Rhomeo Tayag suffers from a variety of medical conditions, including gout, chronic liver and heart disease, rheumatoid arthritis and kidney problems. These illnesses intermittently leave him debilitated. He depends on his wife, Maria, to help him with daily tasks, including basic household chores, preparing food and getting to doctors’ appointments.

From 2003 to 2006, Maria Tayag took intermittent Family and Medical Leave Act (FMLA) leave from her job as a health management clerk at Lahey Clinic Hospital in Boston to care for Rhomeo. Typically her leave requests lasted one or two days at a time. Lahey routinely approved these requests.