Using NYC protected time off for ADHD appointments

An adult ADHD evaluation usually means at least one long appointment, and treatment means regular follow-ups, often during working hours. For many New Yorkers, the question is not whether they want care but whether they can take the time. New York City and New York State both have laws that give most private-sector employees protected time for exactly this. This article explains how they work as of October 2026.

The law has a new name

You may know it as the Earned Safe and Sick Time Act, or ESSTA. The city's Department of Consumer and Worker Protection (DCWP), which enforces it, now calls it the Protected Time Off Law, and it calls the leave "protected time off." The underlying statute is still the Earned Safe and Sick Time Act in Title 20, chapter 8, of the city's Administrative Code. The biggest recent change: as of February 22, 2026, covered employees also get 32 hours of unpaid protected time off that is available immediately.

ADHD care is a covered reason

DCWP says employees can take protected time off when they have a mental or physical illness, injury or health condition, or when they "need to get a medical diagnosis, care, or treatment of a mental or physical illness, injury, or health condition." It also covers appointments for preventive care, and caring for a family member who needs the same. In practice that includes:

• an adult ADHD evaluation, including a visit taken by video;
• medication follow-up visits, which New York's controlled-substance rules make regular for stimulants (see how often ADHD follow-up visits happen);
• therapy or other treatment visits with another clinician; and
• days when you are unwell, including from a medication side effect.

Who is covered

Most employees who work in New York City are covered: full-time, part-time, temporary, seasonal, per diem and domestic workers, undocumented workers, and people who live outside the city but work in it. Employees who telecommute while physically located in the city are covered even if the employer is elsewhere. The law does not cover government employees (federal, New York State or New York City), independent contractors who do not meet the state definition of an employee, certain unionized employees under qualifying collective bargaining agreements, and a few other narrow groups.

How much time you get

Employer size counts all employees nationwide. Paid time accrues at 1 hour for every 30 hours worked, you can carry over up to 40 or 56 unused hours, and probation or waiting periods that stop you using accrued time are not allowed. Every employer must also provide 20 hours of paid prenatal leave on top of this, which matters if you are managing ADHD during pregnancy (see ADHD in pregnancy and postpartum).

The rules that matter for appointments

Notice. An employer may require reasonable notice of a foreseeable need, but its written policy cannot require more than seven days' notice. DCWP gives a doctor's visit scheduled 30 days ahead as an example of a foreseeable need. When the need is not foreseeable, the employer can only ask for notice as soon as practicable.

Minimum blocks. An employer may set a minimum increment, but it cannot exceed 4 hours a day, must be reasonable under the circumstances and must be in the written policy. DCWP's own example: an employer can require a worker with a 9:00 a.m. doctor's appointment to use 4 hours. Plan a morning visit with that in mind.

Who decides how much to use. DCWP says it should generally be the employee, and an employer cannot deduct from your bank when you do not want to use protected time off for an absence.

Documentation and privacy

These rules are especially important for anyone who would rather keep an ADHD diagnosis private.

• An employer can require documentation only if you use more than three consecutive workdays, and only if that requirement was in the written policy you received beforehand.
• An employer cannot require you, or the person writing your note, to disclose the reason. A note signed by a licensed health care provider that shows the need for the time taken must be accepted.
• If the clinician charges for the note, the employer must reimburse you, and it must give you at least seven days after you return to submit it.
• An employer cannot demand a second opinion on the note.
• Information the employer learns because of the law must be kept confidential unless you agree in writing or another law requires disclosure.

For shorter absences, an employer may ask you to confirm in writing that you used the time for a permitted purpose. For more on what to share at work, see telling your employer about ADHD.

Outside the five boroughs: New York State Paid Sick Leave

If you work elsewhere in New York State, Labor Law 196-b applies to private employers. Its paid-hour tiers match the city's: up to 40 unpaid hours for employers with four or fewer employees and net income of $1 million or less, 40 paid hours for those with more income or with 5 to 99 employees, and 56 paid hours at 100 or more. Leave accrues at no less than 1 hour per 30 worked and may be used for the diagnosis, care or treatment of a mental or physical illness or for preventive care. The statute says an employer "may not require the disclosure of confidential information relating to a mental or physical illness", caps minimum increments at four hours and bars retaliation. What the state law lacks, according to DCWP, is the city's extra 32 immediately available unpaid hours and some of its additional uses.

When you need more than protected time off

Protected time off is a minimum. DCWP notes that the federal Family and Medical Leave Act may require intermittent time off in increments shorter than four hours, and that the Americans with Disabilities Act or the New York State Human Rights Law may require a longer leave for an employee with a disability. FMLA applies only to eligible workers at covered employers; see leave and disability benefits for ADHD in New York. A regular schedule adjustment, such as starting late on follow-up days, is usually better requested as a reasonable accommodation; see ADHD workplace accommodations in New York.

The city law also gives employees a protected right to request a temporary schedule change, such as changing shift times, working remotely or swapping shifts. The employer may say no, but cannot retaliate for the request.

If your employer does not comply

Retaliation for requesting or using protected time off, filing a complaint or telling a coworker about the law is illegal. You can file a complaint with DCWP online or by calling 311 and saying "Protected Time Off," or go to court. The deadline is two years from when you knew or should have known about the violation. If disability discrimination is part of the problem, filing a disability discrimination complaint explains the separate process.

Fitting care into a work schedule

Follow-up visits with Dr. Shershow are held by secure video, and for a video visit you must be physically located in New York or New Jersey at the time. Many people take them from a private room at work or from home. If you commute from New Jersey, adult ADHD care for NJ commuters working in NYC explains which state's rules apply where you sit. For Midtown office workers, see adult ADHD care for Midtown Manhattan.