Key Takeaways 

  • Under the FMLA, employees must work for at least one year and 1,250 hours to be eligible for up to 12 weeks of unpaid, job-protected medical leave.
  • Federal and state laws guide when employers can request medical documentation. Employees' medical conditions are protected under privacy laws, and detailed medical information cannot be demanded by employers.
  • Employers may set their own requirements for doctor's notes if state laws do not specify otherwise.
  • A doctor's note should include the date of examination and the period the employee is to be off work due to illness, without violating patient confidentiality.
  • Employers can request a doctor’s note to verify a disability and the need for accommodations.
  • Employees are protected under the FMLA from retaliation when taking medical leave, provided they submit the required documentation.
  • Employers must apply sick note policies equally and protect the confidentiality of medical information.
  • Requesting a doctor’s note typically does not violate HIPAA if done for legitimate purposes.
  • Post a job on UpCounsel to find a top employment lawyer in your state. 

Sometimes, an employee has to take time off work due to illness or injury. 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 on both the Federal and state levels to protect employees and employers.

In this article, we will discuss the rights of employees and employers, best practices, legal considerations, and other vital information relating to doctor’s notes for work laws.

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. 

If an employee requests leave under the FMLA, the employer may require notes from a healthcare provider 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, lack thereof, or company’s policy, ask your company's HR department.

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 lists the dates the employee is to be kept from working due to 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.

Employee Rights 

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

When an employee qualifies and takes leave under the FMLA, they must notify their employer of their status.  

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

If an employee works in a state without doctor's note laws, the company is free to establish its own policies for illness-related absences.  

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 whether a state has or does not have a doctor’s note law or laws. Of course, the employer may verify a doctor’s note with your doctor. 

The FMLA allows employees to take up to 12 weeks off work in a year for medical reasons, and the employer cannot retaliate by firing or otherwise disciplining the employee. 

According to the U.S. Department of Labor, however, employees are under no obligation to provide copies of medical records or discuss details related 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 existing condition exists. In this case, a doctor’s note may be required. 

A doctor's note that has been signed, dated, and written on the doctor's letterhead, along with a general description of the condition(s), is usually sufficient. 

Employer Requirements 

In many cases, employers may legally ask for a doctor's note when accommodating an employee's disability, in accordance with the Americans with Disabilities Act.  

They may also do so when an employee experiences a non-obvious injury 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
  2. Freedom from discrimination allowances 

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

Further, the requirements are limited in some other ways to protect employee rights. 

For example, 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.  

However, companies cannot require employees 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. 

Additionally, companies must keep medical information separate from an employee's personnel file. The employer may also contact the doctor or facility for confirmation of the information. 

It is illegal to fail to protect this information, release an employee’s medical information without their consent, or use medical information to make decisions about employment or advancement within a company.

Best Practices for Employees

For optimal adherence to employee protocols on doctor's notes, consider the following best practices:

  • Get a doctor’s note from your personal doctor, and do not pay an online service for one. Doing so could put you in legal jeopardy should your employer find out that you faked a doctor’s note.
  • Remember that you must have worked for your employee for at least one year and 1,250 hours to be eligible for up to 12 weeks of unpaid, job-protected medical leave under FMLA.
  • Note that paid leave is not required under FMLA, but some employers elect to offer it at their discretion. Comply with all of your company’s paid leave policies to ensure you are eligible.
  • Give your employer practical advanced notice of at least 30 days for any future FMLA leave.
  • You might need to provide a doctor’s certificate but your condition is covered by privacy laws, so your employer cannot ask for more than is necessary to certify your absence.
  • Make sure you’re ready and capable of returning to work and fulfilling your duties. In some cases, you may need to obtain return-to-work clearance from your doctor to confirm you're fit to perform your duties.

Best Practices for Employers 

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 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, medical documentation must support the employee's statement that they were ill and unable to work. 

Employers should take heed of the court decisions and create a system for handling doctor's notes when employees become ill, keeping these best practices for doctor’s notes in mind: 

  • Employers should, at minimum, 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 employees are not required to request FMLA leave in order to gain legal protection.
  • 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 who has been taking excessive sick leave days that negatively impact the operation 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.

Continuous Absence Can Lead To Legal Termination 

Some illnesses and injuries are visible, so the employer can see something wrong and probably will not immediately insist on a doctor's note.  

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 being unable 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 its own sick leave policy and workplace culture, consult with your manager or supervisor about any questions and 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. 

State Requirements for Doctor’s Notes

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 former 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).

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.  

Most employers in some states, including California, do not require proof of disability.  

This is because they are required to provide reasonable accommodations 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 you contact an attorney for counsel and support so you can decide whether to take it to court and possibly sue for wrongful termination.

Employee Termination Is a Challenging Subject

As you can tell, the laws, guidelines, and expectations regarding doctor’s notes, extended absences, and the ability to do the job are complex. At times, they are also very unclear.  

This is why discussing your case with a qualified lawyer is advisable to determine if you have cause to bring a lawsuit. 

As previously mentioned, many states have at-will employment laws that 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 cannot 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.

Conclusion: Speak with an Employment Attorney

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.  

UpCounsel only accepts the top 5% of lawyers. Employment lawyers on UpCounsel come from prestigious law schools such as Harvard Law and Yale Law and average 14 years of legal experience, including work with or on behalf of companies like Google, Menlo Ventures, and Airbnb. 

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

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