What to do if you don’t have a doctor’s note for days missed after an ER visit

Quick answer: Tell your employer what happened, provide any alternative medical documentation you can (ER discharge paperwork, billing, nurse notes), request time to get records, and ask about using paid time off while you collect proof. If your absence may qualify for job‑protected leave (for example under the federal Family and Medical Leave Act) or if you face discrimination or retaliation, contact the Vermont Department of Labor or a lawyer. This is general information and not legal advice.

Detailed answer — steps to take under Vermont law and federal law

1. Understand who can require a doctor’s note

In Vermont, private employers generally may set reasonable attendance and documentation policies (check your employee handbook or written policy). Employers must also follow federal laws such as the Family and Medical Leave Act (FMLA) and federal anti-discrimination laws. For official guidance on employer responsibilities in Vermont, see the Vermont Department of Labor: https://labor.vermont.gov/. For FMLA information, see the U.S. Department of Labor: https://www.dol.gov/agencies/whd/fmla.

2. Provide the documentation you do have

If you visited an emergency department, you often receive or can request immediate paperwork that helps support your absence:

• ER discharge summary or printed after‑visit instructions
• Itemized ER bill showing date and time of service
• Medication receipts or pharmacy printouts tied to the visit
• Test results or imaging reports from the visit

Many employers will accept these as proof when a signed physician note isn’t immediately available.

3. Request your medical records and ask for a signed note

Under federal HIPAA privacy rules you have a right to access your medical records. You can ask the hospital for a copy of the ER chart, discharge summary, or a brief note from the treating clinician. Learn how to request records: https://www.hhs.gov/hipaa/for-individuals/medical-records/index.html. Hospitals often have a medical records or health information management department that handles requests; some will provide an after‑visit summary immediately.

4. If you can’t get a note quickly, communicate and ask for an extension

Tell your employer promptly (preferably in writing) when you had the ER visit, why you missed work, and when you expect to provide documentation. Ask whether your employer will temporarily accept an ER discharge summary or billing statement and allow time for a doctor’s note. Employers commonly grant a short extension when you are actively obtaining records.

5. Consider alternate proof and backup plans

If the ER cannot or will not provide a signed note, possible alternatives include:

• Primary care or urgent‑care physician note confirming you were treated or advised to be off work
• Prescription or pharmacy record showing a medication prescribed at the visit
• Photographs of visible injuries, if relevant, with timestamps
• Receipts from transportation to/from the hospital (taxi, ride‑share) that show dates

6. Know when your absence might be job‑protected

If your condition qualifies as a “serious health condition,” you may be eligible for leave under the federal FMLA (if your employer and your length of service meet the law’s requirements). FMLA allows employers to request medical certification for serious conditions; learn about eligibility and certification at the U.S. Department of Labor: https://www.dol.gov/agencies/whd/fmla. Vermont also enforces state and federal anti‑discrimination laws; for issues involving disability or medical leave, see the Vermont Human Rights Commission: https://hrc.vermont.gov/.

7. If your employer disciplines or fires you

If you believe your employer treated you unfairly, retaliated against you for asking for time to get records, or violated your rights under FMLA or anti‑discrimination laws, document everything (written notices, emails, names and dates) and contact the appropriate agency:

• Vermont Department of Labor for general employment issues: https://labor.vermont.gov/
• U.S. Department of Labor for FMLA questions: https://www.dol.gov/agencies/whd/fmla
• Vermont Human Rights Commission for discrimination concerns: https://hrc.vermont.gov/

Helpful Hints

• Tell your employer right away and put your explanation in writing (email or text). Prompt communication helps avoid discipline.
• Ask the ER for the after‑visit summary or discharge paperwork before you leave; many ERs will provide a printout on departure.
• Request medical records online or by fax if you can’t pick them up in person. Note that hospitals may take several days to fulfill a records request.
• Save any receipts, parking stubs, prescription labels, or photos as supporting evidence.
• If your workplace has HR, involve HR early and ask for clarification of the documentation deadline.
• Consider asking your primary care doctor for a retroactive note based on ER records — many doctors will provide one after reviewing the ER chart.
• If you worry about losing pay, ask about using sick leave, vacation/PTO, or unpaid leave while you secure records.
• Keep a clear timeline: date/time of ER arrival, date/time left, what treatment you received, and when you notified your employer.
• If you face retaliation or believe your rights were violated, contact the Vermont Department of Labor or a lawyer promptly; administrative deadlines may apply.

Resources

• Vermont Department of Labor: https://labor.vermont.gov/
• U.S. Department of Labor — FMLA: https://www.dol.gov/agencies/whd/fmla
• HHS — Accessing your medical records (HIPAA): https://www.hhs.gov/hipaa/for-individuals/medical-records/index.html
• Vermont Human Rights Commission: https://hrc.vermont.gov/