Detailed answer — practical steps under New Hampshire law and federal rules

If you missed work because you went to the emergency room but you don’t have a traditional doctor’s note, you still have options. Start by understanding three things: your employer’s attendance and leave policies, whether federal protections like the Family and Medical Leave Act (FMLA) apply, and what medical or administrative records you can obtain to prove your visit.

1. Check your employer’s policy and talk to HR immediately. Many employers accept alternative documentation for absences. Review your employee handbook or leave policy and contact your manager or human resources as soon as you can. Explain the situation, say when you visited the ER, and say you are working to get records. Clear, prompt communication often prevents discipline.

2. Obtain ER documentation. Emergency departments create records you can request. Useful items include:

• Discharge summary or after-visit summary
• Emergency department record or encounter note
• Itemized billing or insurance claim for the ER visit
• Prescription receipts or pharmacy printouts tied to the visit
• ER wristband photo or intake paperwork

Hospitals and health systems often provide an online patient portal or will provide records on request. Under federal privacy rules, you have the right to access your medical records; see the U.S. Department of Health & Human Services (HHS) explanation of HIPAA rights: https://www.hhs.gov/hipaa/index.html. You may need to sign a release and pay a small fee for copying.

3. Ask your ER physician or urgent care clinician for retroactive documentation. Many clinicians will prepare an “after-the-fact” note or release that explains the visit date and any recommended time off, once they can verify the record. Provide them the hospital encounter number or date/time to speed the request.

4. Consider alternative proof if a doctor’s note isn’t immediately available. Employers commonly accept billing statements, discharge papers, medication receipts, or even screenshots from a patient portal showing the visit. If you used telehealth or urgent care follow-up, those providers may issue notes too.

5. Understand federal leave protections that may apply. If you work for a covered employer and meet eligibility rules, the Family and Medical Leave Act (FMLA) can protect eligible leave for a serious health condition. Employers may require medical certification for FMLA leave, but federal rules give you time to provide it (normally 15 calendar days after the employer’s request). Learn more at the U.S. Department of Labor: https://www.dol.gov/agencies/whd/fmla. If you have a long-term condition, the Americans with Disabilities Act (ADA) may also be relevant; the EEOC explains how medical documentation and accommodation requests work: https://www.eeoc.gov.

6. If it was a workplace injury, follow New Hampshire workers’ compensation rules. If the ER visit was for a work-related injury or illness, notify your employer immediately and file a claim with the New Hampshire Department of Labor’s Workers’ Compensation program. New Hampshire’s Department of Labor site guides the claims process: https://www.nh.gov/labor/.

7. If your employer disciplines you unfairly, know your options. New Hampshire is an at-will employment state, which generally allows termination for many reasons, but employers still must follow their own written policies and federal law. If you believe your employer violated FMLA, ADA, or other federal protections, you can file a complaint with the relevant federal agency (U.S. Department of Labor for FMLA; EEOC for discrimination/ADA). You can also contact the New Hampshire Department of Labor for state-level concerns: https://www.nh.gov/labor/.

8. Keep careful records. Save copies of all communications with your employer, requests for records to the hospital, any responses, receipts, and proof of the ER visit. These records can be crucial if there’s a dispute.

Helpful hints — quick actions and documentation that help

• Request an after-visit summary from the ER before you leave, or take a clear photo of discharge paperwork and wristbands.
• Use the hospital’s patient portal to download visit summaries, test results, and billing statements.
• If a doctor’s note is required quickly, ask the ER or follow-up clinic if they will prepare a retroactive note or a release to return to work.
• Provide any receipts for prescriptions filled the same day as evidence of treatment.
• Document every conversation with your employer: date, time, who you spoke with, and what they said.
• If you need more time to get records, ask your employer for an extension in writing and explain when you will provide the documentation.
• If the ER visit was work-related, notify your employer immediately to preserve workers’ compensation rights.
• Know your federal rights: FMLA rules and timelines are available from the U.S. Department of Labor: https://www.dol.gov/agencies/whd/fmla.
• For New Hampshire workplace information, check the New Hampshire Department of Labor: https://www.nh.gov/labor/ and New Hampshire Employment Security: https://www.nhes.nh.gov/.