Even Working Adults Need to Cough Up a Doctor’s Note Sometimes — How to Know You Need One

woman talking to doctor

Adobe Stock / bnenin

Abby Lee
Abby Lee32
Writing Fellow

In school, students can hand in doctor’s notes for flus, broken arms, chronic illnesses and other medical conditions. Typically, the note verifies the doctor’s visit with a request for the student to be excused from school. But what happens when you are a working adult and have a medical condition? Can you be excused from work? And how does that affect compensation?

When is a doctor’s note required for missing work?

Obtaining a doctor’s note varies based on the company and the workers’ particular medical situation. An employer may generally request a doctor’s note as part of the company’s sick leave or attendance policy, however, such a policy must be applied to all employees. The note should verify that the employee was seen by a health care professional and specify any period of incapacity or job related restrictions. 

Generally, most companies do not require a doctor’s note for missing one to two days of work as that is typically sick leave, a certain number of sick days a person is allotted to take and is usually paid. Sick days are for more common sicknesses like a cold, flu, bug or other personal reasons to take sick days. Employees may request additional information for medical leave, a leave of absence for a much longer period of time than three days due to a serious health condition or family medical emergency. 

This medical leave of absence is under the Family and Medical Leave Act (FMLA), administered by the US Department of Labor. It allows eligible employees to take 12 weeks unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. To obtain this medical leave, employees obtain a certification from the worker's health care provider to substantiate the need for FMLA leave and present it to their employer. 

Other instances where it is permissible for employers to ask for doctors’ notes are for work-related injuries and disabilities. Under Workers’ Compensation, it is generally permissible for employers to require a doctor's note or release to return to work following a work-related injury or illness. The Americans with Disabilities Act (ADA) allows employers to request information from a doctor to find out more about an employee's impairment and to determine whether it is compliant with ADA disability regulations when the disability is not apparent. Under the ADA, disability-related inquiries and examinations must be compliant with the enforcement guidance provided. In other words, disability inquiries must be job-related and consistent with business necessity. 

Laws about medically-excused absences

If you are eligible and have an illness that will require you to miss work for more than two or three weeks, you can obtain a doctor’s note to help ensure you receive all benefits offered under FMLA. Your doctor is not required to discuss the specific nature of your illness in your note, under the protection of the Health Insurance Portability and Accountability Act (HIPAA). 

Your doctor might have to list dates for treatments or other protocols determining you ineligible to work. It's important to also familiarize yourself with FMLA and with your company’s policies related to extended leave. As of 2017, it's important to note that four states have enacted their own family and medical leave laws. These states are California, New Jersey, Rhode Island and New York. 

While you are taking medical leave, it is important to know that a subsequent request for a doctor's note is generally considered a request for recertification, which is only permitted every 6 months or under certain circumstances. Also, if an employee is returning from FMLA leave, a fitness-for-duty request is permitted outlined in FMLA Regulation 825.312.

In regards to sick leave, federal contractors required by contract to provide paid sick leave may require a doctor’s note only for absences of three or more consecutive full days, and the employer must notify the employee of the requirement to provide a doctor's note before the employee returns to work.

In general, doctor’s notes can offer some protection in the event your company decides to use your absence as a reason for withholding a promotion or firing. Should an employer try to fire you, an injury or illness that has been documented by a healthcare professional can provide you with the documentation necessary to keep your job. 

Doctor’s note templates

If a doctor’s note is needed or you would like to request a doctor’s note, below are two templates that your doctor can fill out. Note that these shouldn’t be used to forge a doctor’s note, but make it easier to request one from your physician. 

1.  Doctor Note A

Photo via  www.template.net
Photo via  www.template.net

2. Doctor Note B

Photo via  www.pdfsimpli.com
Photo via  www.pdfsimpli.com


1. Is it legal for an employer to ask for a doctor's note?

In general, employers can ask for a doctor’s note and are able to do so under the law as long as the request does not infringe on the workers' right to privacy and freedom from discrimination. For example, an employer can request a doctor’s note when accommodating a disability, but cannot use it as reason for discriminating against or firing an employee. Also, employers must have consistent policies when asking for doctors’ notes meaning if they request doctors’ notes for sick days from one employee, they must apply the same policy to all other employees. 

2. Is it illegal to make a fake doctors note?

Yes, it is illegal to forge a doctor’s note. According to Criminal Defense Lawyer, federal law and the statutes of all 50 states classify forgery as a felony and potential penalties for the crime include probation, incarceration and fines. 

3. How many days can you be sick without a doctor's note?

Generally, employers do not request a doctor’s note until the sick absence is three or more consecutive days.

4. Will my doctor give me a sick note for stress?

A stress leave is an extended period of time where an employee takes off work to deal with and recover from a serious stress-related illness or injury, typically a mental illness. Reasons included stress, burnout, anxiety or depression. Legally, employees’ rights to a stress leave dependent on whether their company is covered by FMLA. If you are eligible, you can obtain a doctor’s note that indicates your stress leave. If your company is not covered by FMLA, this doesn’t mean that your company cannot approve a stress leave, it just means they don’t have to guarantee you a position when you return.

A doctor's note isn't just for school. Doctor's note can be particularly useful at work to give employers relevant information about an employee's medical condition and is documentation to protect employees from discrimination based on their medical condition. 

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