Detailed Answer — practical steps and legal context

Short answer: You usually have options. Employers commonly ask for medical documentation, but an official doctor’s note is not the only acceptable proof. Provide alternative medical records, communicate quickly with your employer, and understand federal and state rules that may limit what your employer can require.

What employers can generally require

Texas employers may ask for proof of an illness or injury to justify missed days. Most private-employer rules are set by employer policy and the employment contract. Texas follows an at-will employment model, so employers can discipline or terminate employees for absences unless the absences are protected by law or by company policy.

When federal laws apply

• FMLA (Family and Medical Leave Act): If you work for a covered employer (typically 50+ employees) and meet eligibility requirements, certain serious health conditions qualify for protected leave. Employers may require a medical certification. The U.S. Department of Labor explains rights and employer obligations: https://www.dol.gov/agencies/whd/fmla. FMLA regulations allow employers to request certification and generally give employees 15 calendar days to provide it, when practicable (29 C.F.R. § 825.305).
• Disability and accommodation laws: If the ER visit relates to a disability, you may have rights under the Americans with Disabilities Act (ADA) or similar laws. The EEOC provides guidance: https://www.eeoc.gov/statutes/americans-disabilities-act-1990.

What counts as acceptable documentation besides a doctor’s note

If you don’t have a classic “doctor’s note,” many items can serve as proof:

• ER discharge paperwork or summary from the hospital or urgent care.
• Printed records from the patient portal showing date/time of the visit.
• Hospital billing statements, receipts, or encounter records with visit date.
• Prescription or pharmacy pickup receipts tied to the visit.
• Follow-up appointment confirmations or messages from a clinic.
• A written statement from a nurse practitioner, physician assistant, or clinic staff if signed and dated.
• A signed, dated personal statement describing the emergency and why you could not get a formal note, especially if combined with other documentation.

How to act right away

1. Notify your employer as soon as possible. Explain you were in an emergency and that you will provide documentation.
2. Ask HR or your supervisor specifically what documentation they accept. Many employers accept ER paperwork or pharmacy receipts.
3. Request copies of your ER records or discharge summary from the hospital. Hospitals typically have patient portals or records request forms. These records often suffice.
4. If the employer requested FMLA certification, respond within the timeframe given (often 15 calendar days). See 29 C.F.R. § 825.305.
5. If you cannot obtain records promptly, tell your employer why and provide an estimated date when documentation will be available.

Privacy limits and HIPAA

HIPAA protects medical records from disclosure by health providers, but it does not stop you from sharing your own medical information with your employer. You may voluntarily provide documentation. Employers generally should only request information relevant to the absence or accommodation.

Federal HIPAA guidance from HHS: https://www.hhs.gov/hipaa/

What to do if your employer disciplines you or refuses acceptable documentation

• Ask for the specific policy or rule you allegedly violated and for an explanation in writing.
• If you believe your absence was protected by FMLA and your employer is a covered employer, you can file a complaint with the U.S. Department of Labor: https://www.dol.gov/agencies/whd/contact/complaints.
• If you suspect discrimination due to a disability or a medical condition, you can consult the EEOC and consider filing a charge. For state-level claims, see Texas Labor Code Chapter 21: https://statutes.capitol.texas.gov/Docs/LA/htm/LA.21.htm.
• Keep copies of all communications and medical documents. Document dates, times, and names of people you spoke with.

When to get legal help

Consider talking to an employment lawyer if an employer fires you, disciplines you unfairly, or refuses reasonable accommodations. A lawyer can evaluate whether federal or Texas law protects your absence (for example, under FMLA or ADA) and advise on next steps.

Helpful Hints

• Request ER records immediately; many hospitals provide them within days via patient portals.
• Collect any receipts, prescriptions, discharge summaries, or telehealth records—combined they make a strong showing.
• Communicate in writing (email) so you have a record of when you notified your employer and what they requested.
• If you work for a large employer, check whether you qualify for FMLA before giving up on protection.
• Ask HR which forms or formats they accept—some accept electronic records or screenshots from a verified patient portal.
• Keep a private copy of all medical documents. You control what you share with your employer.
• If an employer’s demand for specific medical details feels invasive, request a written explanation of why that level of detail is necessary.
• If a timeline is tight, ask your provider for a brief signed note confirming dates of treatment or inability to work; many providers will provide this for follow-up or administrative needs.