Your doctor’s note is from whom? Documentation rules for pregnant employees
An employee asks for time off for prenatal appointments. The employer responds by asking the employee to get a note from her doctor regarding the time off. The employee provides a note from her doula.
Must the employer accept the note?
Yes, and here’s why.
PWFA documentation
Under the federal Pregnant Workers Fairness Act (PWFA), employers may ask for documentation supporting an employee’s request for a workplace change because of a limitation related to, affected by, or arising out of pregnancy, childbirth, or related medical conditions in many, but not all, situations.
When it’s reasonable under the circumstances for employers to seek supporting documentation, they may require that it come from a health care provider. Health care providers, however, can include, but aren’t limited to:
- Doctors,
- Midwives,
- Nurses,
- Nurse practitioners,
- Physical therapists,
- Lactation consultants,
- Doulas,
- Occupational therapists,
- Vocational rehabilitation specialists,
- Therapists,
- Industrial hygienists,
- Licensed mental health professionals,
- Psychologists, or
- Psychiatrists.
The health care provider may also be a telehealth provider whom the employees see for virtual visits.
Employers may not require that the health care provider be the one treating the condition at issue. It could come from a different provider. Nor may employers require that the employee be examined by an employer-selected health care provider.
The PWFA documentation provisions are a bit different from those under the ADA. Like the ADA, employers may not ask for documentation:
- When the limitation and change needed are obvious, and the employee indicates the need (self-confirmation); or
- When the employer already has enough information to determine whether the employee has a limitation and needs a workplace change.
Under the PWFA, in addition to the above, employers may not ask for documentation:
- When the employee is pregnant and asks to be allowed to keep water near, have more restroom breaks, be allowed to sit or stand, or take breaks to eat and drink.
- When the reasonable accommodation is related to a time and/or place to pump at work, and the employee simply says it's needed, or
- When employees without limitations don’t have to provide documentation for such accommodations.
Key to remember: Employers must accept documentation from a variety of health care providers under the PWFA, and may not always request it.
















































