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

Short answer: Collect alternate medical documentation (ER after‑visit summary, billing statement, medical records), notify your employer immediately, check Washington paid sick leave and paid family & medical leave rules, and ask your employer what proof they will accept. If your employer requires a note you cannot get, there are state options for help. This is general information, not legal advice.

Detailed answer — steps to take under Washington law

1. Understand the rules that may apply

Washington law gives employees certain leave rights and limits on employer conduct. For example, Washington’s paid sick leave rules and related guidance describe your rights to use accrued leave and an employer’s ability to set reasonable documentation policies. See the Washington State Department of Labor & Industries summary for paid sick leave: https://lni.wa.gov/workers-rights/leave/paid-sick-leave/. For state paid family & medical leave, see the Washington Paid Leave site: https://paidleave.wa.gov/.

Employers may have a written attendance or sick‑leave policy. That policy and any collective bargaining agreement can govern whether, and when, documentation is required. If you think your employer’s request discriminates or conflicts with the Washington Law Against Discrimination, you can review the WLAD: RCW 49.60.

2. Immediately gather alternative proof of the ER visit

If you left the ER without a formal “doctor’s note,” you can usually obtain other official records that show you were treated or seen:

• Ask the hospital/ER for the after‑visit summary or discharge paperwork—many ERs give or can email this right away.
• Request a medical records printout that lists the visit date and services provided. Hospitals must provide records upon request (you may need to sign a release and pay a small fee).
• Get a billing statement or itemized bill showing service dates and facility name—this often suffices to prove you were at the ER.
• If you saw any testing or imaging, request copies of those reports or the imaging order.

Under federal HIPAA rules you have a right to access your records; see the HHS overview on getting medical records: https://www.hhs.gov/hipaa/for-individuals/medical-records/index.html.

3. Communicate with your employer quickly and clearly

Tell your employer the date(s) you were at the ER, what you can provide (after‑visit summary, bill, medical record request confirmation), and when you expect to deliver it. Employers often accept alternate documentation when employees explain the situation and provide a timeline for records. Put your communications in writing (email) and keep copies.

4. If your employer requires a specific type of note you cannot get

Ask whether a billing statement or after‑visit summary will do. If they insist on a handwritten note from the treating physician but no such note exists, ask if your primary care provider or an urgent care clinic can provide a retroactive note after they review your records or speak with the ER. Many employers will accept a note from a follow‑up provider.

5. Consider protected leave rules

If your absence is for a serious health condition that impairs your ability to work, you may qualify for job‑protected leave under federal FMLA (if your employer is covered) or under Washington’s Paid Family & Medical Leave program for wage replacement. These programs have their own certification processes and timelines. See the federal FMLA information: https://www.dol.gov/agencies/whd/fmla and Washington’s Paid Leave site: https://paidleave.wa.gov/.

6. If your employer disciplines you or denies leave

Document every interaction and the records you requested. If you believe your employer violated Washington paid‑leave rules, you can contact Washington L&I’s Paid Sick Leave enforcement via: L&I paid sick leave guidance. For discrimination or retaliation concerns, you can contact the Washington State Human Rights Commission or file a complaint under WLAD (RCW 49.60).

Helpful hints

• Always ask for an after‑visit summary or discharge paperwork at the ER before you leave.
• If you can’t get a same‑day note, request medical records or a billing statement immediately—many systems provide electronic access within days.
• Email your employer promptly with dates and a statement that you were treated in the ER and will provide records as soon as you have them.
• Check your employer’s written sick‑leave policy and any employee handbook for documentation rules and timelines.
• Keep copies of all paperwork, emails, receipts, and record requests—paper trails help in disputes.
• If you need help interpreting your rights, contact Washington L&I or the Paid Leave program; both have worker guidance and complaint options.
• When in doubt about a complex denial, consult an employment attorney for rights and options (this article is not legal advice).

Disclaimer: This article explains general Washington state law and common practical steps. It is not legal advice. For advice about a specific situation, consult an attorney licensed in Washington.