Getting a Legitimate Doctor's Note Online in New York: What the Sick-Leave Law Actually Says

Adam Z. Kawalek, MD

Published June 12, 2026 · 7 min read

If you've ever called in sick in New York and immediately worried about whether you'd need a note, here's some good news: New York's sick-leave law is genuinely on your side, and it's stricter with employers than most people realize. As a physician, I spend a fair amount of time untangling what patients <em>think</em> their employer can demand from what the law actually permits. So let me walk you through how sick time works in New York, when a note is even allowed, what your employer is forbidden from asking, and where a legitimate online visit fits in.

Yes, New York mandates sick leave for nearly every worker

New York State requires almost all employers to provide sick leave under Labor Law Section 196-B, which took effect in late 2020. Whether it's paid or unpaid depends on the size of your employer and, for the smallest businesses, their net income.

Here's the breakdown: employers with 100 or more employees must provide up to 56 hours of paid sick leave per year. Employers with 5 to 99 employees must provide up to 40 hours of paid sick leave. Employers with 4 or fewer employees provide up to 40 hours of paid leave if their net income is over $1 million, and up to 40 hours of unpaid leave if it's $1 million or less. Leave accrues at a rate of at least one hour for every 30 hours worked, though your employer can choose to give you the full amount up front.

Note that New York City has its own overlapping law (the Earned Safe and Sick Time Act), and the details can differ slightly. If you work in the five boroughs, the city's rules may also apply on top of the state floor.

When can your employer actually require a doctor's note?

This is the part most people get wrong. Under New York law, your employer cannot require any medical documentation for an absence of fewer than three consecutive previously-scheduled workdays. So for the typical one- or two-day flu, a stomach bug, or a bad migraine, an employer asking you to produce a note is on shaky legal ground.

Only when you use sick leave for three or more consecutive scheduled workdays may an employer request documentation. Even then, the request has to be reasonable, and there are firm limits on what that documentation can say. The intent of the law is clear: routine short illnesses shouldn't require you to drag yourself to a doctor's office just to satisfy paperwork.

What your employer is forbidden from asking

This is where New York is unusually protective, and it's worth knowing your rights. Even when documentation is permitted, the New York Department of Labor is explicit that an employer cannot require you to disclose the nature of your illness — not the diagnosis, not the prognosis, not the treatment. A valid note simply attests that a licensed provider supports the existence of a need for sick leave, the amount of leave needed, and a date you can return to work.

Just as important: your employer cannot make you pay the costs of obtaining that verification. The DOL states plainly that no employer shall require an employee to pay any costs or fees associated with getting medical verification of sick-leave eligibility. And the law prohibits retaliation — your employer can't punish you for using sick time you're entitled to, and you must be returned to your same position afterward.

In short: a legitimate New York sick note is a brief, confidential attestation. Any employer demanding your full diagnosis is overreaching, and you don't have to provide it.

How New York treats telehealth and online notes

A note from a telehealth visit is a real medical note — it isn't a lesser document because the visit happened over video or a secure form. New York permits the physician-patient relationship to be established via telehealth, and the standard of care is the same as for an in-person visit: the clinician must gather enough information to make a sound clinical judgment and must document the encounter in the medical record.

What makes a note legitimate has nothing to do with whether it was issued online and everything to do with whether a licensed provider actually evaluated you and exercised real clinical judgment. A note generated by a real physician after a genuine assessment is valid. A 'note' bought from a site with no licensed clinician behind it is not — and that's the distinction that matters, in New York and everywhere else.

Where an online visit makes sense

For a straightforward, self-limited illness where you mainly need rest and proper documentation, a telehealth visit is often the most sensible option — you're contagious or exhausted, and sitting in a waiting room helps no one. That's the gap a service like SickSlip is built for. It's a flat $29.99, a roughly 2-minute intake form, and a board-certified physician reviews your request and can issue a same-day note. SickSlip's physician is licensed in New York, so a New York patient is being evaluated by a New York-licensed clinician.

I'll be candid about the limits, because that's the only honest way to talk about this. A note is appropriate when you have a real, minor illness and need documentation — not as a way to manufacture an excuse. And telehealth isn't right for everything: severe symptoms, anything that needs a physical exam or testing, or a possible emergency belong in urgent care or an ER. If your situation is genuinely a brief illness and you need a clean, compliant note, an online visit is a reasonable and legitimate path.

Frequently asked questions

Adam Z. Kawalek, MD

Board-Certified Physician · Founder, SickSlip · Cedars-Sinai · Johns Hopkins

Dr. Kawalek is a hospitalist physician with 15+ years of clinical experience. He founded SickSlip to give patients fast, affordable access to legitimate medical documentation without unnecessary clinical barriers.