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What happens if I’ve taken all of my paid time off but I have an emergency and can’t work?

Great question! If you are an hourly worker, then likely you just won’t get paid.  Some employers will allow “negative” vacation days, allowing you to take vacation time you’re not yet entitled and then subtract it from your later entitlement.
If you are a salaried, exempt worker, your employer may “dock” your pay for full day absences only.  If you’ve taken all of your allotted time off and need to miss an afternoon for a doctor’s appointment, your employer may not deduct that from your weekly salary.  However, if you’ve taken all of your time off and need to take an entire day off, your employer may deduct that day from your salary.  Again, this applies unless your employer has the policy of letting employees borrow as yet unaccrued vacation time.
Finally, the rules are somewhat different if you are paid according to the fluctuating work week.  The fluctuating work week generally pays “half time overtime” instead of the standard time and a half; as you work more hours your rate of pay decreases.  In that case, even if you take a full day off, and have no paid time off in the bank, your employer cannot deduct from your weekly salary without violating the strict rules governing the payment of the fluctuating work week.
Think your pay has been unfairly docked?  Let us know!