Use these free letter samples as templates for your formal notification.
A medical leave letter is a formal letter that is written by an employee to his or her employer to request needed time off work for medical reasons. Even if the employee has spoken to their supervisor or management about the need for medical leave, they should also send a formal letter. It will most likely be included in the employee’s file, so it should be clear and professional. If the employee does not plan to return to work, they should write a resignation letter and not ask for medical leave.
The first thing the employee should do is find out the company’s policies for medical leave and whether the company is covered by the Family Medical Leave Act (FMLA). The FMLA protects employees jobs for up to 12 weeks during a one year period. Only companies that have 50 employees or more are accountable to FMLA. The human resources department will have this information. If the employee is requesting leave under the FMLA, there will be certain forms that need to also be completed.
The reason for requesting medical leave must be a valid reason according to the company rules. There may also be a time frame to submit a medical leave letter. The employee should also ascertain to whom the letter should be addressed. If suitable, the letter can also mention any paid leave or vacation time that may be incorporated in the medical leave.
The most common reasons an employee may need medical leave are for:
• The diagnosis of a serious illness
• A chronic condition that requires intermittent leave
• An accident that has debilitated the employee for some time
• Spouse or child medical needs
Most companies require the letter to contain the following information:
• A formal request
• The reason for the request
• The amount of leave required with a return date if possible
• A doctor’s letter included with the leave letter
• What will be done with the employees work while he or she is gone
If the request is for surgery, the employee should also include the type of surgery and the date on which it will take place. If it is not possible to give an exact date when the employee will return to work, an approximate date should be given. For example, if the surgery requires 60 days of recovery, the employee can say they will return about 60 days after the surgery.
The name of the coworker who will take the responsibilities of the employee should also be given as well as a phone number where the employee can be reached in case their advice or help is needed at work. This shows initiative on the part of the employee and takes the responsibility of the employer for covering the absent employee's work. If some work can be done from home, this should also be mentioned. The employee should keep in close communication with their supervisor during their medical leave to update them about their recovery progress.
Here is a sample medical leave to HR letter. Certified mail should be used to send the letter in order for the employee to have proof that they sent the letter within the prescribed time. If there are any documents enclosed such as a letter from a doctor or medical records, only copies should be sent and never original documents.
Sample Medical Leave Letter to HR
Name of Employee
Address of Employee
City, State, Zip Code
Name of HR Manager
Name of Company
Address of Company
City, State, Zip Code
RE: Requesting Medical Leave
Dear Name of HR Manager:
This letter is to formally request leave of absence for medical reasons. I will be having a hysterectomy on DATE and will not be able to work for 90 days. I plan to return to work on DATE if the recovery goes well. I have included a letter from my surgeon that states the need for surgery and the date of the surgery. If any other medical records are required, I will be happy to supply them.
Name of Person in my department will take responsibility for my clients, and I will be available by phone to give any assistance I can at [email protected] or at 555-123-4567.
I greatly appreciate your kind consideration in granting me this leave.
Signature of Employee
Name of Employee printed
List of enclosures
By Andre Bradley