When you’re a kid, a doctor’s note is the ultimate get-out-jail-free card. It means you can escape school early, show up late or avoid gym class entirely. But as an adult, there’s barely enough time outside of work to see a doctor when you’re sick, let alone beg them for a piece of paper that says you’re too stressed or tired to work. Two years ago, though, that’s exactly what Brooke did. Exhausted, overworked and out of options, the 36-year-old marketing strategist in Edmonton convinced her doctor to write her note for burnout.
That said, it didn’t happen in one quick visit. First, Brooke saw her doctor for work-related stress and was referred to a psychologist. After a few months of therapy, the psychologist contacted her doctor and strongly recommended that she take time off work. So her doctor wrote her a note — at first for four weeks, which was later extended to 12. During this time, she received half of her salary through Canada’s employee insurance program (as well as the assurance that her job would be there for her when she returned).
“I’m a pretty driven individual and was very hesitant, but it came to a point where I just couldn’t function at work any longer,” Brooke tells me. And though she was also dealing with debilitating anxiety and struggling to get pregnant, Brooke’s doctor kept it simple: “The note didn’t include many details other than it was recommended that I take a leave.”
In countries like Canada, Germany and Sweden, getting a doctor’s note for a reprieve from your burnout isn’t a new concept. This probably seems like a fever dream for American workers, more than half of whom claim to be burned out. Or to be exact about it — 52 percent, up from 43 percent before the pandemic, according to a recent survey. But ever since 2019, when the World Health Organization cited burnout as an “occupational phenomenon” under the International Classification of Diseases, burned-out American workers have started to take advantage of a small, but important loophole.
The process of taking medical leave for stress is complicated, yet not impossible. It does, however, require getting a burnout note from a medical professional. So here’s what you need to know…
Okay, What Is Stress Leave?
Stress leave is a form of medical leave that can be covered under the Family and Medical Leave Act, or FMLA. Although it sounds suspiciously close to the acronym FML, FMLA is a labor law that requires companies to provide job protection and unpaid leave to workers who are dealing with family or medical issues for up to 12 weeks, with full benefits. Essentially, it’s almost like furloughing yourself.
It’s important to point out that “burnout isn’t automatically assumed to be a serious health condition under the FMLA unless there’s sufficient medical evidence of an underlying or resulting qualifying health condition,” Bradley Katz, a professor and physician at the University of Utah Medical Center, explains.
In other words, you have to have a medical doctor document in writing that burnout has led to a diagnosable condition covered under FMLA in order to take the unpaid leave. Some burnout-related diagnoses that qualify include chronic back pain, irritable bowel syndrome, severe depression and substance abuse disorders. If you’re not able to prove that burnout has caused these issues, “employers can refuse burnout notes unless the employee is using the FMLA for their time off,” says Katz.
How Do I Take Stress Leave?
Before you make an appointment to beg your doctor for a burnout note, there is some more fine print to consider. In order to qualify for FMLA, “a company must have over 50 employees, and an employee has to have at least 1,250 hours under their belt at that company,” Tina Hawk, a senior vice president of human resources, clarifies. She adds that you can also request unpaid “personal leave,” but this may not guarantee your position will be waiting for you when you return.
And while state laws around doctors’ notes can vary, having medical documentation as cause for leave is the most protected route. So again, as long as you have more than 50 coworkers and have worked enough hours, “it’s illegal for a company to refuse an employee time off under medical recommendation and FMLA,” says Hawk.
If You Don’t Qualify, There Are Other Options
In this case, Katz says your best bet is consulting your employee handbook. “Companies may define their own sick-leave policy, and some allow employees to provide doctors’ notes for burnout from a medical or mental-health professional.” Burnout notes from therapists don’t fall under the FMLA purview and typically result in shorter hiatuses, but you also don’t need to receive or disclose a medical diagnosis to get one. Likewise, an increasing number of companies and managers are moving to accept them as a part of a cultural shift to curb burnout. “As mental-health awareness grows in the U.S., we may see more companies adopting a policy where they allow stress leave,” Katz says.
Therapists like Melissa Russiano have witnessed this evolution firsthand. Prior to COVID, she wrote a note or two for stress or burnout every month. But at the start of the pandemic, “it was weekly, sometimes daily, for the frontline workers who were still required to show up every day to do their job.” And during this past year, she tells me, “I could write the notes hourly.”
Russiano views this uptick as a good thing because even though employers aren’t required to listen to her recommendations under any federal labor law, many of them are starting to anyway. Still, without the legal protections of actual medical leave, Russiano says that the fear many employees have of losing their jobs if they report feeling stressed may prevent them from requesting such documentation from a therapist.
It’s a Lot of Work to Take Stress Leave, But It Can Definitely Payoff
Even in Canada, where stress leave is more normalized, Brooke admits it was still a difficult process, and at times, she wondered if it was worth the additional stress. Despite her doctor’s note and close relationship with her manager, they initially brushed it off and offered to reduce her hours instead. “I had to arrange an additional meeting to state more directly that I indeed would be taking the leave my doctor recommended,” she says.
When she did officially go on leave, her stress levels receded, her health rebounded, and “after having tried, unsuccessfully, to get pregnant for a significant amount of time, I was able to conceive within a month.” She, then, can only come to one conclusion: “I wholeheartedly believe my body was just under too much stress and that being able to finally prioritize my health was absolutely essential.”
Lauren Vinopal
Lauren Vinopal is a writer and stand-up comedian based out of New York City, who writes mostly about health, science and men. She is the host of the Mid Riff Comedy Show in Brooklyn, a frequent podcast guest all over, and lives the life of a teen who looks like they haven’t slept in years.
