Do You Have the Right to Paid Time for Medical Visits? Lessons from a Back-Wages Ruling

Do you have the right to paid time for medical visits? What the Wisconsin back-wages ruling teaches patients and caregivers

Hook: If treatments for vitiligo or other chronic conditions force you to take time during the workday, you’re likely worried about lost pay, overtime, and whether your employer must compensate you. A late-2025 federal consent judgment in Wisconsin shows how the law can protect employees — and how you can document and claim back wages if your employer doesn’t.

The headline: what happened in Wisconsin (and why it matters to you)

On December 4, 2025, a federal court entered a consent judgment requiring North Central Health Care (a multicounty medical partnership in Wisconsin) to pay $162,486 in back wages and equal liquidated damages to 68 case managers after a U.S. Department of Labor (DOL) Wage and Hour Division investigation found the employer failed to record and pay employees for hours worked — including overtime — between June 17, 2021 and June 16, 2023. The DOL complaint said case managers were working off the clock.

According to the DOL complaint, the employer violated overtime and recordkeeping provisions of the Fair Labor Standards Act by failing to record and pay case managers for all hours worked, including overtime.

Why this matters: the case is a concrete reminder that employers must record all hours nonexempt employees work and pay overtime (time-and-one-half for hours over 40 in a workweek under the FLSA). For people who need recurring clinic visits — like phototherapy sessions, dermatology appointments, infusion clinics or visits to specialty centers — treating time as ‘off the clock’ can cost you substantial wages. The Wisconsin ruling shows enforcement is active and that employees can recover back pay.

What the law requires (plain language)

1. Employers must record time worked

Under the Fair Labor Standards Act (FLSA), employers are required to keep accurate records of hours worked for nonexempt employees. That includes time spent traveling between work sites, attending required trainings, and tasks performed outside scheduled hours if the employer knows (or should know) about the work. Failing to record this time can lead to back-wage claims, as the Wisconsin consent judgment illustrates.

2. Overtime pay is due for hours over 40 per week

The FLSA generally requires nonexempt employees to receive time-and-one-half their regular rate for hours worked over 40 in a workweek. If medical appointments or treatment requirements push you past 40 hours, your employer must include that time in your total hours and pay overtime. (For a technical overview of the regular rate and overtime, see the DOL fact sheet at https://www.dol.gov/agencies/whd/fact-sheets/56a-regular-rate.)

3. Liquidated damages are common

If the DOL proves an employer failed to pay required wages, courts often award liquidated damages equal to back wages — effectively doubling the recovery — unless the employer shows it acted in good faith. That’s exactly what happened in the Wisconsin case: equal amounts of back wages and liquidated damages were ordered.

4. Statute of limitations

The FLSA normally allows employees to recover wages for the prior two years. The limitation extends to three years if the employer’s violation is willful. That’s why prompt documentation and timely complaints are critical — think of these deadlines like other government timelines (similar in complexity to processes described in guides on automating government renewals).

How this applies to vitiligo treatment and other recurring medical visits

Treatments commonly used in vitiligo care — such as narrowband UVB phototherapy administered at a clinic, dermatology follow-ups, or supervised procedures — can require frequent daytime visits that interrupt work. The Wisconsin case is not about vitiligo specifically, but it offers practical lessons:

• Clinic time counts as work time if you are required to attend during work hours or perform job tasks before or after treatment.
• Travel between job locations and appointments may count in some circumstances.
• Off-the-clock requests from supervisors (for example, “don’t clock in for this”) do not relieve the employer of the obligation to pay.

Document every minute: smart, practical recordkeeping

When treatment consumes work hours, documentation is your single most powerful tool. Below is a practical checklist and sample templates you can use.

Quick documentation checklist

• Daily time log: Keep a simple time log listing start and end times for work, appointments, and travel. Note whether your employer approved or knew about the time. If you want a simple time-log app or helper you can build quickly, consider starter kits that show how to ship a micro-app to collect entries.
• Pay stubs & schedules: Save pay stubs, schedules, and any clock-in/clock-out records. These help demonstrate discrepancies. For secure handling of digital copies, follow safe backup and versioning best practices like those in guides on automating safe backups.
• Email/text records: Keep messages to/from supervisors about scheduling, approved leave, or instructions to work off the clock.
• Appointment records: Save clinic appointment confirmations, receipts, and medical notes showing dates and durations. Clinics and onboarding programs often issue documentation — see resources about clinic onboarding if you need structured confirmation formats.
• Witness statements: If co-workers saw or can confirm you worked during non-recorded times, get short written statements.
• Calcuation worksheet: Prepare a simple spreadsheet that totals hours worked each week and shows overtime.

Sample time log entry (simple)

Use this format in a phone notes app or a spreadsheet: Date | Scheduled Work: 9:00–5:00 | Unpaid Time: 2:00–3:30 (phototherapy at clinic) | Actual Work Time: 8:30–5:30 | Notes: Supervisor said to skip punching for clinic visit.

Sample email to supervisor confirming time and request for pay

Send short, dated emails that create a paper trail. For example:

'Hi [Supervisor], I had a scheduled phototherapy appointment today from 2:00–3:15 PM that required me to leave during my shift. Per our conversation, I'm confirming this time off work. Please confirm how I should record this on my timesheet. Thanks, [Name]'

How to calculate and present a back-wages claim

Preparing a clear summary for HR, an attorney, or the Wage and Hour Division makes recovery more likely. Follow these steps:

1. Compile weekly totals: For each workweek in your claim, list total hours worked and the hours your employer recorded.
2. Identify unrecorded hours: Subtract recorded hours from your documented actual hours to find missing time per week.
3. Calculate overtime: For weeks where the documented total exceeds 40 hours, compute overtime at time-and-one-half the regular rate.
4. Aggregate back wages: Sum unpaid straight time and overtime for the recovery period.
5. Consider liquidated damages: Under the FLSA, you may be able to recover liquidated damages equal to the back wages, effectively doubling the amount.

Example calculation (illustrative):

Week A: documented actual hours = 44; employer recorded = 40. Regular rate = $20/hour.

• Unpaid regular time = 0 (employer recorded 40)
• Overtime pay owed = (44 - 40) x $20 x 1.5 = 4 x $30 = $120
• Back wages for Week A = $120; potential liquidated damages = $120

When to involve authorities or lawyers

Start internally, then escalate:

• Step 1 — HR: Present your documentation to HR and request correction of your pay. Keep copies of all communications.
• Step 2 — DOL Wage and Hour Division: If HR does not resolve the issue, you can file a complaint with the DOL. The DOL investigates wage complaints and can recover back pay; it was the agency behind the Wisconsin investigation.
• Step 3 — Attorney: For complex cases, persistent denial, or situations involving discrimination or retaliation, consult an employment lawyer with experience in wage-and-hour claims. Many take FLSA wage claims on contingency.

How to file a DOL complaint

Visit the Wage and Hour Division website (https://www.dol.gov/agencies/whd) to locate your regional office and file a complaint. Provide your documentation (time logs, pay stubs, emails, appointment confirmations) to help investigators verify the claim. The DOL often mediates or seeks back wages through administrative action or litigation, as seen in the Wisconsin consent judgment.

Other legal protections to consider

FMLA (Family and Medical Leave Act)

FMLA provides eligible employees up to 12 weeks of unpaid, job-protected leave in a 12-month period for serious health conditions or to care for immediate family members. Some chronic conditions and recurring treatments may qualify for intermittent FMLA. Eligibility and employer size requirements apply (typically employers with 50+ employees). If eligible, FMLA can preserve your job while you take unpaid leave. For other timed government processes and eligibility checklists, see guides on automating related renewals.

ADA (Americans with Disabilities Act)

The ADA requires reasonable accommodations for employees with disabilities. Whether vitiligo qualifies depends on whether it substantially limits major life activities or is perceived as such; psychological impacts like severe anxiety related to a condition may also be relevant. Reasonable accommodations may include flexible scheduling, modified break times, or leave—paid or unpaid.

State and local laws

Many states and cities have additional sick-leave or paid-time laws that provide broader rights than federal law. Check your state labor department or local ordinances. Wisconsin’s ruling was federal (FLSA-based), but similar claims can implicate state law where applicable.

2026 trends: enforcement, remote work, and telehealth

Enforcement of wage-and-hour laws intensified in the mid-2020s. Late 2024 through 2025 saw an increase in DOL investigations targeting off-the-clock work and recordkeeping violations; the Wisconsin consent judgment (Dec 2025) is part of that trend. In 2026, expect continued focus on:

• Off-the-clock work: Employers are being held accountable for requiring or permitting work outside recorded hours.
• Remote and hybrid work: Cloud-based timekeeping and expectations of 'always-on' work have led to disputes about what counts as compensable time.
• Telehealth and appointment accommodation: As telehealth remains common, employers and courts are parsing how remote appointments affect scheduling and pay.

For people managing chronic conditions like vitiligo, these trends increase the odds that legitimate claims for unpaid time will be investigated and resolved in employees’ favor — if they are documented effectively.

Practical next steps you can take today

1. Start a time log now: Record your next 30 days of hours, including any medical appointments and travel time.
2. Save paper and digital evidence: Keep pay stubs, schedules, appointment confirmations and screenshots.
3. Communicate via email: Confirm schedule changes or approvals in writing with supervisors.
4. Review employer policies: Understand your PTO, sick leave, and flex scheduling rules. Policies don’t override law.
5. Evaluate FMLA and ADA options: Talk with HR about intermittent FMLA or accommodations if your treatments are recurring.
6. Contact the DOL if needed: If you have unresolved missing pay, file a Wage and Hour complaint and include your documentation.

Template: How to request corrected pay from HR

Use this simple message to open the process with HR:

'Subject: Request for Review of Pay Records — [Your Name] Hi [HR/Payroll contact], I am requesting a review of my pay records for the period [dates]. During these weeks I documented [X] hours of work including [appointments/travel] that were not recorded on my timesheets. I have attached my time log, pay stubs, and appointment confirmations. Please review and advise on correcting my pay. Thank you, [Your Name]'

When an employer pushes back: common defenses and how to respond

Employers often argue that employees failed to report time, that the work was voluntary, or that policies prohibit off-the-clock work. Documented evidence (emails, time stamps, appointment confirmations) directly rebuts those defenses. If an employer retaliates for asserting wage rights, that itself can be unlawful — keep records and escalate to DOL or counsel promptly.

Final takeaways

• Your time matters: Time spent on medical visits during scheduled work hours can be compensable and may generate overtime.
• Document everything: Logs, emails, and appointment records are the backbone of a successful back-wage claim.
• Enforcement is active in 2026: Recent actions, including the December 2025 Wisconsin consent judgment, show regulators are pursuing recordkeeping and unpaid-overtime violations.
• Know your options: HR, DOL Wage and Hour, FMLA, ADA, and employment counsel are all paths to resolution depending on your situation.

Resources and next steps

Start by building your documentation packet today: a 30-day time log, saved pay stubs, appointment confirmations, and copies of any written communications with your employer. Visit the Wage and Hour Division at https://www.dol.gov/agencies/whd for regional contact info and guidance. If you prefer a personalized review, consider consulting an employment attorney or a legal aid clinic.

Call to action: If unpaid time for medical visits has cost you wages, don’t wait. Begin documenting now, send a clear request to HR, and if you get no resolution, file a complaint with the DOL or contact an employment lawyer. Subscribe to our vitiligo support newsletter for downloadable templates — including a time-log spreadsheet and a pay-review checklist — and step-by-step help reclaiming lost wages. For tips on running a paid subscription or newsletter effectively, see this piece on subscription success.

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