After an asthma attack: follow-up care and getting back to work, from the UK fit note to US FMLA and ADA

After an asthma attack you ask two things: when to have follow-up care, and how work will pick up again. What you wrote down around the attack, on paper or in the asthma diary in Sam, gives your doctor a documented period to work from, and you can take it out as a doctor report (PDF). Sleep and respiratory rate from Apple Health sit in the same app, next to what you entered. The NHS advises seeing a GP within two days of an attack, even if you feel better.

This text is general information, not legal advice. Employment law and sick leave differ by country, employer and contract. In the UK, Citizens Advice and ACAS answer questions about sick pay and returning to work; in the US, the Department of Labor's Wage and Hour Division, the EEOC and the Job Accommodation Network (JAN) give guidance. Your own case may differ.

Follow-up care after an asthma attack

An attack is not over when the worst breathlessness passes. The NHS says to see a GP within two days of an attack, even if you feel better, to discuss your treatment and get advice on preventing another. At that visit your care team reviews your written asthma action plan and can adapt it if your symptoms have changed.

For that to be useful, you need to describe the days after the attack clearly. A short record of what happened covers it: when the attack started, how bad it felt, which nights you woke, how often you used your reliever, and what help you needed. If work had to wait, that belongs in the record too.

Who decides when you go back to work

In the UK, the decision about whether you can work is supported by a fit note, the Statement of Fitness for Work that replaced the old sick note. It records a healthcare professional's opinion on whether you are not fit for work, or might be fit for work with support. It is not a verdict you alone or your employer alone makes.

In the US, there is no national sick note. Your doctor's advice supports your absence, and two laws may protect your time off and return: the Family and Medical Leave Act (FMLA) for leave, and the Americans with Disabilities Act (ADA) for reasonable adjustments. Your own record informs these, but it does not grant them. For the basics of what to note from the start, see asthma diagnosis: what now.

UK: fit notes, self-certification and Statutory Sick Pay

In the UK you can self-certify sickness for the first 7 calendar days, including weekends, and you do not need a fit note for that time. After 7 days you should get a fit note from a registered healthcare professional: a doctor, nurse, pharmacist, physiotherapist or occupational therapist. Give it to your employer from the 7th day or as soon as possible after that.

A fit note can say you are not fit for work, or that you might be fit for work. The second option lets a healthcare professional point to support that could help you back, and GOV.UK lists four options on the note: a phased return, altered hours, amended duties and workplace adaptations. These options are not binding, and you can raise other changes with your employer. Statutory Sick Pay (SSP) is paid by your employer for up to 28 weeks if you qualify, and your contract may pay more. Acas says that from 6 April 2026 it is payable from the first day of sickness, at the lower of the weekly rate or 80 percent of your average weekly earnings, and the lower earnings threshold is removed. ACAS and Citizens Advice can check the current rules and amounts for you. The sources used here cover Great Britain; if you live in Northern Ireland, check nidirect.gov.uk.

US: FMLA leave and ADA accommodation

The FMLA gives eligible employees up to 12 weeks of unpaid, job-protected leave in a 12 month period for a serious health condition. The Department of Labor lists asthma as an example of a chronic condition that can qualify. To be eligible you must have worked for a covered employer for at least 12 months and at least 1,250 hours in the 12 months before leave starts, at a location where the employer has at least 50 employees within 75 miles. Your employer may ask for medical certification from your care provider. Many states have their own leave and disability laws that can add protection, so ask your state labor department or the Department of Labor.

The ADA covers employers with 15 or more employees and protects you if asthma substantially limits a major life activity, including breathing. Where it applies, an employer may need to make a reasonable accommodation. The Job Accommodation Network lists ideas for respiratory conditions such as a working ventilation system, an air cleaner, a workstation away from strongly scented products and breaks to take medication, though JAN says a fully fragrance-free workplace may not be reasonable. State laws can give more protection. Whether asthma counts as a disability for you is decided case by case, so ask the EEOC, your state agency or JAN before you rely on it.

What to record for your doctor and your employer

A consistent record makes both conversations easier. Keep it factual and short:

• The attack: date, how bad it felt, whether the reliever helped.
• Nights: which ones asthma woke you.
• Reliever: each use with the date, puffs and what came before.
• Work: the days you could not work.
• Unplanned care: same-day GP visit, urgent care or hospital.

You record; your care team and employer make the decisions from it. For other symptoms and work days alongside, keep them in the symptom diary. There is no fixed sickness length that follows automatically from an asthma attack, and nobody should ask you to invent one. Never bend the facts to an employer, insurer or authority. Your record is for an honest conversation, not a negotiation tool.

Practical steps for a smooth return

A calm return needs planning, not a surprise on the first morning back. Tell your employer you are off early, and keep in touch while you are away so nobody has to guess. Ask for a return to work conversation, so you can agree a phased return or a lighter first week. In the UK, mention what the fit note says and what your occupational health team can arrange. In the US, raise FMLA and any accommodation with HR before you need them.

Bring your written asthma action plan to work or know where it is. Keep a reliever with you, and tell a close colleague what to do if you need help. A short note in Sam can sit beside your entries to help you track how returning to work affects your symptoms. For more on keeping records tidy across appointments, see our doctor appointment checklist for a chronic condition.

When not to wait: emergency with asthma

Severe breathing trouble is not a topic for a blog post, and a diary does not replace an emergency call. The NHS says to call the emergency number if you have an asthma attack and you feel worse at any time, do not feel better after the maximum dose of your reliever, or do not have your inhaler. Use your local emergency number (999 in the UK, 911 in the US), and do not drive yourself to hospital. What counts as getting worse for you belongs in your written action plan.

Record the attack and your days off in Sam and take them to follow-up

Walk into follow-up with the attack and the days after in one place, not from memory. In the asthma program the attack becomes its own entry, with nights woken and reliever uses beside it.

• Instead of paper or a notes app: each entry has a date, so the sequence of the attack and recovery is easy to follow.
• Instead of memory: days with reliever and nights woken are counted for you already.
• Instead of Apple Health alone: your night-time respiratory rate sits next to your entries in the same app.
• The doctor report (PDF) covers the period you choose, so you can show it when you plan your return.

Sam does not detect an attack and cannot certify you fit for work. Your care team and employer make those calls from your record and your doctor's opinion.

Try Sam for free

Sam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.

Related reading

• Asthma not well controlled? What that means
• Asthma symptoms: when to seek help
• Respiratory rate, sleep and asthma
• Asthma triggers: exercise, sleep and stress

Sources

Updated: October 2026

• NHS: Asthma - asthma attack and seeing a GP after, Treatment and living with asthma (page last reviewed 7 April 2025)
• GOV.UK: Fit note: guidance for patients and employees (last updated 6 October 2023)
• ACAS: Fit notes and proof of sickness (last updated 6 January 2025)
• Acas: Statutory sick pay changes 2026
• GOV.UK: Statutory Sick Pay (SSP)
• GOV.UK: Statutory Sick Pay (SSP): employer guide - notice and fit notes (last updated 25 November 2014)
• U.S. Department of Labor: Fact Sheet #28F: Reasons that workers may take leave under the FMLA and FMLA overview
• U.S. Department of Labor: FMLA elaws glossary - chronic conditions (asthma)
• EEOC: Enforcement guidance on reasonable accommodation and undue hardship under the ADA
• Job Accommodation Network: Scents and sensitivity in the workplace