Detailed Answer

If you missed work because you went to an emergency room (ER) but you do not have a doctor’s note, you still have several practical and legal options in Maryland. Your employer may ask for documentation, but Maryland law and federal law limit what employers can require and create alternatives you can use to verify your absence.

1. First, check your employer’s written policy and company practice

Review your employee handbook, attendance policy, or any written communications from HR. Many employers allow different forms of verification (ER discharge paperwork, after-visit summary, pharmacy receipts, billing records, or a patient portal summary) instead of a traditional “doctor’s note.” If the policy is unclear, ask HR in writing what documentation they accept.

2. Maryland paid sick leave rules (what employers can reasonably require)

Under Maryland’s paid sick and safe leave framework, employees may use earned paid leave for their own medical care. Employers may request reasonable documentation for absences lasting multiple days, but they cannot require documentation that violates privacy rules. For general information about Maryland’s paid sick leave requirements, see the Maryland Department of Labor’s guidance on paid leave: https://www.dllr.state.md.us/paidleave/. For the statutory language, see Maryland Code, Labor & Employment, Title 3 (paid sick leave provisions): https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gle&section=3-901.

3. Federal FMLA and employer size

If you work for a covered employer (generally 50 or more employees within 75 miles) and you meet eligibility, the federal Family and Medical Leave Act (FMLA) may apply for serious health conditions. Employers can require certification for FMLA leave, and they may have a specific form. For basics about FMLA certification and employee rights, see the U.S. Department of Labor: https://www.dol.gov/agencies/whd/fmla.

4. What counts as acceptable evidence if you don’t have a doctor’s note?

• ER discharge paperwork or an after-visit summary (many hospitals provide this before you leave or via the patient portal).
• A copy or screenshot of the ER registration, timestamped receipt, or visit bill showing date/time of service.
• Prescription labels or pharmacy printouts showing date/time of pick-up.
• Medical billing records or insurance claim statements showing the visit date.
• Patient portal printouts or secure messages from the ER or hospital confirming the visit.
• A signed written statement from you describing the reason for the absence, backed up by any of the above items or contemporaneous evidence (texts, emails asking to leave work, witness statements about your condition).

5. How to get ER documentation when you left without a note

Hospitals and ERs keep medical records. You can request a copy of your discharge summary or after-visit summary. Expect to sign an authorization for release of medical records and possibly pay a small fee. Many hospitals also provide immediate access through an online patient portal where you can download visit summaries and prescriptions.

6. Privacy and medical records

HIPAA protects the privacy of medical records, but it also allows you to obtain your own records and share them with your employer. You decide whether to release detailed records; often a simple visit confirmation or discharge summary suffices. If you have a sensitive diagnosis you do not want to share, you may provide a note confirming you were treated without disclosing details.

7. If your employer still disciplines you

If your employer disciplines you for failing to provide a doctor’s note, first provide any alternative documentation you can obtain and a written explanation. If the employer’s action appears to violate Maryland paid leave rules or federal law (for example, retaliation for taking protected leave), you can file a complaint or request help:

• Contact the Maryland Department of Labor for paid leave and employment rights guidance: https://www.dllr.state.md.us/paidleave/.
• For potential FMLA violations, contact the U.S. Department of Labor Wage and Hour Division: https://www.dol.gov/agencies/whd.

8. When to get legal help

If your employer refuses reasonable alternative verification, disciplines you unfairly, or you suspect discrimination or retaliation, consider consulting an employment lawyer. A lawyer can advise whether a state law claim (for paid leave or retaliation) or a federal claim (FMLA, ADA) applies and can help you preserve evidence and file a complaint.

Quick checklist of immediate steps:

1. Request your ER after-visit summary or discharge paperwork (online or in writing).
2. Collect supporting items: pharmacy receipts, billing statements, patient portal screenshots, time-stamped messages.
3. Send a written note to HR explaining the absence and attach whatever documentation you have.
4. If your employer asks for more and you cannot get a doctor’s note quickly, ask if they will accept the alternatives above.
5. If disciplined, document that discipline in writing and contact the Maryland Department of Labor or a lawyer if needed.

Note on documentation timing: Ask your medical provider for records as soon as possible. Hospitals and clinics often handle record requests within days to weeks, so prompt requests reduce friction with employers.

Disclaimer: This article is for general informational purposes only and does not constitute legal advice. It does not create an attorney-client relationship. For advice about your specific situation, consult a licensed Maryland attorney.

Helpful Hints

• Always request an after-visit summary at discharge from the ER or download it from the patient portal—this often works as a substitute for a doctor’s note.
• Keep screenshots of any timestamps (registration, discharge, pharmacy pickup) to prove the timing of your visit.
• When you contact HR, communicate in writing (email) so you have a record of what you provided and what they requested.
• If you have a chronic condition, consider informing HR about ongoing leave needs and whether FMLA or an accommodation under the ADA may apply.
• If you cannot obtain records quickly, ask HR for a short extension to produce documentation and explain that medical records requests can take time.
• Save all billing statements and insurance explanations of benefits (EOB); they often list service dates and provider names and are accepted by employers.
• If your employer’s policy seems inconsistent with Maryland law, contact the Maryland Department of Labor before taking any formal step.