Missing Work After an ER Visit Without a Doctor’s Note: Practical Steps Under Virginia Law

Short answer: You can usually document your emergency visit without a traditional “doctor’s note.” Ask the ER for discharge paperwork or a records summary, request copies of medical records under HIPAA, collect supporting evidence (prescription receipts, pharmacy labels, follow-up appointment confirmations), and communicate promptly with your employer. If your situation involves a serious medical condition, federal rules like the Family and Medical Leave Act (FMLA) and disability protections may apply. This article explains realistic steps under Virginia law and federal rules, and what to do if your employer disciplines you.

Detailed answer

1. Can your employer require a doctor’s note?

Yes. Many employers can require medical documentation for absences. Virginia does not require private employers to provide paid sick leave statewide, so employer attendance and documentation rules usually come from company policy or your handbook. However, documentation requests must not run afoul of federal anti-discrimination or leave laws (see below).

2. Immediate practical steps after an ER visit when you don’t have a traditional note

• Get the ER discharge paperwork right away. Most hospitals provide a discharge summary or after-visit summary when they release you. If you left without it, return to the hospital’s registration or medical records office and ask for the ER visit summary or discharge instructions.
• Request your medical records (HIPAA request). Under federal HIPAA rules you can request and obtain copies of your medical records, often for a reasonable fee. The record will show date/time of arrival, diagnosis codes, treatments, and discharge instructions — all strong proof of a legitimate emergency visit. See U.S. HHS: https://www.hhs.gov/hipaa/for-individuals/medical-records/index.html
• Collect corroborating documents. Keep your ER receipt, billing statements, lab or imaging reports, prescription labels or receipts, parking receipts, and any follow-up appointment confirmations. These items can support your claim if you cannot get an immediate signed note.
• Ask for an expedited note or employment verification. Many hospitals or urgent care centers will provide an after-visit note for work that states the date(s) you were treated and whether you were treated as an inpatient or outpatient. If the ER will not produce a detailed note, a records release showing the visit date and treatment often suffices.
• Tell your employer as soon as you can. Inform your supervisor or HR promptly, explain you had an ER visit, and state you are obtaining records. Good communication often reduces the risk of disciplinary action.

3. Federal leave and disability protections that may limit an employer’s ability to demand notes

• FMLA (federal): If you work for a covered employer (50+ employees within 75 miles) and meet eligibility (1,250 hours in the prior 12 months), a qualifying serious health condition may make your absence FMLA-protected. Employers may request certification, but must follow FMLA procedures. For general info: https://www.dol.gov/agencies/whd/fmla
• ADA and disability accommodations: If your condition qualifies as a disability under the Americans with Disabilities Act, the employer may ask for documentation to support a request for reasonable accommodation, but they must engage in an interactive process and cannot demand excessive medical details. The Virginia Human Rights Act also prohibits disability-based discrimination by employers. See Va. Code § 2.2-3903 (unlawful employment practices): https://law.lis.virginia.gov/vacode/title2.2/chapter39/section2.2-3903/

4. What to do if your employer disciplines you for missing work

• Ask for a written explanation of the discipline and cite your efforts to obtain and submit documentation.
• Provide the ER records as soon as you receive them and ask HR to reconsider the discipline in light of the documentation.
• If you believe the discipline violates FMLA or disability law, preserve all communications and consider filing a complaint with the U.S. Department of Labor (for FMLA) or the EEOC/state civil rights agency (for disability discrimination).

5. How to request medical records from the ER (practical checklist)

1. Call the hospital’s Health Information Management or Medical Records department.
2. Complete the hospital’s medical records authorization form (they must accept a signed request from you).
3. Ask for an “after visit summary” or “discharge summary” and any visit timestamps.
4. Request electronic copies if possible (faster) and ask about fees.

6. Timing: what employers can reasonably expect

Employers often expect documentation within a reasonable time after you return to work. If records take several days, send an interim update (email or voicemail) saying you sought a records copy and will provide it when available. This shows good faith and can prevent immediate discipline.

7. When to get legal help

Consider consulting an employment attorney or contacting the U.S. Department of Labor or EEOC if:

• Your employer refuses to accept reasonable documentation that proves an ER visit.
• You are disciplined or terminated and you believe the action violated FMLA, the ADA, or state anti-discrimination laws.
• You need help getting or interpreting medical records that the hospital delays or denies.

Helpful Hints

• Keep copies of everything: discharge papers, receipts, emails, and notes about who you spoke with and when.
• If you frequently visit urgent care or ER, ask your regular doctor for follow-up visits that create a clearer medical trail.
• If you believe your employer’s documentation policy is too invasive (e.g., demanding detailed diagnoses), remind them of federal limits under the ADA and FMLA, and ask HR to explain the specific policy basis.
• Use secure email or HR portals when sending medical documentation. Avoid sharing sensitive data in unsecured formats.
• If an employer requests a specific form for FMLA certification, ask HR which form they need (employers often have a designated form). For FMLA guidance: https://www.dol.gov/agencies/whd/fmla
• When obtaining records, ask for a timestamped record that shows visit date/time — that is often enough for attendance verification.