A sick note is written confirmation from a licensed provider that you were evaluated for an illness and that time away from work or school was appropriate. In the United States it means the same thing as a doctor’s note or medical excuse note, and you can request one online from a licensed physician without booking an in-person appointment. What’s less obvious is when your employer is actually allowed to ask for one, how many days of absence typically trigger the requirement, and what the note can realistically do once you hand it over.
Key takeaways
- Sick leave rules in the U.S. are set by employers and by state or local law, not by a single federal standard. The U.S. Department of Labor notes that the Fair Labor Standards Act doesn’t require payment for time not worked, including sick leave, so your employer’s policy and any applicable state or local law are what govern.
- Access varies enormously by job. According to the U.S. Bureau of Labor Statistics, access to paid sick leave among civilian workers ranged from 61 percent in the lowest average wage quartile to 95 percent in the highest as of March 2025. Whether you have leave at all, and whether documentation is required to use it, depends heavily on where you work.
- Read your written policy before you request anything. It tells you how many days trigger the requirement and exactly what the note has to contain, which is the difference between one submission and three.
What is a sick note?
A sick note is a short document from a licensed healthcare provider confirming that you were evaluated for an illness and stating the dates you should be out. It’s meant for a third party, usually an employer or a school, who wants something in the file beyond your word for it.
A typical sick note includes:
- Provider identification. Name, credentials, and contact information so it can be verified.
- The date of evaluation. When the provider assessed you.
- The dates of absence. The specific days the provider considers clinically appropriate.
- A signature.
What it usually doesn’t include is your diagnosis. For routine short absences, confirmation and dates are generally enough, and there’s a good reason for that limit. Under the Americans with Disabilities Act (ADA), the EEOC restricts the disability-related inquiries and medical examinations an employer can require of an employee, and medical information an employer does receive has to be kept confidential and stored separately from the regular personnel file.
Sick note vs. doctor’s note: is there a difference?
In practice, no. “Sick note” is the more common phrasing in the UK, Ireland, Australia, and New Zealand, where it can also refer to a specific statutory form. In the United States the equivalent document is usually called a doctor’s note or a medical excuse note, and American employers and schools use those terms in their written policies.
A few related terms that do mean something different:
- Fit note. A UK document that describes whether you may be able to work with adjustments, rather than simply certifying that you can’t. There’s no direct U.S. equivalent.
- Medical certification. In the U.S., this usually means structured statutory paperwork, such as a Family and Medical Leave Act (FMLA) certification, where the required content is defined in federal regulation.
- Fitness-for-duty certificate. Confirms you’re medically able to return to work, sometimes with restrictions.
If your employer’s policy uses one of those specific terms, they’re asking for a specific document. When what you need is a straightforward absence note and your own provider can’t see you in time, you can request a doctor’s note online and a board-certified physician will review your request.
When can an employer ask for a sick note?
Generally, whenever their written policy says so, within the limits of applicable law. There’s no single federal rule capping how often an employer can request documentation for ordinary sick days.
What tends to govern in practice:
- Company policy. Most policies set a threshold, commonly three consecutive days, after which documentation is required. Some require it for any absence. Some never ask.
- State and local paid sick leave laws. Many states and cities have their own paid sick leave laws, and a number of them limit when an employer may require documentation, often by setting a minimum number of consecutive days first. These vary widely, so check the rules where you work.
- FMLA certification. Separate from an ordinary sick note. The Department of Labor explains that the FMLA provides eligible employees of covered employers with job-protected, unpaid leave for qualifying medical and family reasons, and employers may require certification from a health care provider to support the request. The content requirements are set out in 29 CFR Part 825.
- ADA accommodation requests. If a health condition is affecting your ability to do your job on an ongoing basis, that’s an accommodation conversation rather than a sick note conversation, and the EEOC describes how the interactive process generally works.
The practical takeaway is to read your employee handbook before you’re sick, so you already know what the threshold is.
How many days before you need a sick note?
Three consecutive days is the most common threshold in U.S. employer policies, though it isn’t a legal standard and plenty of employers use something different. Your handbook is the authority.
It’s also worth checking how long you’re likely to need. The CDC recommends staying home while you’re sick with a respiratory virus and returning to normal activities when, for at least 24 hours, your symptoms are improving overall and any fever has resolved without the use of fever-reducing medication. For a typical cold or mild respiratory illness, that often lands in the two to five day range, which is exactly the window a sick note is designed to cover.
If you need longer than that, you’re likely into leave territory. See how to obtain a sick note for extended leave for where that line sits, or start with online FMLA certification if your absence is connected to a serious health condition.
Can you get a sick note online?
Yes. For a mild illness you’re managing at home, an online request is often faster than waiting for an appointment, and the review is a genuine medical review.
Through My Dr’s Note, regular and COVID-19 notes are handled asynchronously. You fill out an online form describing your symptoms, onset, and what the note needs to cover. A board-certified physician licensed in all 50 states reviews it, and the note is delivered through a secure portal, often within an hour of review. You’re only charged if the request is approved.
The eligibility line matters: this service is for adults 18 or older who are recovering from a mild illness at home. A physician decides whether documentation is clinically appropriate based on what you report. Date coverage has real limits too, with a maximum of five days within any 30-day period, and a regular note covering a range from two days before submission through five days after.
For the full process, eligibility details, and date rules, see the online doctor’s note page.
What a sick note can’t do
- It can’t guarantee your absence will be excused or paid. Your employer decides, based on their policy and applicable law.
- It can’t cover an absence that didn’t involve an actual illness. Eligibility comes from a physician’s review of your reported symptoms.
- It can’t stretch beyond five days in a 30-day period. Longer absences go through a leave process.
- It can’t substitute for FMLA certification or an ADA accommodation. Those are different documents with different requirements.
- It isn’t legal advice. For your rights under the FMLA or the ADA, the Department of Labor and the EEOC are the authoritative sources, and your HR or leave administrator can speak to your specific situation.
Medical documentation supports your request. The final decision belongs to your employer, school, insurance carrier, or leave administrator.
When your illness needs more than a note
Sick notes are for mild illness you’re recovering from at home. Some symptoms need care rather than paperwork.
Contact a healthcare provider promptly, or seek emergency care, if you have:
- Difficulty breathing or shortness of breath
- Chest pain or persistent pressure
- Confusion, or difficulty staying awake
- Severe or persistent vomiting, or signs of dehydration
- Symptoms that improve and then clearly get worse
This is not an emergency service. In an emergency, call 911 or go to the nearest emergency room.
If what you’re dealing with isn’t mild, or if you need a diagnosis rather than documentation, virtual primary care through HealthSource Medical Associates is the better place to start.
Frequently asked questions
Is “sick note” the same as “doctor’s note” in the U.S.? Yes, they refer to the same document. “Sick note” is more common in the UK and Australia, while U.S. employers and schools usually say doctor’s note or medical excuse note in their written policies.
Can my employer require a sick note for a single day off? Some can, depending on their policy and on state or local law. A number of state and city paid sick leave laws limit when documentation can be required, often by requiring a minimum number of consecutive days first. Check your handbook and the rules where you work.
Does a sick note have to say what’s wrong with me? Usually not. Most routine sick notes confirm that you were evaluated and state the dates. The EEOC limits what employers can require and requires that medical information they do receive be kept confidential and separate from your personnel file.
How quickly can I get a sick note online? Regular and COVID-19 notes are often delivered within an hour of physician review, during operating hours, which are Sunday through Thursday 6 a.m. to 6 p.m. PST and Friday 6 a.m. to 1 p.m. PST. The service is closed Saturday.
Will my employer be able to verify it? Yes. Notes issued through this service are verifiable, and the practice will confirm a note if an employer or school calls to check. That’s what distinguishes real documentation from a downloaded template.
What if I’m going to be out longer than five days? That’s a leave conversation. Talk to your HR or leave administrator about your employer’s process, and look at whether FMLA or a short-term disability claim applies to your situation.
Requesting a sick note
If you’re an adult recovering from a mild illness at home and your own provider can’t see you before your employer’s deadline, a board-certified physician can review your request through My Dr’s Note. Notes are verifiable, HIPAA compliant, and delivered through a secure portal, and you’re only charged if your request is approved. Get started now and see current pricing on the request page.
Sources
- U.S. Department of Labor, Sick Leave. https://www.dol.gov/general/topic/workhours/sickleave
- U.S. Department of Labor, Wage and Hour Division, Family and Medical Leave Act. https://www.dol.gov/agencies/whd/fmla
- eCFR, 29 CFR Part 825: The Family and Medical Leave Act of 1993. https://www.ecfr.gov/current/title-29/subtitle-B/chapter-V/subchapter-C/part-825
- U.S. Equal Employment Opportunity Commission, Enforcement Guidance on Disability-Related Inquiries and Medical Examinations of Employees Under the ADA. https://www.eeoc.gov/laws/guidance/enforcement-guidance-disability-related-inquiries-and-medical-examinations-employees
- U.S. Equal Employment Opportunity Commission, Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the ADA. https://www.eeoc.gov/laws/guidance/enforcement-guidance-reasonable-accommodation-and-undue-hardship-under-ada
- U.S. Bureau of Labor Statistics, Percentage of civilian workers with access to paid leave by wage category. https://www.bls.gov/charts/employee-benefits/percent-access-paid-leave-by-wage.htm
- U.S. Bureau of Labor Statistics, Employee Benefits in the United States, March 2025. https://www.bls.gov/news.release/ebs2.nr0.htm
- Centers for Disease Control and Prevention, CDC Updates and Simplifies Respiratory Virus Recommendations. https://www.cdc.gov/media/releases/2024/p0301-respiratory-virus.html
- U.S. Department of Health and Human Services, Your Rights Under HIPAA. https://www.hhs.gov/hipaa/for-individuals/index.html
- Mayo Clinic, Common cold: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/common-cold/symptoms-causes/syc-20351605
- StatPearls, National Center for Biotechnology Information, Common Cold. https://www.ncbi.nlm.nih.gov/books/NBK431087/
Medical documentation supports your request but does not guarantee approval. Final decisions are made by your employer, insurance carrier, leave administrator, school, or applicable state program.
This article is for informational purposes only and is not a substitute for professional medical advice.