Sick in South Carolina? Do You Need a Doctor's Note? Here's the Law

Overview of South Carolina’s Health Benefits for Employees

South Carolina currently has no state law that mandates private employers to provide health benefits, including sick leave, to their employees. This means that employers are not legally required to offer paid or unpaid sick leave. Additionally, they have the right to ask employees to provide a doctor's note if they take time off due to illness.

South Carolina is one of 20 states in the U.S. that do not have specific legislation requiring private companies to provide sick leave to their workers. However, some states have taken steps to address this issue. For example, Alaska and Nebraska recently passed bills requiring sick leave. In addition, two other states have updated their laws to expand eligibility for sick leave.

Changes in State Laws

Connecticut is set to implement new rules in January 2026, requiring companies with 11 or more employees to offer sick leave, down from the previous threshold of 25 employees. The state will further reduce the requirement in January 2027. Meanwhile, Michigan will require all companies to provide sick leave starting in October.

According to JUST Capital, which evaluates and ranks companies based on fair practices, 77% of workers in the private sector had access to paid sick leave as of February 2023. However, part-time workers often do not receive this benefit.

The federal Family and Medical Leave Act (FMLA) provides certain protections for employees who need time off due to serious health conditions, the birth or adoption of a child, or caring for a family member with a serious health condition. Under the FMLA, employees are entitled to up to 12 weeks of unpaid leave, but it does not guarantee paid time off. To qualify, an employee must work for a company with at least 50 employees, have worked for the company for at least 12 months, and have logged at least 1,250 hours in the previous year.

Legislative Efforts in South Carolina

In 2023, South Carolina Representative Chris Wooten, who represents Lexington County, introduced a bill that would allow employees to take three sick days without needing to submit a doctor's note. However, the bill did not advance beyond the House Committee on Ways and Means.

Employer Requirements for Doctor's Notes

Employers in South Carolina can request a doctor's note if they choose to do so. According to the law firm Wusinich, Sweeney & Ryan, companies may refuse to accept a note if it lacks clarity about the expected duration of absence or if they suspect it is fake.

Upcounsel, an online platform offering legal assistance, notes that while state laws may not mandate the use of doctor's notes, employers can still establish requirements for them. A valid note should include the date of examination and the period during which the employee will be absent due to illness, while maintaining patient confidentiality.

Employers may also ask for a doctor's note to verify a disability and the need for workplace accommodations. This may be necessary if the disability is not immediately visible, such as in cases of heart conditions or arthritis. However, employers cannot use the note as a basis for discrimination or termination.

Additional Considerations

If a company is concerned about the spread of contagious diseases, it may request a doctor's note confirming that the employee is no longer contagious before returning to work. However, according to the U.S. Department of Labor, employees are not obligated to share copies of medical records or discuss details about their health conditions. Such information is protected under privacy laws.