Can I get excused for missed work after an ER visit if I don’t have a doctor’s note?

Short answer: Yes — often you can provide alternative proof, request documentation from the hospital, and ask your employer to accept substitute records. If you’re eligible, federal protections like the Family and Medical Leave Act (FMLA) or the Americans with Disabilities Act (ADA) may apply. Act quickly, keep records, and communicate in writing. This is not legal advice.

Detailed answer — what to do under Iowa law and federal law

Missing work because you went to the emergency room is common. Employers often request a doctor’s note to excuse the absence. If you don’t have a formal “doctor’s note,” take these steps to protect your rights and limit disciplinary consequences.

1. Check your employer’s policies and company handbook

Look for the attendance, sick-leave, and medical documentation rules. Many employers list what kind of proof they accept (e.g., discharge paperwork, “after visit summary” from the ER, hospital billing, or a phone call to HR). Follow any notice or verification procedures exactly and promptly.

2. Gather alternative documentation

• Request the ER after-visit summary or discharge paperwork. Hospitals routinely provide documentation that shows arrival and discharge times, diagnoses, and follow-up instructions.
• Ask for a copy of your medical record or chart notes from the ER. Under federal privacy rules (HIPAA), you have a right to access your records; the hospital must provide them within a specified time and may charge a reasonable fee. See HHS guidance: HHS — Requesting Medical Records.
• Keep any receipts (pharmacy, parking, toll), prescription labels, or follow-up appointment confirmations. These support a timeline and show you sought treatment.
• Note the names and contact information of staff who treated you, and create a dated log of what happened and when (times you left/returned to work, who you told, etc.).

3. Ask the hospital for the documentation you need

Contact the medical records or health information management office at the ER/hospital and request an “after-visit summary,” discharge summary, or the portion of your chart showing the visit date and times. Hospitals know employers frequently request that documentation and can often provide it quickly.

4. Communicate promptly and in writing with your employer

Explain you sought emergency care and are obtaining documentation. Attach any interim proof (e.g., pharmacy receipt, ER triage slip, billing statement) and provide a date when you expect the official record. Keep copies of every message you send and receive.

5. Consider FMLA or ADA protections if they apply

If your condition meets FMLA’s definition of a serious health condition and you work for a covered employer, you may be entitled to job-protected leave. Employers may request medical certification to support FMLA leave. See the Department of Labor’s FMLA page for details: DOL — FMLA Overview.

If your health condition qualifies as a disability under the ADA (and you work for a covered employer), your employer must provide reasonable accommodations unless doing so causes undue hardship. The Equal Employment Opportunity Commission explains employer responsibilities and permissible medical inquiries: EEOC guidance.

6. Ask for retroactive or excused leave

If you were unable to get a signed note at the time of the visit, ask your employer to accept the ER documentation once you obtain it. For FMLA-eligible employees, employers may allow retroactive designation of FMLA leave if appropriate.

7. If your employer disciplines you

If you are disciplined or fired for taking emergency medical care, review whether protected leave (FMLA), disability discrimination (ADA or Iowa Civil Rights law), or retaliation might apply. You can contact the Iowa Workforce Development or a private attorney to discuss your situation and possible unemployment benefits. Iowa Workforce Development: iowaworkforcedevelopment.gov.

Practical timeline and checklist

1. Immediately: Tell your supervisor or HR you needed emergency care and when you’ll provide documentation.
2. Within 24–72 hours: Request ER after-visit summary or medical records from the hospital; collect receipts and discharge paperwork.
3. Within 3–7 days: Send the documentation to HR and request confirmation that your absence will be excused or handled as appropriate leave.
4. If denied or disciplined: Ask for the reason in writing and consider contacting state agencies or a lawyer for advice about FMLA, ADA, or wrongful discipline.

Sample message you can send to HR or your manager

Use plain language and attach any interim proof you have.

Subject: Missed work on [date] — ER visit

Hi [Name],

I missed work on [date] because I required emergency medical treatment. I am obtaining the ER after‑visit summary and medical records and will provide them by [date]. In the meantime, I have attached a pharmacy receipt/ER triage slip/billing statement that confirms I sought care. Please let me know if you need anything else to document this absence.

Thank you,

[Your name]

Helpful hints

• Hospitals often produce an “after-visit summary” immediately or within a day — ask for it when you check out of the ER.
• HIPAA protects your medical records; you have a right to access them. HHS explains the process: HHS — Medical Records.
• Keep a contemporaneous log (dates, times, who you told). A clear timeline helps support your case.
• If you expect ongoing restrictions, talk to HR about reasonable accommodations under the ADA and when you might qualify for FMLA. See: DOL — FMLA and EEOC — ADA.
• If your employer won’t accept records or disciplines you unfairly, keep all correspondence and consider contacting Iowa Workforce Development or a private employment lawyer for next steps.

Disclaimer: This article explains general legal principles and practical steps for people in Iowa. It is for educational purposes only and is not legal advice. Laws change and individual circumstances vary. For legal advice tailored to your situation, consult a licensed attorney.