Return to Work Doctor's Note

FAQ: Return to Work Doctor's Note

• Can an employer require a doctor's note to return to work?

  It depends on the law that applies and on the employer's policy. Under the ADA, EEOC guidance lets an employer ask for a doctor's note to justify the use of sick leave if it requires one from all employees, with and without disabilities; questions about the employee's ability to return are a separate matter. After medical leave that is not FMLA leave, the employer may make disability-related inquiries or require a medical exam if it reasonably believes, based on objective evidence, that a medical condition will impair the employee's ability to perform essential job functions or that the employee will pose a direct threat. Under the FMLA, an employer may require a fitness-for-duty certification after leave for the employee's own serious health condition that made the employee unable to do the job, under a uniformly applied policy, with notice no later than with the designation notice. If State or local law or a collective bargaining agreement governs the return to work, those provisions apply to the FMLA process.

• What should a return-to-work note from a doctor include?

  A clear work status and its date, any restrictions and how long they last, the follow-up plan, and the provider's signature and contact details; this form has a field for each. Under the FMLA, the certification must certify that the employee is able to resume work, and it addresses the job's essential functions only when the employer asked for that and supplied a list of them no later than with the designation notice. Under EEOC guidance, an employer may ask why restrictions are needed and how long they may last, so stating the duration saves a round trip.

• Does a return-to-work note have to include my diagnosis?

  This form's line reads "Diagnosis or description", so the provider can describe the injury or limitation instead of naming the condition. Under the FMLA, the fitness-for-duty certification must certify that the employee is able to resume work. Under EEOC guidance for leave that is not FMLA leave, return-to-work inquiries must be limited to what is needed to assess the ability to work, and in most situations an employer cannot request complete medical records. An employer that reasonably believes, based on objective evidence, that a medical condition will impair the employee's ability to perform essential job functions or that the employee will pose a direct threat may still make disability-related inquiries or require a medical exam. If the restrictions are a request for an ADA accommodation and the disability or the need for it is not obvious, the employer may also ask for reasonable documentation about the disability and functional limitations.

• What is the difference between a return-to-work note and a fitness-for-duty certification?

  In the FMLA rules, a fitness-for-duty certification is a certification from the employee's health care provider that the employee is able to resume work after FMLA leave for the employee's own serious health condition that made the employee unable to do the job, required under a uniformly applied policy. It covers only the condition that caused the leave. "Return-to-work note" is the everyday name for any provider's statement of work status, like this form.

• Who can fill out and sign a return-to-work form?

  The treating health care provider signs it, and the provider or the provider's office fills it in; the employee does not. For FMLA purposes, a health care provider includes doctors of medicine or osteopathy and also, among others, nurse practitioners, nurse-midwives, clinical social workers, physician assistants, podiatrists, dentists, clinical psychologists, optometrists and chiropractors (chiropractors only for manual manipulation of the spine to correct a subluxation shown by X-ray), each authorized under State law and acting within the scope of practice. For leave that is not FMLA leave, ask your employer whose notes it takes.

• How do I get a return-to-work note from my doctor?

  Ask the provider who treated you (your own doctor, an urgent care clinic or a specialist), ideally at the visit that clears you, and bring your job description. You can send the provider the link to this form; the provider fills it in, signs it and downloads or prints it.

• Can I return to work with restrictions, and can my employer refuse?

  It depends on the facts and the law that applies. According to the EEOC, an employer violates the ADA if it requires an employee with a disability to be "100%" healed when the employee can do the job with or without reasonable accommodation, unless the employer can show the accommodation would cause undue hardship. An employer may also keep an employee from returning if an individualized assessment based on objective evidence shows a direct threat that reasonable accommodation cannot eliminate or reduce. If you were on leave for a disability, a doctor's note releasing you with restrictions may itself be a request for reasonable accommodation, and the employer may ask why the restrictions are needed and how long they may last. Under the FMLA, an employee who cannot perform an essential function of the position has no right to restoration to another position, though the ADA, state leave laws or workers' compensation laws may impose obligations on the employer.

• Who pays for a fitness-for-duty certification?

  Under the FMLA, the employee pays for the certification from the employee's own provider and is not entitled to be paid for the time or travel spent getting it. In the ADA reasonable-accommodation context, EEOC guidance says that if the employee's documentation from the treating provider is insufficient and the employer requires a visit to a health care professional of the employer's choice, the employer pays all costs of the visit.