Updated on January 25, 2023

What Is a Doctor's Note for Work Law​?

Sometimes an employee has to take time off work as a result of illness. A doctor's note may be required to verify that they were ill. This is sometimes also referred to as a “doctor’s note from work” letter. 

A doctor’s note for work law governs when and how a doctor’s note may be required, and there are various laws and acts in place on both the Federal and state levels to protect both employees and employers.

Here is a complete list of states and their various “doctor’s note for work” laws, or lack thereof. We should also note that there is no federal law requiring paid sick leave for the private sector, though President Barack Obama did issue an executive order requiring it for government contractors. That said, this does not mean that employees have no protection, under acts like the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA).

In many cases, employers may legally ask for a doctor's note when accommodating the disability of an employee, in accordance with the Americans with Disabilities Act, or when an employee experiences an injury that is not obvious and may require the employer to make extensive allowances for that employee to continue to do their job. 

Employers who require a doctor’s note may do so legally under the law as long as their sick note policy does not: 

  1. infringe on the workers' right to privacy, and 
  2. freedom from discrimination allowances.

Can an Employer Require a Doctor's Note for One Day?

Employers have the right to ask for a letter from a physician when an employee takes time off for sickness, but they must apply the policy equally to all employees.

Companies can require employees to turn in a doctor's note when they are off for more than three consecutive absences and cite sickness as the reason

What companies cannot do is require an employee to submit a sick note each time they take a sick day and let other employees off the hook by not requiring a note at all.

Contents of a Doctor's Note

A doctor's note can only state that the physician examined the named employee on a certain date and time and list the dates the employee is to be kept from working as a result of illness. Any more details than that and the note may be at risk of violating laws that cover patient confidentiality.

If companies are concerned about a contagious disease, they can request a doctor's note that states the employee is not contagious before returning to work for safety precautions. The employer must be able to demonstrate that this is a necessity for the business.

Doctor's Notes and Accommodations

When an employee needs special accommodations due to a disability, an employer can ask for a doctor's note that verifies the disability and need for accommodation. 

A doctor’s note may also be requested when the disability is not readily apparent, such as a heart condition or arthritis. 

The company may not then use the note as a reason for discriminating against or firing the employee.

Privacy Laws Under HIPAA

The Health Insurance Portability and Accountability Act is a set of national standards that protect the privacy of medical records for individuals. 

It is usually not a violation of HIPAA to request a note from a doctor if the company needs information about sick leave, worker's compensation, or health insurance. 

Additionally, companies have to keep medical information separated from the personnel file of the employee. Failure to do so, releasing an employee’s medical information without their consent, or using medical information to make decisions about employment or advancement within a company is illegal.

FMLA Protection Regarding Doctor's Notes

Court cases have established that an employee's personal testimony combined with some medical evidence, such as a doctor's note, is enough to demonstrate that the absence of work was due to a "serious health condition." 

When this occurs, the employee is protected by the Family and Medical Leave Act’s (FMLA) prohibition on retaliatory or disciplinary action related to the leave of absence. 

However, there must be some kind of medical documentation to back up the employee's statement that they were ill and unable to work.

Steps Employers Should Consider in Light of the Court's Decision

Employers should take heed of the court decisions and create a system for handling doctor's notes when employees become ill. 

At minimum, employers should turn the issue over to human resources and other trained personnel to handle the sick leave with the employee instead of leaving it to a manager or supervisor. Doing so diminishes the risk of retaliatory action by the employee’s supervisor, which can lead to an unwanted lawsuit brought by the employee. 

Employers should also know that employees are not required to request FMLA leave in order to gain legal protection. Instead, companies bear the burden of complying with the FMLA and must recognize that an employee who has taken extensive sick leave and supplies a physician's note backing up their illness cannot be fired or disciplined. 

Can you Get Fired from Work if you Have a Doctor's Note? 

States with at-will employment laws give employers the freedom to fire someone even if they're sick and have adhered to company policy with a sick note. 

It's up to the employee to take legal action against their employer if they were fired and suspect that it was for reasons that are protected under the law. 

That said, an employee that has been taking excessive sick leave days which impact the operation negatively may be fired. In this instance, the employer is firing an employee who is not performing as required.

However, an employer can't do as they please when it comes to sick leave requirements. They cannot ask about the nature of the illness as this can lead to a discrimination claim from the employee.

When Is a Doctor's Note Required?

Federal and state laws provide guidance on how and when an employer can request medical documentation from an employee. A doctor’s note is not mandated by states or at the federal level, but it may be required by individual employers based on their policies.

In the event the employee requests leave under the FMLA, notes from a healthcare provider may be required by the employer regardless of how long the employee anticipates a leave of absence. 

If a state does not have a doctor's note law, the company can dictate its own requirements for a physician's note. If you are unsure about your state’s laws, or lack thereof, or your company’s policy then it is best to ask your company HR department.

Is It Illegal for an Employer Not to Accept Doctors' Notes, and Make You Work?

It is not necessarily illegal for an employer to not accept doctor’s notes, but it may be in your state or when an employee is using the FMLA for time off. 

Every company with full-time employees should have their own sick leave policy, though that sick leave policy may differ from another company’s. 

If an employee is working in a state with no doctor's note laws, the company is free to establish its own policies for illness related absence. The only time it is illegal for an employer to not accept a note is when the employee has a medical need and is using the FMLA to take time off. This is the case regardless of if a state has or does not have a doctor’s note law or laws. The employer may, of course, verify a doctor’s note with your doctor.

The FMLA allows employees to take up to 12 weeks of time off work for medical related needs, and the employer cannot retaliate by firing or otherwise disciplining the employee.

What Is and Is Not Required Under FMLA Leave

When an employee qualifies and takes leave under FMLA, they must notify their employer of their status. According to the U.S. Department of Labor, however, employees are under no obligation to provide copies of medical records or talk about details that relate to their injuries or illnesses. That information is considered private under the law. 

That said, employers may legally ask employees to provide medical certification that the condition in question does exist. In this case, a doctor’s note may be required.

A doctor's note that has been signed and dated and written on the doctor's letterhead along with a general description of the condition(s) is usually sufficient. The employer may also contact the doctor or facility for confirmation of the information.

Don't Overlook the Obvious: Continuous Absence Can Lead To Termination Legally

Some illnesses and injuries have a visible appearance, and as such the employer can see there's something wrong and probably will not insist on a doctor's note right away. 

However, if the injury is severe, such as a broken arm or other impairment that prevents the employee from doing their job, the employer might face the decision to lay the employee off or keep them on the payroll on a part-time basis. In a situation like this, a doctor's note may not sway the decision of the employer.

To answer the question you may be asking yourself, it is indeed legal for a company to excuse, or fire, someone who was injured for inability to do the job required of them. The company just cannot do so as a retaliatory effort, such as firing the employee for being careless and therefore becoming injured.

Because each company may have their own sick leave policy and workplace culture, it is important to consult with your manager or supervisor about any questions and to understand your company’s policies in case you are injured on the job. For employers, all managers should be familiar with the company’s policies to guarantee compliance and to reduce the risk of a terminated employee bringing a lawsuit. 

The Americans with Disabilities Act Protects Disabled People

The Americans with Disabilities Act, or ADA, makes it illegal for an employer to discriminate against a qualified individual with a disability. 

In response, it has become customary for companies to ask prospective employees to disclose any disabilities upfront. In some states, such as California, most employers do not require proof of disability as they are required to provide reasonable accommodation for those who are unable to perform jobs due to disabilities, in accordance with reasonable accommodations laws.

If you or anyone you know has been discriminated against due to a disability, we recommend that you contact an attorney for counsel and support so that you can decide whether to take it to court and possibly sue for wrongful termination.

Doctor’s Note Examples

Here are a few doctor’s note examples we’ve seen, anonymized for legal reasons, that people have used to explain an absence or when asked by their employer for such documentation.

Doctors Note for Work Template

You should always get a doctor’s note from your personal doctor, and not pay an online service for one. Doing so could end you up in legal jeopardy should your employer find out that you faked a doctor’s note.

Employee Termination Is a Challenging Subject

As you can tell, the laws, guidelines, and expectations around doctor’s notes, extended absences, ability to do the job, and more are complex and at times very unclear. This is why it is advisable to discuss your case with a qualified lawyer to determine if you have cause to bring a lawsuit.

As previously mentioned, many states have at-will employment laws which enable employers to fire employees at any time for any reason except discrimination. That means an employer can fire an employee even if they have a doctor's note and haven't used FMLA. An employer can't fire an employee for filing worker's compensation, nor can they fire them if the employee has become disabled and a reasonable accommodation can be made that allows the employee to continue to do their job effectively.

If you need help with employment law, either as an employer creating a sick leave policy or as an employee, post your legal needs on UpCounsel's marketplace. 

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