You've been out for a week with the flu. You feel human again. HR's policy is clear: anyone out four or more consecutive days needs a return-to-work clearance from a doctor before they can be back at their desk on Monday. Or you're on intermittent FMLA leave for a chronic condition and you need a recertification submitted before the deadline. Or you're coming back from a surgery and your employer needs the lifting restrictions documented in writing.

Different needs, same wall: your primary care office is scheduling three weeks out, and the urgent care doesn't really do these — they do acute illness, not paperwork. Here's how to get the documentation HR is actually asking for in 1 hour, without the wait.

What a Return-to-Work Note Actually Contains

A return-to-work clearance note is a short, specific document. HR's policy will name the elements they need; they're typically:

• Patient name and date of birth

• Date the patient was seen by the doctor

• Clearance date — the specific date the patient is cleared to resume work

• Restrictions, if any — "no lifting over 10 pounds for two weeks," "no extended standing," "modified hours through [date]," or "full duty without restrictions"

• Doctor's full name, credentials, state license number, and signature

• Clinic contact for verification

The key phrase HR is looking for is "cleared to return to full duty as of [date]" or, if there are restrictions, a specific list of what the patient can and cannot do for how long. That's the document that lets HR mark the leave closed and the employee back on the schedule.

What FMLA Documentation Looks Like

FMLA — the Family and Medical Leave Act — is administered by the US Department of Labor, which gives eligible employees up to 12 weeks of unpaid, job-protected leave per year for qualifying medical and family situations. The DOL publishes the standard certification forms employers use, including WH-380-E (Certification of Health Care Provider for Employee's Serious Health Condition).

The form has several specific sections a healthcare provider completes:

• The medical condition and whether it meets the FMLA definition of a "serious health condition"

• Whether the condition is continuous or intermittent

• Expected duration and frequency of incapacity

• Whether the employee needs to be absent from work and for how long

• Whether the condition is chronic and what the recertification cadence should be

• Provider signature, credentials, and date

Intermittent FMLA — the more complex case — typically requires periodic recertification, often every six months or as the employer's policy specifies. Continuous FMLA usually has a single certification covering the leave period. Both forms have to be completed by a healthcare provider, and "completed" means actually answering the medical questions, not just signing the bottom.

The 3-Step CodyMD Process for Return-to-Work and FMLA

1. Chat with Cody, our AI doctor, 24/7/365. Cody opens with "Hey — I'm Cody. What's going on?" From there it's a conversation. Your name, date of birth, state, the illness or condition involved, the dates you were out, your current symptom status, what kind of work you do, and the specifics of what the documentation needs to say. For FMLA cases, Cody will ask about the condition's history, prior diagnoses, frequency and duration of episodes, and whether you have an existing care provider — this matters because some FMLA cases need an ongoing provider rather than a one-off visit. Cody summarizes the case for the reviewing doctor.

2. A US-licensed doctor reviews and writes within 1 hour. A named, board-certified physician reads your case and writes back in the same chat thread. If your case is a clean fit, the doctor produces the documentation — a return-to-work note with the clearance date and any restrictions, or completed FMLA form sections — and delivers it to your inbox as a PDF. If the case needs an ongoing care relationship the doctor will tell you so and route you to the right path.

3. Forward to HR. Most HR departments accept the PDF over email. Some have a specific upload portal. Either works.

The visit is $49 flat. No insurance required. HSA and FSA eligible under IRS Publication 969.

Plus 14 Days of Unlimited Follow-Up

Your $49 includes 14 days of unlimited messaging with Cody and the care team. If HR comes back with questions, if a date needs adjustment, if the restrictions need to be modified after the first week back — you reply in the same chat thread. The doctor can issue an updated note if the situation genuinely warrants it. That two-week window is exactly the right length for the back-and-forth that often happens between employees and HR during a return-to-work process.

For acute sick notes during the actual illness, see our doctor's note for work post. For the broader cost comparison against in-person options, see our doctor's note cost guide.

ADA Accommodation Letters: An Honest Note

Some employees need formal ADA accommodation letters — documentation supporting a reasonable accommodation request under the Americans with Disabilities Act, as enforced by the EEOC. These are different from return-to-work and FMLA documentation in an important way: they often require an ongoing care relationship, a longitudinal view of how the condition affects work, and sometimes specialty-specific assessments.

CodyMD doctors can write accommodation letters in specific narrow cases — typically when the underlying condition is acute, well-defined, and the accommodation is short-term. For ongoing accommodations tied to chronic conditions, the doctor will likely tell you that the right path is a provider who knows your case over time. That's an honest answer, and the part of the service that protects you from submitting documentation that won't hold up to an employer's interactive-process review.

If you have an existing provider who's already managing your condition, the cleanest path is usually to have them complete the accommodation letter and use CodyMD for the acute episodes and routine documentation around it.

What CodyMD Doctors Will Not Do

The honesty layer is the same here as for any other CodyMD note. Our doctors will not:

• Write a return-to-work clearance with a date that doesn't match when you were actually cleared

• Write FMLA certifications for conditions the visit doesn't actually establish

• Sign accommodation letters for situations where the case requires a longer relationship and a specialty assessment

• Document "leave that didn't happen" or restrictions that aren't clinically supported

Every CodyMD note is signed by a US-licensed, board-certified physician with their state license number on the document — verifiable, defensible, and built to survive an HR review. More on who actually signs these notes in our licensed doctor's note post.

When CodyMD Is the Right Fit — and When It Isn't

Good fit:

• Return-to-work clearance after a typical acute illness (flu, GI bug, sinus infection, COVID)

• Return-to-work with simple short-term restrictions (no lifting for 10 days after a minor procedure)

• Initial FMLA certification for a clearly-defined acute condition

• Recertification when your case has been stable and you have an existing record of the condition

Not the right fit:

• Complex FMLA cases involving multiple specialists

• ADA accommodation letters for long-term chronic conditions requiring ongoing care

• Post-surgical clearance from a major procedure (the surgeon clears those)

• Cases involving workers' compensation, which has its own documentation requirements

If your case isn't right for an online visit, the CodyMD doctor will tell you so and route you to the right path.

Back at Work Monday

You finished the chat Sunday at 6 PM. By 7 PM the return-to-work clearance is in your inbox. You forward it to HR with a short note. Monday morning you're at your desk, the leave is closed, the schedule is back to normal. Compliant, documented, no drama. That's what $49 and 1 hour buys when the alternative is a three-week wait for your primary care.