Some departments have a written or unwritten policy that any absence in excess of three working days must be accompanied by a physician’s statement.

The MOUs and the Ordinance Code provide management the right to require a physician’s statement or make whatever other investigation into the circumstances of a request for sick leave that appears warranted before taking action on the request. Under this provision, a supervisor may require an employee to submit a physician’s note upon return to work if the supervisor feels there are circumstances that warrant such a statement. In order to require the employee to provide a physician’s statement in this manner, the supervisor must advise the employee of the requirement to submit a statement prior to the employee’s return to work. In other words, if an employee is out sick on Monday and Tuesday, you cannot tell him/her on Wednesday when he/she returns that a statement is required. The employee should be advised of the need to provide a statement when he/she calls in sick.

Medical providers, and Kaiser in particular, routinely do not see patients in person for minor or common illnesses, such as fevers and colds. Instead, phone consultations are frequently used for cost containment purposes.

Under most circumstances, statements from Kaiser and other providers that simply state that the employee “states he/she is ill and unable to work” are acceptable and should not be questioned by the supervisor or manager. Since the County’s HMO rates are driven by utilization, forcing employees to provide a doctor’s note indirectly contributes to higher health insurance premiums for all employees.

However, a medical note issues from a phone assessment without an actual office visit is not adequate when:

• An employee requested a particular day off, was denied, and then called in sick.

If this happens, the supervisor should call the employee while he/she is still out and advise him/her to bring a physician’s note that states he/she was physically seen by the physician and was assessed unable to work any portion of the day. This note should be provided to the supervisor/manager upon the employee’s return to work.

• An employee has been issued a leave restriction letter with a condition that all sick leave absences require a physician’s statement. These letters are issued if verbal counseling is not effective in correcting excessive absenteeism. Normally such letters, and the restrictions in them, are rescinded after one year if the employee improves his/her attendance to an acceptable level.
• An employee is requesting a Medical Leave of Absence. Medical statements to support such requests must demonstrate that the treating health care professional has examined the individual (or their family member for FMLA leaves) and has determined that a leave of absence is required.
• Any time an employee uses sick leave in conjunction with a Workers’ Compensation claim.