IV. CONCLUSION

       We hold that the district court erred in determining that Hurlbert failed to


       17
          In addition, the PAR accompanying Hurlbert’s final corrective counseling statement is
incomplete on its face–the reasons for Hurlbert’s termination were not listed as required by the
directions on the form itself.

                                               26
raise a genuine issue of material fact on whether he suffered from a “serious health

condition,” as defined by the FMLA and applicable regulations. We further hold

that the district court erred in determining that Hurlbert failed to present evidence

of pretext sufficient to preclude summary judgment on his retaliation claim.

Accordingly, the district court’s order granting summary judgment on Hurlbert’s

interference and retaliation claims is REVERSED, and the case is REMANDED

for further proceedings consistent with this opinion.




                                          27