Doctor's-Note & Sick-Leave Laws in Texas

Texas has no statewide paid-sick-leave mandate for private employers, so paid or unpaid sick time is set by employer policy or contract. The paid-sick-leave ordinances passed by Austin, Dallas, and San Antonio were all struck down or enjoined by the courts and never took lasting effect, and a 2023 state law (HB 2127) was written to broadly preempt local labor ordinances. A July 2025 ruling from the Third Court of Appeals addressed only whether Houston, San Antonio, and El Paso had legal standing to challenge that law, not whether its preemption of local ordinances holds up on the merits, so the underlying constitutional question remains untested. With no state sick-leave law restricting documentation, an employer is generally free to require a doctor's note under a reasonable policy, and that policy sets what documentation it accepts.

How sick leave works in Texas

Texas does not require private employers to provide paid or unpaid sick leave. Any sick time an employee receives is a voluntary benefit defined by the employer’s policy or employment agreement. The main federal job-protected leave law for eligible employees is the Family and Medical Leave Act (unpaid). Separately, the ADA can require an employer to grant leave as a reasonable accommodation for an employee with a disability, decided case by case rather than as a guaranteed floor like FMLA’s. Several Texas cities tried to create local paid-sick-leave mandates, but those efforts were blocked in court, and a 2023 state law (HB 2127, the Texas Regulatory Consistency Act) was written to broadly preempt local regulation of employment matters. Whether that broader preemption actually holds up is still an open legal question: see below.

When a doctor’s note can be required

No Texas or federal law forbids an employer from asking for a doctor’s note to support an absence. Because Texas has no paid-sick-leave statute setting limits, the employer’s written policy controls when documentation is required. Many policies ask after several consecutive days, though that is the employer’s choice, and a note usually only needs to confirm the dates, not a diagnosis. Federal rules (the ADA and FMLA) govern how and when medical information can be requested for qualifying situations and require employers to keep any medical details confidential.

Local ordinances

There are no active local paid-sick-leave ordinances in Texas. Austin (2018), San Antonio (2018), and Dallas (2019) each passed paid-sick-leave ordinances, but all three were struck down or enjoined by the courts as conflicting with the Texas Minimum Wage Act. Texas appellate courts blocked the Austin and San Antonio measures, the Texas Supreme Court let the Austin ruling stand in 2020, and a federal court permanently enjoined the Dallas ordinance in 2021. None took lasting effect, independent of HB 2127.

The state’s 2023 preemption law (HB 2127) was written to independently foreclose any new local sick-leave mandate, but that broader preemption has not been tested on the merits. Houston, joined by San Antonio and El Paso, sued the state arguing HB 2127 is unconstitutional, and a Travis County district court agreed in 2023. In July 2025, the Third Court of Appeals reversed that decision, but only on standing grounds: it held the cities had not shown a concrete enough injury from the law itself, since no specific local ordinance had yet been challenged under it. The San Antonio city attorney’s office said the ruling leaves the door open to raise the constitutional question again once a specific ordinance is challenged. In short, HB 2127 is currently in effect and unopposed by any live court order, but whether its broad preemption of local sick-leave ordinances would survive a direct constitutional challenge remains legally untested.

The specifics above are summarized at a high level and are not legal advice. See the linked primary sources for exact current requirements, and confirm anything time-sensitive with the state agency or an employment attorney.