Sick Leave & Doctor's-Note Rules in Chicago

Chicago overhauled its sick-time rules with the Paid Leave and Paid Sick Leave Ordinance, which took effect July 1, 2024 and replaced the city’s older 2017 sick-leave law. It’s unusual because it gives workers two separate banks of time, and the doctor’s-note rules differ between them. This guide explains the 2026 rules, when a note can actually be required, and how a note from a licensed physician fits in. It’s general information, not legal advice.

What the ordinance gives you

Anyone who works at least 80 hours within any 120-day period inside Chicago city limits is covered, regardless of full-time or part-time status. For every 35 hours you work, you accrue:

• One hour of Paid Leave, usable for any reason, no explanation required; and
• One hour of Paid Sick Leave, for medical and safety reasons.

You can accrue up to 40 hours of each per year, as much as 80 hours total, and employers may set higher limits. The two banks are governed differently, which is the key to understanding the note rules.

When can a Chicago employer require a doctor’s note?

It depends on which bank you’re using.

Paid Leave (any reason): Your employer may not require a reason for using Paid Leave and may not require documentation to support it. Employers can set reasonable advance-notice rules for foreseeable use, but no doctor’s note enters the picture.

Paid Sick Leave: Here documentation can be required, but only past a threshold. Under the city’s official guidance, an employer may require certification after you use Paid Sick Leave for three or more consecutive workdays. If you did not use Paid Sick Leave for three or more consecutive workdays, the employer cannot require documentation from a medical or service provider. For those shorter absences, the most an employer can ask is that you confirm in writing that the leave was for a permitted purpose.

Even when certification is allowed, what’s required is confirmation from a provider that your sick leave was warranted, not a disclosure of your specific diagnosis. The ordinance’s framework is about verifying a covered use, not exposing your medical condition.

Who enforces it, and suburban Cook County

The ordinance is enforced by the City of Chicago Department of Business Affairs and Consumer Protection (BACP), through its Office of Labor Standards. BACP takes complaints (including via the city’s 311 system), can impose penalties, and prohibits retaliation for asserting your rights.

If you work in suburban Cook County rather than the City of Chicago, a different law applies: the Cook County Paid Leave Ordinance, effective December 31, 2023 and enforced by the Cook County Commission on Human Rights. It uses a single bank of paid leave, one hour per 40 hours worked, usable for any reason, rather than Chicago’s two banks. The catch is that individual municipalities can opt out, and opt-out status varies and changes over time, so it’s worth confirming with your specific town. Workers in a municipality that has opted out are generally covered instead by the Illinois Paid Leave for All Workers Act. For the wider state context, see our overview of Illinois doctor’s-note laws.

How an online doctor’s note fits in

Two things follow from Chicago’s structure. First, if you’re drawing on Paid Leave, no note is involved at all. Second, for Paid Sick Leave, a note only comes into play once an absence reaches three or more consecutive workdays, and even then, what your employer is entitled to is confirmation that the time was a covered use, not your diagnosis.

A note from a physician licensed in Illinois can meet that need whether the evaluation happened in person or through a legitimate telehealth review. What makes a note valid is that a real, licensed clinician genuinely assessed your situation, not the format it arrived in. A document stating you were seen and that time off was appropriate gives your employer everything the ordinance allows it to ask for.

A few practical pointers for Chicago workers:

• Know which bank you’re using. Paid Leave needs no reason or documentation.
• For Paid Sick Leave under three consecutive workdays, your employer can ask only for written confirmation of a covered purpose, not a provider’s note.
• Keep any note minimal; you’re not obligated to disclose what was wrong with you.

Common misunderstandings

The biggest source of confusion in Chicago is the two-bank structure. Many people assume any sick day can prompt a note, but for the Paid Leave bank, no reason or documentation can be required at all, and for Paid Sick Leave, a provider’s note only enters the picture once an absence reaches three or more consecutive workdays. Below that, the most an employer can ask is written confirmation that the time was for a permitted purpose. Another mistake is assuming a note must disclose your condition; the ordinance’s framework is about verifying a covered use, not exposing a diagnosis.

It’s also worth separating these banks from other leave programs. Paid Leave and Paid Sick Leave are distinct from federal family or medical leave and from workers’ compensation, each of which carries its own paperwork and eligibility rules. CuroNote’s guides, and any note a licensed physician might issue, concern routine sick-time documentation for work or school, not those programs. If your situation involves a serious or extended condition, that’s a conversation for your own clinician and, where appropriate, an employment attorney.

What to do if you’re asked for a note

If you’re using Paid Leave, you can simply point to the rule that no reason or documentation is required. If you’re using Paid Sick Leave for three or more consecutive workdays and your employer requests certification, provide a note that confirms only what’s needed, that you were seen and that time off was appropriate, without volunteering your diagnosis. For shorter Paid Sick Leave absences, written confirmation of a covered purpose is all that can be required. If you believe your employer is overreaching, the BACP Office of Labor Standards takes complaints and prohibits retaliation. Keeping a copy of anything you submit, with the dates, is sensible record-keeping.

CuroNote is preparing to launch online doctor’s-note services and is not yet issuing notes. This page exists to help you understand your rights under Chicago and Cook County law in the meantime. For related reading, see do you actually need a doctor’s note?, can employers verify a note?, and are online doctor’s notes legal?.