What to do if you don’t have a doctor’s note after an ER visit — South Dakota guidance

Short answer: South Dakota employers can generally ask for medical documentation, but you have options if you don’t have a formal doctor’s note from the emergency room (ER). Collect your ER paperwork or medical records, notify your employer quickly, ask for reasonable time to produce documentation, and explore federal protections (FMLA or ADA) if they may apply.

Detailed answer — practical steps and legal context

This is not legal advice. It explains common options under South Dakota employment practice and federal law so you can decide whether to speak with an attorney.

1. Understand what employers can and cannot require

Private employers in South Dakota generally may require proof of an illness or medical visit to excuse missed work or to approve leave under an employer policy. South Dakota does not have a statewide paid-sick-leave mandate that limits an employer’s ability to set documentation rules, so many employers require documentation for absences.

2. Use ER paperwork and alternative documentation

If the ER did not give you a signed “doctor’s note,” you can usually provide other official documents showing you were treated. Useful items include:

• ER discharge instructions or printed after-visit summary.
• Itemized ER bill or insurance claim showing date and location of service.
• Prescription receipts or medication labels issued at discharge.
• Diagnostic test results (labs, imaging) or copies of clinician notes from the ER chart.

These documents often suffice for employers who only need proof you were under medical care on specific dates.

3. Obtain your ER medical records (HIPAA rights)

Under federal privacy rules (HIPAA) you can request copies of your medical records from the hospital or emergency department. That request may take a few days to weeks, but it will give you clinical notes, diagnoses, and timestamps that function like a physician’s note.

Federal HIPAA information: https://www.hhs.gov/hipaa/index.html

4. Ask your treating clinician or primary care provider for a retrospective note

If you see your primary care doctor or an urgent care after the ER visit, ask them to write a note confirming you needed medical attention on the ER date and whether you were medically unable to work. Many outpatient providers will provide a retroactive work note when they can confirm an ER visit from records or discharge paperwork.

5. Notify your employer promptly and in writing

Tell your manager or HR as soon as possible that you had an ER visit and that you are getting documentation. Send your message in writing (email or letter) and keep a copy. Ask for a reasonable deadline to provide documentation and explain any delay in getting records.

6. Consider federal protections that may apply

If your employer has 50 or more employees and you meet eligibility rules, the federal Family and Medical Leave Act (FMLA) can protect certain medical leave and limit an employer’s ability to discipline you for protected leave. See the U.S. Department of Labor’s FMLA overview: https://www.dol.gov/agencies/whd/fmla

If your ER visit was for a serious long-term medical condition or disability, the Americans with Disabilities Act (ADA) may require your employer to provide reasonable accommodations. For ADA rules and how to request accommodations, see the EEOC: https://www.eeoc.gov/statutes/americans-disabilities-act-1990

7. If the employer disciplines you or denies leave

First, request a written explanation of the employer’s reason. If you believe the denial or discipline violates federal law (FMLA or ADA) or amounts to discrimination or retaliation, you can file a charge with the U.S. Equal Employment Opportunity Commission (EEOC) or contact the U.S. Department of Labor for FMLA matters. For state-level questions about wage or workplace practices, contact the South Dakota Department of Labor & Regulation: https://dlr.sd.gov/

8. Keep a paper trail

Save all ER paperwork, emails to and from your employer, receipts, and records showing when you requested medical records. If you end up needing legal help, this documentation is critical.

Helpful hints

• Ask the ER for an after-visit summary or discharge paperwork before you leave. Many hospitals will print this when you check out.
• If you need records quickly, request them in writing and ask the medical records department for an expedited copy; sometimes fees apply but you can explain urgency to your employer.
• Offer alternative documentation immediately (prescription, receipt, ER stamp) while you wait for full records.
• Know whether your employer is covered by FMLA (generally 50+ employees) so you can check eligibility for protected leave.
• If you suspect discrimination or retaliation, note dates and witnesses, then contact the EEOC or the South Dakota Department of Labor for guidance.
• Be polite but persistent with both the hospital records office and your employer; many issues resolve once documentation arrives.

Where to get more information

• U.S. Department of Labor — FMLA: https://www.dol.gov/agencies/whd/fmla
• U.S. Department of Health & Human Services — HIPAA: https://www.hhs.gov/hipaa/index.html
• EEOC — ADA guidance: https://www.eeoc.gov/statutes/americans-disabilities-act-1990
• South Dakota Department of Labor & Regulation: https://dlr.sd.gov/

Final note: This article provides general information only and is not legal advice. If your employer threatens discipline or termination, or if you believe your rights under FMLA or ADA may apply, consider speaking with an employment attorney who knows South Dakota law.