A reader writes:

I have a very bizarre situation. I read your article about a forged doctor’s note and this is similar, but different.

An employee came to me with a note stating that she was at the doctor on a particular date and cleared to return to work four days later. She then told me that the appointment was with her doctor and a cancer doctor and that she had stomach cancer and was starting chemo and radiation. I forwarded this information to my administrator, HR director, and the owner of my company. We have concerns about an employee being on chemotherapy due to the dirty nature of our jobs and the risk for potentially contagious illness.

Our adminstrator called her doctor to ask about work restrictions due to chemotherapy. The receptionist there stated that there were no work restrictions and they had no record of cancer, no record of chemotherapy, and had never referred her to a specialist.

The employee is now pissed that we called her doctor and is talking to some employees threatening a lawsuit but is otherwise acting sweet as pie. I am beside myself with anxiety and distrust. Thoughts? Are we in the wrong for trying to protect a potentially immunocompromised person?

There are two pieces of this: what you did and what your employee may have done.

Let’s cover yours first. You weren’t in the wrong to bring up concerns about work conditions that could dangerous for someone with a compromised immune system … but the way you bring that up is to talk to the employee directly, not to call her doctor on her behalf. Calling an employee’s doctor to discuss her medical condition, especially without her permission, isn’t illegal but it’s a real violation of her privacy. It’s also a violation of HIPAA for the doctor’s office to have released the information they did to you — but that’s a violation on their side, not yours. (In fact, it’s pretty shocking that the doctor’s office released that information to you, since HIPAA regulations are so clear on this. That makes me wonder if your employee isn’t even a patient there, since I believe HIPAA does allow them to say that someone is not a patient there.)

Now let’s talk about your employee’s piece of this. Has she … lied about having cancer? If so, her piece of this is far, far worse.

Have you asked her to explain why the doctor’s office told you what they did? Have you looked into whether the note itself was forged?

There are really only two possibilities here — either your employee does have cancer and there’s been a miscommunication somewhere and she’s owed a huge apology, or she told a particularly egregious lie (or series of lies) that warrants firing. Those are two very different scenarios, so you’ve got to talk with her and figure out what the hell is going on.

So, talk to her. Acknowledge that you should have spoken with her directly about your concerns originally, and apologize for seeking information about her health without her permission. Explain that you are now trying to make sense of the statement from her doctor’s office that they don’t have a record of anything she relayed to you. Ask if she can help you understand what happened there. (Say this kindly — the way you’ll want to have said it if it turns out that she didn’t lie to you. If it does turn out that she lied, you can deal with that once you’ve figured that out. But if it turns out that she’s telling the truth, you won’t be able to erase treating her as a liar.)

Given the circumstances, it would also be smart to have the doctor’s office verify that the note from them is real. HIPAA does allow them to confirm or deny that they wrote this sort of note, so you could fax it to them with a request for that confirmation. (To be clear, I don’t think you should be requiring employees to supply doctors’ notes at all because your employees are generally adults, not wayward children, but you have and in a case that has so many hallmarks of fakery, it’s reasonable to confirm it’s real.)

It’s also okay to let your thinking here be informed — at least to some extent — by what you know of this employee aside from this. Is she someone who you’ve previously known to be trustworthy? Or have there been other times where things haven’t added up? People are often pretty consistent when it comes to having or lacking integrity, so it’s not unreasonable to calibrate your suspicion meter based on what else you know of how she generally operates, whether it’s good or bad.

Update: The letter-writer has updated in the comments here, noting that the employee has now acknowledged she doesn’t have cancer and that she lied because the letter-writer was asking too many questions.