Doctors note for work: What employers need & how to get one

Doctor’s Note Requirements for Sick Leave, Medical Leave, & ADA Accommodations

Employers sometimes request employees to provide a doctor’s note to verify the need for sick leave or workplace accommodations. However, matters related to an employee’s illness or medical condition can be tricky. Savvy employers recognize this personal information’s sensitive nature and guard its confidentiality. They stick to an “only what needs to be known” attitude to avoid the appearance of prying.

They also pay attention to legality. Various federal, state, and local laws exist to protect workers. Guidance from legal counsel ensures proper action and documentation. Such attentiveness offers defense should someone later accuse the company of improper handling.

The following presents a few of the most common situations in which an employer might ask for a doctor’s note. Each discusses the particularity of paperwork and other relevant concerns.

Sick days

At some point, most workers experience an illness or injury requiring a day off. The individual notifies the appropriate pre-designated person of the absence through a phone call or email. The company subtracts the sick leave from the worker’s bank of accumulated PTO. If no such time off exists or remains, the employee does not receive payment for hours missed.

Most companies do not require an excuse note for the occasional sick day. It simply is not worth the time to collect and monitor. Plus, such a move breeds feelings of distrust between workers and management.

However, concern mounts in some places when an absence extends more than three consecutive days. The organization may have a company policy requiring a sick note.

Employees sometimes view this mandate in a negative light. They see it as the company’s way of checking that a medical condition necessitating missing work occurred instead of just taking their word. Such documentation from a healthcare provider potentially protects the well-being of the individual and the staff.

When Are Doctor’s Notes Typically Required?

Say an employee suffered a back injury. The work note can specify limitations on lifting until a specific date. The injured party need not guess parameters nor try to convince the employer of the inability to perform particular tasks.

Another example is when a team member catches the flu or another infectious disease. A too-soon return endangers the health of others. A medical excuse note listing when the affected worker is safe to return to the office provides peace of mind.

Organizations should spell out their policies clearly in their employee handbook. This action gives everyone a reference point and eliminates claims of “I didn’t know.” Then, keep to what is written. Sloppy, inconsistent enforcement potentially leads to charges of favoring some employees and picking on others.

Some employers provide employees with a doctor’s note template to bring to their doctor’s appointments. Such an outline collects basic need-to-know information without overstepping bounds. Employers should never try to solicit unrelated additional information, which could lead to charges of invading privacy.

An acceptable doctor’s note generally includes:

  • The place of the visit (clinic, hospital, urgent care center, etc.)
  • Date and time of the visit
  • The patient’s name
  • Affirmation that the person was seen for a medical reason (without naming the condition, providing a diagnosis, or offering details)
  • Any recommendations for time off work and when it is safe for the person to return
  • Any accommodations the individual needs when returning to work and for how long
  • A doctor’s signature

With the rise of telemedicine, many doctors conduct virtual medical appointments. The healthcare provider should still be able to provide a work note if asked. Include submission guidelines for an online doctor’s note in the information offered in the employee handbook.

Unfortunately, various questionable Internet companies profit from generating work or school notes signed by (supposedly) board-certified doctors. Many of these operations “see” patients to write a doctor’s excuse. Tell employees to stick to real doctor’s notes, and warn of the consequences if they submit a fake doctor’s note.

Extended medical leave

Some medical conditions involve a recovery time beyond a day or two. The healthcare professional may not clear the patient to return to work. Other situations allow a return, but the employee may need to take time off on certain days for follow-up doctor appointments or completion of a treatment plan.

In such scenarios, the employer obviously wants to know what to expect. The company needs to maintain productivity and adjust schedules accordingly. A doctor’s note provides relevant answers.

What the note need not contain are particulars. Employee privacy remains a top concern. According to the Health Insurance Portability and Accountability Act (HIPAA):

“Your employer can ask you for a doctor’s note or other health information if they need it for sick leave, workers’ compensation, wellness programs, or health insurance. However, suppose your employer asks your healthcare provider for information about you directly. In that case, your provider cannot give your employer the information without your authorization unless other laws require them to do so.”

Some workers who need extended leave for their own sake or to care for a family member seek it under the Family and Medical Leave Act (FMLA). The FMLA provides eligible employees of covered employers with job-protected leave for qualifying family and medical reasons. It also requires continuation of their group health benefits under the same conditions as if they had yet to take leave. The leave can be up to 12 workweeks within a 12-month period. It can be taken all at once, in separate blocks of time, or by reducing the amount of time worked each day or each week.

Before cases even arise, an organization should know if it is considered a “covered employer.” According to the U.S. Department of Labor (DOL), covered employers under the FMLA include:

  • Private-sector employers who employ 50 or more employees in 20 or more workweeks in either the current calendar year or the previous calendar year,
  • Public agencies (including Federal, State, and local government employers, regardless of the number of employees) and
  • Local educational agencies (including public school boards, public elementary, private elementary, and secondary schools, regardless of the number of employees).

Likewise, human resources must clearly understand who the DOL considers an “eligible employee.” The definition states, “Employees are eligible if they work for a covered employer for at least 12 months, have at least 1,250 hours of service with the employer during the 12 months before their FMLA leave starts, and work at a location where the employer has at least 50 employees within 75 miles.”

Among its FAQs about the FMLA, the DOL says the following about requesting an FMLA leave of absence:

“Employees do not have to ask for FMLA leave specifically but need to provide enough information so the employer knows the FMLA may cover the leave. Employees must notify their employer immediately that they must use FMLA leave. For example, suppose an employee knows they have a procedure for a serious medical condition scheduled in three weeks. In that case, the employee must notify the employer as soon as the procedure is scheduled. Employers may ask for information from the healthcare provider before approving FMLA leave and must allow 15 calendar days to provide the information. In some circumstances, such as when the employee’s healthcare provider cannot complete the certification information timely, employees must be allowed additional time.”


Workers with disabilities sometimes seek accommodations to help them perform their jobs. What someone asks for varies by the nature of the disability. One person might need more breaks in the workday or a flexible work schedule. Another might desire a reserved parking or a cubicle closer to a washroom. Adaptive equipment or instructional material provided in larger print could benefit certain individuals.

The federal Americans with Disabilities Act (ADA) requires employers with 15 or more employees to provide “reasonable accommodations” for employees with disabilities. (Note that state or local laws may lower that number.)

According to, a person with a disability is someone who:

  • has a physical or mental impairment that substantially limits one or more major life activities,
  • has a history or record of such an impairment (such as cancer that is in remission) or
  • is perceived by others as having such an impairment (such as a person who has scars from a severe burn).

In some cases, the presence of an employee’s disability is clear. When a disability or the need for an accommodation is not obvious, an employer can require sufficient documentation of the employee’s disability from a healthcare provider.

Once again, employers should tread carefully when asking for a doctor’s note. Limit the request to sufficient medical documentation to substantiate an ADA disability and the need for the requested accommodation. Do not ask for unrelated medical information.

Employees presenting a doctor’s note should not treat it as a guarantee of automatic change. Title I of the ADA requires an employer to provide reasonable accommodation to qualified individuals with disabilities who are employees or applicants for employment, except when such accommodation would cause an undue hardship. Before granting, employers and their legal team may determine whether what is being asked is “reasonable” and if it could be considered an “undue hardship” under EEOC enforcement guidelines.

Considerations about record-keeping and privacy

Companies collect and retain a lot of physical and/or electronic paperwork. General employee personnel files maintained by the human resources department include various things. You might find job descriptions, job offer letters, transcripts from educational institutions, and annual performance reviews among the contents. What they should not contain, however, are doctor’s notes and other healthcare paperwork (FMLA documents, health insurance forms, medical leave of absence requests, workers’ compensation claims, etc.). Employers must store this sensitive, confidential information in a separate place.

Lastly, be aware that a special consideration exists for employers requiring job applicants and employees to self-identify as individuals with a disability. Per Section 503 of the Rehabilitation Act, these voluntary forms must be kept separate from all other records, including other medical records.