I've worked at a place where use of PTO had to be authorized. If you were sick, you needed to get that approved a week before calling in. There was an exception

I've worked at a place where use of PTO had to be authorized. If you were sick, you needed to get that approved a week before calling in. There was an exception if you had a doctor's note, but too many of those, note or not, you'd be fired. Using federally-protected unpaid leave would get you fired under some other pretense when you returned to work. At a different job, I was doing fine without accommodations until the new HR manage decided to get rid of flex time and require PTO to be taken in 8 hours blocks. Shortly after I applied for ADA accommodations, they took a few montsh to move me into a different department under a very specific role made for just for me. Then after a few months in that role, they cut the position. Finding another job wasn't an option. I had recently been diagnosed with bipolar and couldn't afford losing my insurance.