How to handle missing work after an ER visit when you don’t have a doctor’s note

This article explains practical steps under Pennsylvania employment rules and federal leave laws for employees who miss work after an emergency room (ER) visit but do not yet have a doctor’s note. It is written to help you understand options, employer rights, and how to protect yourself. This is general information and not legal advice.

Detailed answer: What to do and what your employer can reasonably require

Overview: Employers in Pennsylvania generally may set attendance and documentation rules, including requiring medical verification for missed time. Pennsylvania does not require private employers to provide paid sick leave statewide. Federal protections like the Family and Medical Leave Act (FMLA), the Americans with Disabilities Act (ADA), and state anti-discrimination rules may limit what an employer can lawfully do in certain cases.

1. Notify your employer immediately and explain the situation

Contact your supervisor or HR as soon as possible. Tell them you went to the ER, give the dates you missed, and state whether you expect to return soon or need more time. Many employers accept timely notice and a statement that you sought medical care.

2. Provide substitute proof if you don’t yet have a doctor’s note

If you cannot get a formal doctor’s follow-up note right away, offer other documents that show you were at the ER and were treated. Acceptable substitutes often include:

• ER discharge paperwork or after-visit summary (often available at discharge or via a patient portal)
• Hospital or clinic billing statements showing the date/time of service
• Prescription receipts or pharmacy printouts with date/time
• Appointment confirmation for a follow-up visit with a provider
• A dated message or secure message from the clinic confirming your visit

Keep copies of everything you send and document every contact with your employer.

3. Understand what documentation an employer may lawfully request

Employers commonly request a note confirming that you were seen and whether you were medically unable to work during specific dates. They can require reasonable verification under workplace policies. However, they generally cannot demand your full medical record or detailed health information beyond what is relevant for the leave or absence. Medical privacy laws (HIPAA) protect detailed health information; employers may ask for limited documentation that shows incapacity to work.

4. If the absence qualifies as FMLA leave

If you work for a covered employer (50+ employees within 75 miles) and your condition meets the FMLA threshold for a serious health condition, you may have job-protected leave. Under FMLA rules, the employer can require medical certification (Form WH-380) from a health care provider. The U.S. Department of Labor explains FMLA notice and certification requirements here: https://www.dol.gov/agencies/whd/fmla.

5. If your condition implicates disability or accommodation rules

If the ER visit connects to a long-term or substantial impairment, you may be protected by the ADA and by Pennsylvania anti-discrimination law. Your employer may ask for documentation to support a reasonable accommodation request, but the request must be related and not overly invasive. For local guidance on discrimination and employer obligations in Pennsylvania, see the Pennsylvania Human Relations Commission: https://www.phrc.pa.gov/Pages/default.aspx.

6. If your employer is inflexible or disciplines you

First, read your employer’s written attendance and leave policies and compare them to what they require from you. If you believe the employer is overreaching, inconsistent, or retaliating because you sought medical care, keep written records of communications and copies of any proof you provided. You can contact the Pennsylvania Human Relations Commission if discrimination or retaliation is suspected, or consult an employment attorney to discuss options.

7. Practical steps to get a proper note quickly

• Request your ER after-care summary through the hospital or health system patient portal or medical records office.
• Contact the ER clinic or your primary care doctor for a short follow-up or to issue a work note documenting incapacity for specific dates.
• If you have trouble obtaining records, ask the medical records department for a time-stamped receipt or confirmation of your request; give that to your employer while you wait.

8. Keep careful records

Save emails, text messages, voice mail details, copies of discharge paperwork, billing statements, and any notes you get from pharmacies or labs. Document the date and time you called and who you spoke with at work about your absence. Clear records help if your employer later questions the absence.

Helpful hints

• Tell your employer as soon as you can, even if you do not yet have paperwork.
• Ask HR which documents they accept as proof for an ER visit; employers vary in what they will accept.
• Use the patient portal to download visit summaries—these are often accepted as proof quickly.
• If you expect ongoing problems, ask whether the absence could qualify as FMLA and what steps you must take to request it: DOL FMLA guidance.
• Limit medical details when communicating with your employer; provide only the information necessary to justify the absence.
• If you get disciplined unfairly, request the disciplinary decision in writing and ask HR for the factual basis so you can respond formally.
• Keep copies of all paperwork you give or receive. If records are delayed, provide dated proof of your request for records to your employer.
• If you think your employer’s demand violates your privacy or discriminates because of a disability, contact the Pennsylvania Human Relations Commission: PHRC.

Where to get more information and formal help

• U.S. Department of Labor (FMLA information and forms): https://www.dol.gov/agencies/whd/fmla
• U.S. Department of Health and Human Services (HIPAA basics): https://www.hhs.gov/hipaa/index.html
• Pennsylvania Human Relations Commission (state anti-discrimination resources): https://www.phrc.pa.gov/Pages/default.aspx
• Pennsylvania Department of Labor & Industry: https://www.dli.pa.gov/Pages/default.aspx

Final note: Employers have a right to enforce reasonable attendance and documentation rules. You have options to document an ER visit even without an immediate doctor’s note and may have protections under federal law if your condition qualifies. If you are unsure about your rights or face discipline, consider contacting the PHRC or speaking with an employment lawyer.

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