Support for Clients. Relief for Clinicians.

If you are a client in need of documentation for a leave of absence from work—such as short-term disability, FMLA, or medical leave—or a clinician unsure how to navigate this process, I’m here to help.

As a licensed LCSW in 9 states (with licensure pending in 2 more), I provide clinical assessments solely for the purpose of leave documentation, while collaborating with your existing therapist for ongoing treatment.

What This Service Includes:

  • One 60-minute clinical assessment (virtual only)

  • One 55-minute follow up after coordination with primary therapist (virtual only)

  • Completion of standard employer leave paperwork (e.g., FMLA, short-term disability forms)

  • Written clinical summary if required by employer or insurance

  • Coordination with your primary therapist, including:

    • Signed consent

    • Treatment planning collaboration

    • Ensuring appropriate continuity of care

Important: I do not provide ongoing therapy. This service is designed to ethically support documentation needs while maintaining your therapeutic relationship with your established provider.

Mental Health Leave of Absence Evaluations

Insurance & Fees

Covered by Insurance:

  • The clinical assessment session may be billed through your insurance (if I am in-network in your state and plan).

  • Standard documentation completed during or immediately following that session (e.g., FMLA paperwork) is included.

Billed Separately (if needed):

  • Additional or extended paperwork not completed during the session: $50–$75 per form

  • Clinical letters or narrative summaries outside of standard form documentation: $75

  • Out-of-network/private pay clients: $250 assessment fee

For Therapists Referring a Client:

This service is ideal if:

  • You're not comfortable completing disability paperwork

  • You’re unsure how to assess functional impairment

  • You want to maintain your clinical role without crossing documentation boundaries

As the assessing clinician, I will handle the evaluation and documentation. Your role as the ongoing provider remains central to the client’s long-term success. I only proceed with this service if:

  • The client provides written consent to involve you

  • You agree to participate in treatment planning

  • You’re comfortable following through on the clinical care plan

Licensed States:

  • Wisconsin (WI): 8948-123

  • Florida (FL Telehealth): TPSW371

  • Illinois (IL): 149.028046

  • Ohio (OH): I.2506205

  • Iowa (IA): 129971

  • Pennsylvania (PA): CW025650

  • South Carolina (SC): TLS 1255 CP

  • Minnesota (MN): 34622

  • North Carolina (NC): C018530

  • Texas (TX): Pending

  • Indiana (IN): Pending

Important Disclaimer:

Assessments and payments do not guarantee leave approval.
All recommendations are based on clinical judgment and functioning at the time of evaluation. Employers and insurers make final determinations on whether leave is granted.

Ready to schedule or refer a client? Fill out this form below: