Detailed answer — steps to take right now

1. Tell your employer as soon as possible and explain the situation

Contact your supervisor or HR promptly. Explain you were treated in the emergency department and you do not yet have a formal doctor’s note. Ask what type of documentation your employer will accept and whether they can grant provisional or informal leave while you obtain records. Many employers will accept other proof temporarily rather than immediately disciplining an employee.

2. Gather alternative documentation from the emergency visit

If you don’t have a signed doctor’s note, you can usually obtain other proof quickly. Useful items include:

• ER discharge paperwork or after-visit summary (often printed at discharge or available in a patient portal)
• Hospital or ER billing statements showing dates of service
• Medication or prescription labels written the day of the visit
• Lab or imaging reports with the ER visit date
• Checklist or record from triage showing times of arrival/departure

These items typically show you were treated on the date(s) you missed work and are often accepted by employers as proof of the visit.

3. Ask the ER for a retrospective note or medical records

Many emergency departments can provide an “after-the-fact” note, discharge summary, or medical record release if you request it. Contact the hospital’s medical records or health information management (HIM) office, or use the hospital/clinic patient portal to download visit summaries. Expect the hospital to have a process for medical record requests; you may need to sign an authorization.

4. Use a follow-up or primary care visit to obtain a note

If the ER cannot quickly give a doctor’s note, schedule a follow-up with your primary care provider (PCP) or an urgent care. Explain the dates you missed and ask for a backdated note (providers commonly document prior ER visits and provide notes covering the time you were incapacitated).

5. Understand your legal protections — North Dakota and federal

North Dakota employers can set reasonable documentation requirements for absences, but your rights depend on whether any state or federal protection applies:

• Family and Medical Leave Act (FMLA): If you work for a covered employer and meet eligibility rules, FMLA can protect qualifying medical leave and allows employers to request medical certification. See the federal Department of Labor’s FMLA overview: https://www.dol.gov/agencies/whd/fmla.
• Disability protections: If your medical condition qualifies as a disability, the Americans with Disabilities Act (ADA) and similar state protections may limit an employer’s ability to discipline you or require certain documentation; the EEOC explains ADA protections: https://www.eeoc.gov/statutes/americans-disabilities-act-1990.
• North Dakota resources: For general state labor information and guidance about employer policies in North Dakota, see the North Dakota Department of Labor website: https://www.nd.gov/labor. You can also review the North Dakota Century Code online: https://www.legis.nd.gov/cencode.

Note: North Dakota does not require private employers to provide paid sick leave by statute, and most workplaces operate under at-will employment. Employer policies vary, so check your employee handbook and the company’s attendance policy.

6. Use HIPAA and medical record release procedures

If you need someone else (for example, HR) to receive your records, sign a HIPAA authorization form. For guidance on getting medical records under HIPAA, see the Department of Health & Human Services page on medical records: https://www.hhs.gov/hipaa/for-individuals/medical-records/index.html.

7. Keep careful records of communications and attempts to get documentation

Document emails, phone calls, patient portal messages, and any forms you submit. If your employer disciplines you despite reasonable attempts to provide proof, that record will help if you later need to contest the action.

8. If your employer refuses reasonable accommodations or disciplines you unfairly

If you believe your employer violated federal protections (FMLA, ADA) or discriminated against you based on disability, you may contact the U.S. Department of Labor, the Equal Employment Opportunity Commission (EEOC), or the North Dakota Human Rights Office for guidance. Useful federal links: U.S. Department of Labor and EEOC. For state-level questions, the North Dakota Department of Labor can provide resources: https://www.nd.gov/labor.

Helpful hints

• Ask the ER for an after-visit summary before you leave or request it via the patient portal for the quickest proof.
• Keep photos or scans of all receipts, prescriptions, and discharge papers on your phone.
• If your employer has a strict policy, ask what alternative documents they accept (billing, receipts, patient portal screenshots).
• If you think you might qualify for FMLA or disability protections, mention it to HR — but only after you understand eligibility and paperwork requirements.
• Use written communication (email) where possible so there is a record of what you asked for and what you provided.
• If you cannot get a doctor’s note quickly, a short follow-up visit with your PCP or urgent care often results in a note covering the prior ER visit.
• Respect privacy: sign any required medical-release forms rather than asking your employer to contact the hospital directly without authorization.